142nd APHA Annual Meeting and Exposition

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Trust in physicians and its link to intermediate diabetic outcomes

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Andrew Wilson, BS , School of Medicine, University of Alabama at Birmingham, Birmingham, AL
Yulia Khodneva, PhD , Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
Susan Andreae, BA, MPH , Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
April A. Agne, BA, MPH , Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
Monika Safford, MD , Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL
Andrea Cherrington, MD MPH , Division of Preventive Medicine, University of Alabama Birmingham, Birmingham, AL
Purpose: Trust in your physician has been previously linked to better glycemic control. We examined the relationship between general trust in physicians and diabetic outcomes as measured through blood pressure and glycemic control (HbA1c).

Methods: This is a secondary data analysis using cross-sectional data from a community-based trial. Patients were mostly African Americans with diabetes living in southern, rural Alabama. Face-to-face interviews by trained interviewer assessed general trust in physicians using a previously validated instrument (TMP-11). HbA1c and blood pressure were measured at baseline using a standardized protocol. Categorical variables were compared using chi square tests. Continuous variables were compared using bivariate linear regression. Multivariable analyses included general linear regression models adjusted for gender, income, education, insulin use, medication adherence, number of ambulatory visits, perceived discrimination, and depressive symptoms.

Results: 418 patients provided information for the trust scale (6 were missing). Mean age was 59, 75% were female and 87% were African American. High Trust (TMP > 30) was associated with older age, less perceived discrimination, and lower medication adherence. In bivariate analyses, HbA1c (p=0.26) and mean blood pressure (p=0.64) showed no significant association with provider trust.  

Discussion: General trust in physicians was not associated with change in glycemic control or blood pressure at follow-up in unadjusted analyses. Though it did not reach statistical significance, higher general trust was associated with higher systolic blood pressure. Future research should further explore these relationships.

Learning Areas:

Chronic disease management and prevention

Learning Objectives:
Identify the relationship between general trust in physicians and diabetic outcomes. Describe the results of the analyses of diabetic outcomes and general trust in physicians among a sample of patients with diabetes living in southern, rural Alabama.

Keyword(s): Diabetes, Chronic Disease Management and Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a program manager who worked with the author (Wilson) to write, edit, develop and submit the abstract. I have extensive experience implementing and managing ongoing diabetes management and prevention studies.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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