Abstract

Objective: Trust in the healthcare system and health information is an important determining factor for patient healthcare utilization. This study examines the relationships among healthcare trust, health information trust, and barriers to screening, and their association with receipt of cervical and colorectal cancer screening.
Methods: Women aged 45 years-65 years in central Pennsylvania completed a survey about cancer screening (n=474). We used chi square tests, bivariate and multivariable logistic regression, and moderation analysis to examine associations among healthcare trust, health information trust, barriers to screening, and being up to date with cervical cancer screening and with colorectal cancer screening.
Results: On average, participants were 55.1 years old. Being up to date with cervical and colorectal cancer screening was more common in participants with private insurance and those who had a check-up within the last year (all p<0.05). Cervical cancer screening was higher for participants with greater health information trust and fewer barriers (both p<0.05). Colorectal cancer screening was higher for participants with fewer barriers to screening (multivariable odds ratio [OR]=0.54, 95% confidence interval [CI]=0.35-0.82). There was no evidence of an interaction between barriers to screening and healthcare trust or health information trust with cervical cancer screening (p=0.70 and p=0.07, respectively) or colorectal cancer screening (p=0.59 andp=0.93, respectively).
Conclusion: Measures of trust did not moderate the relationship between barriers to screening and screening uptake, suggesting that interventions may directly impact screening behaviors by targeting either trust or barriers. The findings of this study can guide future interventions to promote cervical and colorectal cancer screening uptake.