Defense Date


Document Type


Degree Name

Master of Science



First Advisor

Kristina Hood, PhD


Health care system distrust is a well-known barrier to health utilization and engagement in older African Americans. However, it has not been explored in Black emerging adults, individuals 18- 26. It is important to explore the social and psychological effects of systemic barriers, such as health care system distrust, in this developmental period as emerging adults undergo unique demographic shifts, changes in sense of self, and identity exploration. Due to emerging adulthood being an exploratory and challenging transitionary phase, emerging adults have an increased susceptibility to preventable morbidity and mortality issues and decreased access to important preventive services. Thus, health care system distrust and how it interacts with other barriers to accessing health services, specifically preventive care, needs to be examined in Black emerging adults. The current study aimed to evaluate if insurance access and usual source of care influences the relationship between health care system distrust and preventive service utilization and engagement. A confidential Qualtrics survey was completed by 329 participants, utilizing college student and community based recruitment procedures. Two moderated moderations in SPSS 27 using Hayes’ (2020) PROCESS macro assessed the two outcomes of preventive service receipt and routine health examinations. The proposed hypotheses were not supported, however additional analyses were conducted that examined how trust in provider and other demographic factors influenced the relationship between health care system distrust and both outcomes. This study explores the implications of these discoveries and how they can be used to improve health outcomes and quality of care for Black emerging adults.


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