The Medical Mistrust Multiformat Scale: Links with vaccine hesitancy, treatment adherence, and patient-physician...

Area of Science:

• Psychology
• Public Health
• Health Services Research

Background:

• Medical mistrust significantly impacts behavioral health outcomes, including vaccine hesitancy, treatment adherence, and patient-practitioner relationships.
• Existing scales for medical mistrust have limitations and lack comprehensive psychometric data.
• There is a need for a reliable and valid instrument to assess medical mistrust across diverse populations.

Purpose of the Study:

• To develop and validate a new Medical Mistrust Multiformat Scale (MMMS).
• To evaluate the psychometric properties of the MMMS, including its factor structure, item discrimination, and reliability.
• To assess the convergent and discriminant validity of the MMMS in relation to relevant health behaviors and psychosocial variables.

Main Methods:

• Two studies were conducted with a total of 975 participants (741 in Study 1, 234 in Study 2) recruited via online marketing panels.
• Participants included individuals with hypertension and/or diabetes, representing diverse racial/ethnic identities and socioeconomic statuses.
• The MMMS underwent item selection, cross-validation, and measurement invariance testing across racial groups. Correlations with vaccine compliance, treatment adherence, and patient-practitioner relationships were examined.

Main Results:

• The MMMS demonstrated a robust unidimensional factor structure and high item discrimination in both studies.
• The scale showed good reliability and was significantly correlated with vaccine compliance, treatment adherence, and patient-practitioner relationships.
• Measurement invariance was confirmed across Black and White participants, and the MMMS exhibited superior convergent validity compared to an existing scale.

Conclusions:

• The MMMS is a psychometrically sound instrument for assessing medical mistrust.
• The scale is suitable for use in diverse populations, including those with chronic conditions and lower incomes.
• Findings underscore the importance of addressing medical mistrust in healthcare settings and research.