Trust in the Medical Profession Among Adolescents in an Emergency Department

Objective The aims of this study were to assess trust in the medical profession among adolescents in an urban pediatric emergency department (ED) and explore factors associated with trust. Methods We used a computerized survey to assess personal trust, perceived trust among family/friends, health care use, general and genital examination preferences, health behaviors, and demographics among youth aged 14 to 19 years. The primary outcome was the mean composite score of a validated 5-item scale. Responses were summed (range, 5–25); higher scores indicated greater trust. We compared trust between subgroups using the t test for independent samples. Results We enrolled 150 adolescents (80% of approached); 146 completed the survey (mean age, 15.6 y; 40% male; 36% African American, 40% white, 17% Hispanic; 29% commercial insurance). The mean trust score was 19.51 ± 3.1 (range, 7–25), indicating a fairly high level of trust. Trust was not associated with race, ethnicity, sex, type of insurance, or health care use. The mean score for those with high paternal trust was higher than those reporting low paternal trust (19.8 ± 2.2 vs 15.3 ± 5.7, P = 0.02); there was no association with perceived trust among mothers or friends. Preference for a chaperoned genital examination was associated with lower trust and female sex. Conclusions Adolescents in this ED reported high levels of trust in the medical profession, and trust was not associated with race, ethnicity, sex, insurance, or health care use. Youth with lower trust preferred chaperoned genital examinations. Adolescent trust may be influenced by perceived trust among important adults. Exploration of these associations seems warranted to facilitate optimal sexual health outcomes.