Background/Purpose: Previous research has found that young minority women tend to be more risk averse compared to their Caucasian counterparts. The reasons underlying these differences, however, are not well understood. The objective of this study was to examine whether factors influencing perceived treatment importance vary by minority status.

Methods: Women between the ages of 20 and 45 receiving treatment at an academic hospital either as an inpatient or in an infusion center completed a survey. The survey ascertained sociodemographic data, affect, trust in healthcare systems, and medication beliefs using validated instruments. The survey included a hypothetical scenario in which subjects were asked to rate the importance of taking a medication for a patient with joint pain, migraines and fatigue that benefits 70% of people and is well tolerated except for the rare risk (1 per 100,000) of a neurologic disease that may cause weakness, trouble with vision and numbness. Associations between patient characteristics, affect, medication beliefs, and trust with perceived importance of taking the medication were evaluated using two sample t-test, Mann Whitney U test, and Spearman correlation as appropriate. Variables found to be statistically significant (p < 0.05) were subsequently evaluated using multiple linear regression. Minority women were defined as women who did not self-identify as White non-Hispanic.

Results: 174 women completed the survey. Patient characteristics by minority status are summarized in the table below. Perceived importance of taking the medication varied by minority status. Among minority women, perceived medication importance was correlated with trust in healthcare systems (r= 0.2, p= 0.03), hopefulness regarding the medication (r= 0.3, p= 0.002), and difficulty paying for medications (z= -2.3, p= 0.03). The relationship between trust and perceived importance was completely mediated by hopefulness. Among non-Hispanic White women, medication beliefs (r= -0.5, p= 0.001), hopefulness (r= 0.5, p< 0.001) and worry related to the medication (r= -0.4, p= 0.002) were correlated with perceived medication importance. Hopefulness and difficulty paying for medications remained significantly associated with perceived medication importance in the multivariate regression model among minority women, as did affect and medication beliefs in non-Hispanic White women.

Conclusion: In contrast to previous findings, minority women rated the importance of taking medication higher than non-Hispanic White women. Our findings confirm the important influence of affect on decision making, and suggest that financial constraints can influence the perceived value of treatment among minority women.

 

 

 

Table: Patient characteristics by minority status

Variable	Non-Hispanic White	Minority	P value
Age (mean, SD)	32.8 (7.2)	33.1 (7.9)	0.80
Medication beliefs (mean, SD)	20.9 (4.8)	21.8 (4.7)	0.22
Trust (mean, SD)	28.5 (5.3)	28.7 (6.0)	0.86
Hopefulness (mean, SD)	4.1 (1.6)	3.6 (1.6)	0.05
Worry (median, range)	5 (1-7)	5 (1-7)	0.07
Important (median, range)	5 (2-7)	6 (1-7)	0.01
Some college education (%)	79.1 %	51.4 %	(< 0.001)
Difficulty paying for meds (%)	21.2 %	25.7%	0.50

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/racial-disparities-in-attitude-towards-treatment-in-young-women/