A systematic review of medical mistrust measures

Patient Educ Couns. 2018 Oct;101(10):1786-1794. doi: 10.1016/j.pec.2018.05.007. Epub 2018 May 17.


Objective: Medical mistrust is seen as a barrier to health promotion and addressing health disparities among marginalized populations. This study seeks to examine how medical mistrust has been measured as a step towards informing related health promotion efforts.

Methods: A systematic review of medical mistrust scales was conducted using four major databases: PubMed, PsycINFO, ERIC, and Communication & Mass Media Complete. Databases were searched using the terms "medical mistrust scale" "medical mistrust" and "medical distrust."

Results: The search returned 1595 non-duplicate citations; after inclusion and exclusion criteria were applied, 185 articles were retained and coded. Almost a quarter of studies used a single-item or a few items. Among validated scales, the Group-Based Medical Mistrust Scale, Medical Mistrust Index, and Health Care System Distrust Scale were most frequently used. There were important differences among these scales such as the object of mistrust (e.g., system, individual physician) and referent specificity (e.g., group). The measurement of medical mistrust varied by health topic and sample population.

Conclusion: These differences in scales and measurement should be considered in the context of intervention goals.

Practice implications: Researchers should be aware of differences in measures and choose appropriate measures for a given research question or intervention.

Keywords: Health disparities; Health promotion; Medical mistrust; Systematic review.

Publication types

  • Systematic Review

MeSH terms

  • Health Knowledge, Attitudes, Practice*
  • Health Promotion*
  • Health Status Disparities*
  • Humans
  • Surveys and Questionnaires
  • Trust / psychology*