ASCO 2022: Racial Concordance and Trust in Health Communications: A Randomized Trial of Videos About Prostate Cancer

(UroToday.com) At the 2022 American Society of Clinical Oncology Annual Meeting held in Chicago and virtually, the poster session focused on Prostate, Testicular, and Penile cancers on Monday afternoon included a presentation from Dr. Stacy Loeb presenting a randomized trial of 2904 U.S. adults age ≥40 that sought to evaluate the association between racial representation in online content about prostate cancer and trust in the content. A secondary objective was to identify additional attributes that influence trust in online content.

Racial and socioeconomic disparities in prostate cancer care and outcomes have been long recognized. Black men have a significantly higher risk of prostate cancer and more aggressive disease compared to White men. While these were initially attributed to differences in underlying biology, it is increasingly recognized that these are often due to health systems factors and access to care.

Patients often seek health information from the internet. However, Black adults are underrepresented in online content about prostate cancer. Due to historical disparities in care, medical mistrust is greater among Black compared to White adults. These authors sought to assess whether racial representation in online content about prostate cancer was associated with patients’ trust in that content.

To do so, they performed a randomized trial of 2904 U.S. adults aged 40 years and older. Participants were randomly assigned to view one of 8 different online videos. Videos used an equivalent script about either prostate cancer screening or clinical trials presented by one of 4 different presenters: Black physician, Black patient, White physician, or White patient.

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The primary outcome of the study was trust in the information using a Likert scale. Logistic regression models were used to compare trust in the videos, based upon the characteristics of the speaker and topic of the video.

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Among the 2904 study participants, 1703 (59%) were Black and 1201 (41%) were White. Black adults were 1.5 times more likely to trust a Black presenter compared to a White presenter (p<0.001). For White adults, no significant difference in trust was identified between Black or White presenters (p=0.21). For both Black and White adults, a physician presenting the information was more trusted than a patient, and videos discussing screening were more likely to be trusted than those discussing clinical trials.

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The authors, therefore, conclude that, while there is no difference among White adults, there is a significant association between racial concordance of the presenter and trust in prostate cancer information among Black adults. Further, for both Black and White patients, health information is considered more trustworthy when delivered by a physician. These results highlight the importance of physicians in disseminating health information to the public, and of increasing racial diversity among healthcare providers. They also suggest an ongoing need for public education about clinical trials to prioritize issues of mistrust and distrust.


Presented by: Stacy Loeb, MD, NYU Langone Health, New York City, NY