Determinants of Latine Patients’ Trust in an Immigrant-Inclusive Health Care Institution: A Mixed-Methods Study

Introduction: Past research has overlooked both the institutional factors of medical mistrust and immigrants’ perspectives. We aimed to understand factors influencing Latine immigrant patients’ medical mistrust, focusing on their perspectives of immigrant-inclusive institutional policies. Methods: We conducted a sequential explanatory mixed-method study at a Federally Qualified Health Center (FQHC) in Los Angeles, CA, involving surveys ( N = 170) and interviews ( n = 20). Survey and interview data were descriptively and thematically analyzed, respectively. Results: The mean age of the total sample was 54.5 years, among whom 69.4% were women. Patients trusted physicians more than health care systems. Group-based medical distrust related to immigrant identity was below the median, though participants highlighted differences in their more “immigrant-friendly” local context. Over half expressed moderate-to-high worry about deportation, with nearly a quarter avoiding health-related activities due to these fears. However, 99% still visited their health care center and most (92.9%) had received the COVID-19 vaccination. Among “immigrant-friendly” institutional policies, confidentiality of patient information was ranked most important. The interviews revealed six themes on the determinants of trust: (1) confidentiality, (2) in-person clinical encounters, (3) perceptions in social networks, (4) prior health care experiences, (5) health system staff and processes, and (6) addressing social needs. Conclusion: Medical trust is shaped by interconnected micro- and macrolevel relationships, requiring multilevel efforts to strengthen it. For Latine immigrants, this includes institutional immigrant-inclusive policies, efforts to address social needs, patient-centered and diverse staff, and efficient processes of care.