An Exploration of Trust and Health Related Self-efficacy Among African American Adults Who Smoke: Insights From the 2020 Hints

Background: Smoking is a robust risk factor for several different types of cancer, and effective cancer prevention (e.g., smoking cessation) and early detection (e.g., screening) programs can be life-saving for those at high risk for cancer. Among individuals who smoke, self-efficacy predicts engagement in smoking cessation and participation in cancer screening. As such, it is important to identify predictors of self-efficacy in order to develop effective health promotion strategies for those who smoke. One predictor that merits study is trust, given that low trust in the healthcare system is a prominent barrier to engaging in preventive care, especially among African Americans—who evidence disproportionately high cancer-related morbidity and mortality. There are many sources of information that individuals use to learn about cancer risk (e.g., doctors, friends, and family), but less is known about whether trust in each of these information sources predicts self-efficacy to take care of one’s health. Understanding relationships between trust in different sources of cancer-related information and self-efficacy can guide the development of tailored programs that focus on prevention and early detection for African Americans at high risk for cancer.
Purpose: Using data from the 2020 Health Information National Trends Survey (HINTS), we explored relationships between levels of trust in four different sources of cancer-related information (i.e., doctors, government health organizations, friends and family, religious organizations, and leaders) and health-related self-efficacy among African Americans who smoke. Methods: From a total of N=6,252 respondents in the HINTS dataset, the current study analyzed data from a subsample of n=110 African Americans who reported current smoking and no prior diagnosis of cancer. Pre-registered multivariable linear regression models were conducted to explore relationships between trust in each of the four different sources of cancer-related information (entered as the predictor variable in separate models) and health-related self efficacy (entered as the outcome variable), controlling for the covariates of age, gender, education, income, and insurance coverage.
Results: Results indicated that trust in each of the four sources of cancer related information was not associated significantly with health-related self efficacy (all p > 0.5).
Discussion: These findings highlight the need to better understand the factors influencing health-related self-efficacy among African Americans who smoke. Future studies should consider exploring additional variables (e.g., social support) that may contribute to self-efficacy in health-related behaviors and address potential cultural and contextual factors that could influence trust in cancer-related health information sources.