*PURPOSE: Medical distrust is a salient sociocultural factor affecting patients’ health behaviors and clinical outcomes. Distrust in the healthcare system can have consequences for kidney transplant (KT) patients, many of whom frequently interface with the system through years of dialysis or through multiple specialists in the management of comorbidities. We sought to examine the prevalence and dynamics of medical distrust among KT candidates. *METHODS: We evaluated the prevalence of medical distrust among 571 adult KT candidates (2018-2021) and identified factors associated with higher levels of distrust. Medical distrust was surveyed at KT evaluation using the Health Care System Distrust Scale (higher scores indicate greater distrust). We further assessed two primary domains of distrust (“competence” and “values”) and used logistic regression to identify predictors of high medical distrust across the composite scale and subscales. *RESULTS: 11.6% of KT candidates had high medical distrust; there were no patients in this study who were without some level of distrust. Black patients were more likely than white patients to exhibit high distrust in composite healthcare system beliefs (adjusted Odds Ratio (aOR)=1.92, 95%CI:1.03-3.60) and values beliefs (aOR=2.49, 95%CI:1.31-4.72). Compared to patients aged 65 and older, patients aged 35-49 had over twice the odds of high distrust in their composite (aOR=2.67, 95%CI:1.30-5.49), competence (aOR=2.89, 95%CI:1.48-5.61), and values beliefs (aOR=2.34, 95%CI:1.20-4.67). In the competence domain, female (aOR:1.69, 95%CI:1.03-2.78) was an additional predictor of high distrust. In the values domain, “Other” non-white racial-ethnic group (aOR=2.9, 95%CI:1.14-7.62) was also a significant predictor of high distrust. *CONCLUSIONS: Our results demonstrate the prevalence of medical distrust among KT candidates and its dimensions in a healthcare systems context. Understanding the persistence and nature of medical distrust may help inform strategies for ameliorating distrust and building trustworthiness across systems, centers, and practices. [

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]CITATION INFORMATION: Thompson V., Chen X., Segev D., McAdams-DeMarco M. Prevalence of Medical Distrust Among Kidney Transplant Candidates AJT, Volume 23, Issue 6, Supplement 1.

Valerie Thompson BA

JHU

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