Defense Date


Document Type


Degree Name

Master of Science in Dentistry



First Advisor

Carlos Smith

Second Advisor

Jayaraman Jayakumar

Third Advisor

Paula Coates

Fourth Advisor

Caroline Carrico


Purpose: Studies have drawn varying conclusions on the importance of a racially concordant patient provider relationship. Medical mistrust has continued to garner attention as healthcare enterprises thread equity, diversity and inclusion throughout their organizational policies, practices and systems.

Methods: Parents/caregivers of pediatric patients at VCU Pediatric Dentistry were invited to participate. Surveys included questions about demographics, racial concordance, language preference, and the validated Group-Based Medical Mistrust Scale.

Results: A total of 246 guardians completed the survey. For guardians, 40% reported Black or African American, 31% Hispanic, and 19% Caucasian. Seventy-one percent of guardians reported speaking English, 18% Spanish, and 11% bilingual. Ten percent indicated they preferred a provider with the same race as their child, 57% prefer the provider speak to the child in the primary language spoken at home, and 56% prefer the provider speak to them in the primary language spoken at home. Preference for same-race providers was not significantly associated with guardian race (p-value=0.2860) or child’s race (p-value=0.2136). An increase in the Group-Based Medical Mistrust Scale was significantly associated with preference for same-race providers for children (OR: 1.09; 95% CI: 1.04-1.14). Preference for a provider who speaks the primary language spoken at home was significantly associated with the patient’s home language (p-value=.0002).

Conclusions: While race was shown to be a nominal factor in provider selection, those parents/guardians who expressed a higher degree of medical mistrust, were significantly more likely to desire a racially concordant provider relationship. Mitigating systemic barriers in healthcare should include a focus on embracing language differences and acknowledging historical lapses in ethics, cultivating trust in the healthcare system.


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Available for download on Friday, May 03, 2024