Guided by the patient-centered care (PCC) model, this study aims to examine interpersonal aspects of care that shape African immigrants’ trust and utilization of healthcare in Florida, USA.
In-depth interviews were conducted with 19 African immigrants aged 18 or older, living in Florida for 5 or more years and with recent experience with the US healthcare system. Interviews were audio-recorded, transcribed verbatim and analyzed using NVivo14.
The thematic analysis revealed that the clash of healthcare cultures, including cultural differences between patients and providers and the lack of cultural competency among providers, hindered trust in healthcare. Discriminatory behaviors that eroded trust included mistreatment and disrespect by providers. The findings also highlighted communication problems, particularly a lack of adequate time and attention, disregard for patients’ concerns and feelings and a sense of being pushed rather than consulted, which led to distrust in healthcare among participants.
Clinicians must be trained in communication skills and cultural humility, approaching patients as experts in their own experiences and being attentive to their values and expectations. Healthcare systems should implement structural accountability when applying PCC, including immigrant-informed patient satisfaction tools and routine equity review of service delivery.
This study is among the few that focus on the significance of trust in shaping healthcare experiences among African immigrants, an understudied population. The authors’ analysis uniquely shows how interpersonal encounters, when misaligned with PCC ideals, serve as powerful determinants of trust.
