Advisor(s)

Larrell Wilkinson

Committee Member(s)

Carol Griggs
David MacRina
Mary Ann Bodine Al-Sharif
Susan Passmore

Document Type

Dissertation

Date of Award

6-1-2026

Degree Name

Doctor of Education (EdD)

School

School of Education

Department

Health Education/Promotion (Education)

Abstract

Medical mistrust, a type of institutional distrust, has been identified as a social determinant of health and a barrier to utilization of healthcare services. It has been negatively associated with preventive disease screenings, vaccine hesitancy, medication adherence, organ donation, research participation, and overall lower healthcare satisfaction. This can result in a widening of health disparities, an increase in prevalence of preventable diseases, and negative health outcomes despite accessibility to healthcare. The purpose of this study is to assess how medical mistrust manifests across the higher education context and explore what factors contribute to its existence among this population. An explanatory mixed methods research design was utilized to conduct this study. A convenient sample of 177 individuals were recruited for the quantitative strand. Participants completed a sociodemographic survey and the Medical Mistrust Index using REDCap. The quantitative strand was used to inform the qualitative strand by way of stratified sampling based on primary role at their institution (faculty, staff, or student) and representation for both statistically significant and non-significant variables. 17 individuals participated in the qualitative strand, which consisted of individual semi-structured interviews conducted via Zoom. The interview guide was created based on Social Cognitive Theory (SCT). The findings revealed that moderate medical mistrust is pervasive among those within the higher education context. Personal, environmental, and behavioral factors were identified that influence medical mistrust in this population. Transparency, equity, and person-centered care were stated to be beneficial in increasing trust and building a therapeutic patient-provider alliance. A SCT-based model was developed to understand the factors that influence medical mistrust within the higher education context. This study demonstrates that medical mistrust is ubiquitous throughout higher education despite individual differences and lived experiences. More effort needs to be placed on addressing systemic barriers, increasing health education around navigating the healthcare system, and providing person-centered care.

Keywords

Healthcare System;Higher Education;Institutional Distrust;Medical Mistrust

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