Trust Issues: 5 Reasons Mistrust Creates Barriers to Medication Adherence
CMS has emphasized the importance of addressing social health drivers through multiple health equity initiatives and disparities reduction efforts, stressing the importance of providing individuals of any background a fair chance to reach optimal health.
If we wish to reach every community, we must understand a wide range of mindsets and experiences around health providers and medication. In some communities, this includes deep mistrust toward the overall health system. Studies show that nonadherence rates are higher in certain ethnic communities due to a variety of factors, with lack of trust being one of the most influential.
By identifying these concerns, providers and health plans can create targeted strategies, promoting healthier lifestyles and improving outcomes. Here’s how trust issues create medication adherence hurdles and how to overcome them using behavioral science technology.
- Historical and Systematic Mistreatment
It’s not all in their heads. Unfortunately for us all, some members view the healthcare system as a source of disappointment because that’s how they experience it. The public system has often overlooked and underserved vulnerable groups, leading to a long-standing and justifiable lack of trust. Examples include about a third of Americans who believe racism is a major problem in healthcare and the alarming fact that women and ethnic minorities are 20-30% more likely to be misdiagnosed than white men.
Some members grew up hearing stories about dismissive treatment, patronizing attitudes, and even historical cases of unethical medical experiments. We can easily see how these factors contribute to a general reluctance to engage with the healthcare system, leading to fewer doctor visits and poor adherence. To fix this, members need reassurance that the system respects and values their well-being.
- Health Literacy and Accessibility
The general connection between health literacy and medication adherence has been long proven. It makes sense because understanding healthcare instructions requires a certain level of health literacy. We can’t trust what we don’t understand. However, this isn’t accessible to everyone. Many members struggle to access accurate health information or rely solely on their provider’s guidance, which is a lot to ask. When members lack the resources to fact-check or comprehend their healthcare needs, it becomes harder to build trust with providers.
If members can’t understand their health options or lack reliable information sources, they may become skeptical. Therefore, it’s essential to make information as accessible as possible and encourage health literacy simultaneously. We aim to enable members to ask questions and make informed decisions about their care.
- Alternative Health Beliefs
In some communities, alternative approaches to healthcare are more common and trusted than Western medicine. Some communities have roots in regions where Western medicine was less available, and many had to find an alternative when the mainstream health system proved unreliable. For members who grew up with these beliefs, there may be skepticism toward prescribed medications or conventional treatments. Providers sometimes dismiss these beliefs when they should instead aim to understand them and incorporate these methods in treatment plans. It helps to remember that nowadays, people from every background embrace alternative treatments, and respecting members’ cultural beliefs can go a long way in building trust.
- Language and Communication Barriers
Language barriers pose a significant challenge to building trust between members and providers. When there’s a lack of clear communication, it’s harder for members to feel confident in their care, and research shows it results in lower satisfaction rates among members. CMS recognizes that effective communication is a critical component of health equity, and it’s particularly relevant here. Making information available in multiple languages can build a bridge where it is needed most.
- Socioeconomic Challenges
Members dealing with financial or logistical challenges that make medication adherence more difficult to achieve are often skeptical of the healthcare system’s ability to help them at all. Issues like travel distance, cost, and time may seem trivial to some of us but prove to be substantial hurdles for many. To improve adherence, health plans communicating with members should consider these issues and understand how they add to a member’s sense of being unsupported or undervalued.
How Behavioral Science Can Help Address Trust Issues
Behavioral science-based communication offers valuable tools for health plans seeking to address members’ unique challenges with trust issues. With technology that identifies individual hurdles to adherence, health plans can create personalized messaging strategies that build trust and promote healthier behaviors. Here’s how:
- Demonstrate cultural sensitivity: A behavioral science-based algorithm should consider members’ specific backgrounds and various environmental factors rather than assume all members view healthcare the same way. Certain terms can be triggering and feel dismissive to marginalized groups. Tailored messages that respect and reflect members’ cultural and personal beliefs can build a sense of understanding and trust.
- Simplify the communication: We’ve mentioned communication barriers as a cause for mistrust, and using clear language that resonates with members can break down these barriers and make healthcare more approachable. Behavioral algorithms can identify members at high risk of presenting communication barriers and help determine the best ways to deliver complex information in a way that members find accessible and trustworthy.
- Show empathy: Outreach efforts that acknowledge the unique struggles of each member build rapport. Health plans can utilize behavioral insights to shape empathetic messaging that also considers logistic hurdles some audiences may face, which members may find more relatable and less intimidating.
- Focus on data, not bias: Making broad assumptions regarding members’ behavior based solely on their background doesn’t improve trust but instead creates an atmosphere of bias. Behavioral science looks at each person’s real-world choices and studies them from every angle, providing a holistic and realistic point of view.
- Offer support: Behavioral science can identify areas where members need additional support, such as health literacy and language assistance. Health plans can build trust and make members feel more valued and supported by proactively offering relevant resources.
Health plans have a unique opportunity to improve adherence and keep up with evolving CMS requirements. Behavioral science enables us to tailor solutions for communities that experience trust issues and offer impactful solutions. Investing in strategies that promote trust improves medication adherence and paves the way for more comprehensive, long-term health improvements among members.