Racial concordance associated with trust of online prostate cancer videos among Black Americans

Prostate cancer information included in online videos was viewed as more trustworthy by Black Americans when it was delivered by a physician or patient of the same race, according to findings from a study (NCT05886751) recently published in JAMA Network Open.^1,2

"Our findings demonstrate the need to increase diversity in the healthcare workforce," says Stacy Loeb, MD.

"Our findings demonstrate the need to increase diversity in the healthcare workforce," said lead author Stacy Loeb, MD, in a news release on the findings.² Loeb is a professor of urology and population health at New York University Langone Health in New York, New York.

In total, 2904 men and women aged 40 years and older were included in the study. Of those, 1703 participants were Black. The median age among all participants was 59 years.

Patients were randomly assigned to watch the same video script about either prostate cancer screening or clinical trials. The information was presented by either a Black physician, a Black patient, a White physician, or a White patient. Following the video, participants in the study were given an online questionnaire.

Findings from the survey showed that 72.7% of Black participants who watched videos that were presented by Black speakers trusted the information, compared with only 64.3% of Black participants who watched videos presented by White speakers (adjusted odds ratio [aOR], 1.62; 95% CI, 1.28-2.05; P < .001).

White participants, on the other hand, showed no significant difference in trust based on the race of the presenter. Overall, 76.8% of White participants who watched videos with a Black speaker trusted the information presented, compared with 73.7% of White participants who watched videos with a White speaker (aOR, 1.11; 95% CI, 0.83-1.48; P = .49).

Both Black and White participants showed less trust in the information presented when it was delivered by a patient rather than a physician. Among all Black adults included in the study, 64.6% trusted the information when it was presented by a patient, compared with 72.5% when it was delivered by a physician (aOR, 0.63; 95% CI, 0.49-0.80; P < .001). Among all White adults included in the study, 72.0% trusted the information when it was presented by a patient, compared with 78.6% when it was delivered by a physician (aOR, 0.71; 95% CI, 0.54-0.95; P = .02).

Similarly, both Black and White participants showed lower trust in the information when it was about clinical trials than when it was about prostate cancer screening. Among Black adults, 66.3% trusted the information when it was about clinical trials, compared with 70.7% when it was about screening (aOR, 0.78; 95% CI, 0.62-0.99; P = .04). Among White adults, 71.4% trusted the information when it was about clinical trials, compared with 79.1% when it was about screening (aOR, 0.57; 95% CI, 0.42-0.76; P < .001).

These findings add to previous work by the group that assessed representation in online prostate cancer videos and websites.³ Overall, the team found that Black and Latinx adults were underrepresented in online content on prostate cancer.

With that data as additional context, the authors wrote in the most recent publication, “Increasing the representation of physicians (or actors) who appear concordant with the target audience may be an important tool for more effective health communication strategies to mitigate health disparities.”

The research team next plans to hold focus groups with Black patients with prostate cancer in order to better understand their experiences with online medical information, as well as to gather possible solutions to improve online resources.

References

1. Loeb S, Ravenell JE, Lin Gomez S, et al. The effect of racial concordance on patient trust in online videos about prostate cancer: A randomized clinical trial. JAMA Netw Open. 2023 Jul 3;6(7):e2324395. doi:10.1001/jamanetworkopen.2023.24395

2. Diversity plays a key role in Black Americans trust of videos about prostate cancer. News release. NYU Langone Health. July 19, 2023. Accessed July 31, 2023. https://www.prnewswire.com/news-releases/diversity-plays-a-key-role-in-black-americans-trust-of-videos-about-prostate-cancer-301877220.html

3. Loeb S, Borno HT, Gomez S, et al. Representation in online prostate cancer content lacks racial and ethnic diversity: Implications for Black and Latinx men. J Urol. Published online February 4, 2022. Accessed July 31, 2023. doi:10.1097/JU.0000000000002257