Effects of Care Navigation by Nurse Practitioners in the Context of Health Disparities Driven by Medical Mistrust

Abstract

The U.S. healthcare environment offers a unique platform for integrating modern healthcare delivery models to advance health equity. However, disparities—particularly those impacting African Americans—are exacerbated by medical mistrust, which impedes timely care, adherence to treatments, and acceptance of medical advice. This dissertation explored the nature of medical mistrust as a defensive mechanism within the African American community, emphasizing the need for culturally sensitive delivery models tailored to distinct health consumer groups. Nurse practitioners (NPs), recognized as the most trusted professionals in American healthcare, were positioned to mitigate disparities through targeted interventions. This pilot study used the well-validated, abbreviated Wake Forest Physician Trust Survey, adapted to a visual analog format, to assess how NP-led care navigation influences medical mistrust among African American adults. The study was conducted with 15 volunteers from Jackson, MS, and its greater metropolitan area. It employed descriptive statistics, t-tests, analysis of variance, and one-on-one interviews to evaluate survey response data. The findings suggest that healthcare models leveraging culturally sensitive interventions by NPs, accessed through cultural customs behind the firewall of medical mistrust, offer African American health consumers a preferred alternative to traditional healthcare delivery. These results underscore the importance of healthcare policies that leverage patient trust in NPs to bridge care gaps and improve health outcomes.