Diversity plays a key role in Black Americans' trust of prostate cancer videos

Black Americans are 1.6 times more likely to believe medical information presented by a Black physician or patient compared with information presented by a white speaker, a new study shows. This finding, the authors say, highlights the importance of increasing racial diversity among health care providers in order to improve discussions about health care among minority populations.

Led by researchers at NYU Grossman School of Medicine, the new investigation involved more than 2,900 men and women. It showed that while Black participants were more trusting of videos about prostate cancer that featured a Black presenter, race made no difference for their White counterparts.

"Our findings demonstrate the need to increase diversity in the health care workforce," said study lead author and urologist Stacy Loeb, MD. Loeb is a professor in the Departments of Urology and Population Health at NYU Langone Health.

The investigation also revealed that regardless of their race, the surveyed participants were more trusting of a physician discussing prostate cancer than of a patient explaining the same information.

According to the U.S. Centers for Disease Control and Prevention, aside from skin cancer, prostate cancer is the most prevalent cancer among American men, killing over 30,000 each year. Black men are more than twice as likely to die from the disease compared with other racial groups, experts note.

"Our study emphasizes the responsibility of health care providers to play an active role in public communication, particularly in an environment flooded with misinformation and confusion," said study co-investigator Joseph Ravenell, MD. "Clearly, people really do trust what doctors have to say," adds Ravenell, an associate professor in the Departments of Population Health and Medicine at NYU Langone.

An earlier study by the same research team revealed that only a small percentage of online content about prostate cancer features Black or Hispanic men. The new investigation, publishing online July 19 in JAMA Network Open, was designed to demonstrate the direct impact of this under-representation on audiences, says Ravenell, who also serves as the associate dean for Diversity Affairs and Inclusion at NYU Langone Health.

For the investigation, researchers randomly assigned U.S. adults ages 40 and older to watch one of eight videos about prostate cancer, with half of them about cancer screening and the other half about clinical trials. Notably, clips from each category shared the same script. The presenter of each video was either a white or Black doctor, or a white or Black patient.

After watching the clips, the participants were asked to rate how strongly they trusted the information presented in the video using the following scale: "no trust at all," "a little," "somewhat," or "very much." They also answered questions about their age, race, and other information about their background.

Among the study's other findings, the responses revealed that participants were more trusting of videos about prostate cancer screening than about clinical trials. According to the researchers, this result could reflect the deep-seated distrust of clinical research that in part stems from a history of unethical practices before the onset of strict protections for human research participants since the 1950s. It may also reflect the fact that many Americans generally have low understanding about clinical trials compared with other health topics.

"These results underline the need to ensure that all patients, regardless of their racial or ethnic background, have knowledge of clinical trials and can participate if they are eligible," said study senior author Aisha Langford, MPH, Ph.D., an assistant professor in the Department of Population Health at NYU Langone.

Langford cautions that since their investigation only focused on videos about prostate cancer, it remains unclear whether the findings about public trust in medical information extend to other health topics, such as misinformation about vaccines.

She adds that the study team next plans to lead focus groups with Black patients with prostate cancer to discuss their experiences with online sources of medical information and their suggestions for improving the quality, accessibility, and impact of those resources.