Black Women in Florida Reveal What Builds Trust in Reproductive Healthcare

A new mixed-methods study of 255 self-identified Black women in Alachua County, Florida, has mapped how medical mistrust takes shape in reproductive healthcare settings and, crucially, what providers can do to build trust. The research, published in BMC Public Health, combined an online survey with follow-up interviews to capture both the scale of mistrust and the lived experiences behind it. The team, led by Karen Awura-Adjoa Ronke Coker and Sarah L. McKune, used a nested sequential explanatory mixed-methods design.

They first developed an Integrated Black Women's Reproductive Health Social Ecological Model to shape the survey, interview tools, and analysis. A sample of 255 Black women aged 18 and older completed the online survey, and a subsample of 16 took part in semi-structured individual and group interviews. Psychometric testing confirmed that the Group-Based Medical Mistrust Scale was valid for this population, with excellent internal reliability (alpha = 0.80) and marginal to excellent model fit indices, including CFI of 0.87, TLI of 0.83, RMSEA of 0.07, and SRMR of 0.07.

The survey results revealed patterns in who reported higher mistrust. Younger women, married women, and women who sought both allopathic and holistic care reported higher mistrust. Those using both conventional and holistic settings also recorded higher suspicion scores.

In addition, younger women and women holding graduate or professional degrees showed higher suspicion and higher health disparity scores. The interviews added depth to these numbers, identifying five key trust-building provider characteristics: transparency, humanizing interactions, comfort and provider tone, acknowledgment of patient insight, and time spent with the patient. The authors conclude that structural changes are needed to improve both institutional systems and interpersonal provider characteristics in reproductive healthcare settings.

They argue that intervention strategies must center Black women so that, over time, they are supported and unburdened of the need to self-advocate and remain vigilant during care. As an early-release, peer-reviewed accepted article, the findings are citable and carry a permanent DOI, though the version is subject to further edits before the final Version of Record appears.

Subject of Research: Medical mistrust and trust-building in reproductive healthcare among Black women in Florida

Article Title: Understanding Black Women’s Lived Experiences of Medical Mistrust and Trust in the Reproductive Care Setting: a nested sequential explanatory mixed methods study

Article References: Coker, K. A.-A. R., Nesbit, T. S., Forthun, L., Dixon-Daniel, B. N., Havelaar, A. H., Hunt, N., Milbrandt, S., Louis-Jacques, A. F., & McKune, S. L. (2026). Understanding Black Women’s Lived Experiences of Medical Mistrust and Trust in the Reproductive Care Setting: a nested sequential explanatory mixed methods study. BMC Public Health. https://doi.org/10.1186/s12889-026-30023-6

Image Credits: AI Generated

DOI: 10.1186/s12889-026-30023-6

Keywords: medical mistrust, reproductive health, Black women's health, mixed methods, patient-provider trust, health disparities, Florida, survey research, qualitative interviews, psychometric validation, BMC Public Health, healthcare-seeking behavior