{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T20:42:59Z","timestamp":1793652179420,"version":"4.5.1"},"reference-count":23,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2019,4,1]],"date-time":"2019-04-01T00:00:00Z","timestamp":1554076800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Vanderbilt Medical Scholars","award":["UL1RR024975"],"award-info":[{"award-number":["UL1RR024975"]}]},{"name":"Meharry-Vanderbilt Alliance Community","award":["UL1TR000445"],"award-info":[{"award-number":["UL1TR000445"]}]},{"name":"Meharry-Vanderbilt Alliance Community","award":["U54MD007593"],"award-info":[{"award-number":["U54MD007593"]}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100006108","name":"NCATS","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Abuse"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:p>\n                    <jats:italic toggle=\"yes\">Background:<\/jats:italic>\n                    Trust in health care has been shown to influence health care utilization, perceptions of fair treatment, and health outcomes in the general population. The literature on trust in health care in individuals with a history of substance use disorder (SUD) is more limited, primarily examining the patient-provider relationship. Women seeking substance abuse treatment in community-based programs have higher rates of prior trauma and health disparities compared with male counterparts and the general population. With higher rates of prior trauma, this population is theoretically at high risk of decreased interpersonal trust and altered interpersonal relationships.\n                    <jats:italic toggle=\"yes\">Objective:<\/jats:italic>\n                    This study sought to identify factors influencing trust in the health care system for women seeking substance abuse treatment in a community-based residential treatment program.\n                    <jats:italic toggle=\"yes\">Methods:<\/jats:italic>\n                    Six client focus groups (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200930), 1 provider focus group (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u20097), and 2 individual clinical administrator interviews (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u20092) were conducted between November 2016 and August 2017. Focus groups and interviews were audio recorded and transcribed. Coding and coding reconciliation were conducted by 2 independent coders. Themes were extracted and analyzed from sorted and coded quotes.\n                    <jats:italic toggle=\"yes\">Results:<\/jats:italic>\n                    Six themes emerged. Factors that influence trust in the health care system in this population include (1) prior experiences with diagnosis, treatment, and outcomes; (2) stigma of addiction; (3) payment and reimbursement structure; (4) patient rights and protections; (5) efficiency-driven care; and (6) the health care system's role in causing and\/or enabling addiction.\n                    <jats:italic toggle=\"yes\">Conclusions:<\/jats:italic>\n                    These themes demonstrate a general distrust of the health care system by women in this population. Distrust is influenced by a perception of a health care system providing care that is variable in quality, often stigmatizing, unaffordable, efficiency driven, and often influencing individuals\u2019 SUD. This aligns with and extends prior literature around trust of health care in individuals with SUD. Future directions in research include formally assessing the impact of trust on health outcomes such as treatment entry and retention.\n                  <\/jats:p>","DOI":"10.1080\/08897077.2018.1544184","type":"journal-article","created":{"date-parts":[[2019,2,13]],"date-time":"2019-02-13T13:32:08Z","timestamp":1550064728000},"page":"170-177","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":46,"title":["\u201cA Scarlet Letter\u201d: Stigma and other Factors Affecting Trust in the Health Care System for Women Seeking Substance Abuse Treatment in a Community Setting"],"prefix":"10.1177","volume":"40","author":[{"given":"Joshua D.","family":"Cockroft","sequence":"first","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susie M.","family":"Adams","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Nursing, Nashville, Tennessee, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kemberlee","family":"Bonnet","sequence":"additional","affiliation":[{"name":"Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deondria","family":"Matlock","sequence":"additional","affiliation":[{"name":"The Next Door, Inc., Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"McMillan","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Nursing, Nashville, Tennessee, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Schlundt","sequence":"additional","affiliation":[{"name":"Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,4,1]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2009.01017.x"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-014-2986-7"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/19.5.476"},{"key":"e_1_3_4_5_2","first-page":"327","article-title":"Mutual Mistrust in the Medical Care of Drug Users: The Keys to the \u201cnarc\u201d cabinet","volume":"17","author":"Merrill JO","year":"2002","unstructured":"Merrill JO, , Rhodes LA, , Deyo RA, , Marlatt GA, , Bradley KA. Mutual Mistrust in the Medical Care of Drug Users: The Keys to the \u201cnarc\u201d cabinet. J Gen Intern Med. 2002;17:327\u2013333.","journal-title":"J Gen Intern Med"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2008.12.033"},{"key":"e_1_3_4_7_2","first-page":"1","article-title":"Patient-provider rapport in the health care of people who inject drugs","author":"Salvalaggio G","year":"2013","unstructured":"Salvalaggio G, , McKim R, , Taylor M, , Wild TC. Patient-provider rapport in the health care of people who inject drugs. Sage Open 2013;3(4):1\u201313.","journal-title":"Sage Open"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12493"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1037\/rmh0000064"},{"key":"e_1_3_4_10_2","volume-title":"Substance Abuse Treatment: Addressing the Specific Needs of Women: A Treatment Improvement Protocol TIP 51","author":"Substance Abuse and Mental Health Services Administration.","year":"2009","unstructured":"Substance Abuse and Mental Health Services Administration. Substance Abuse Treatment: Addressing the Specific Needs of Women: A Treatment Improvement Protocol TIP 51. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2009."},{"key":"e_1_3_4_11_2","volume-title":"Substance Abuse Treatment and Family Therapy: A Treatment Improvement Protocol TIP 39","author":"Substance Abuse and Mental Health Services Administration","year":"2005","unstructured":"Substance Abuse and Mental Health Services Administration. Substance Abuse Treatment and Family Therapy: A Treatment Improvement Protocol TIP 39. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2005."},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1080\/10884600802111648"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1081\/ADA-120018838"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0899-3289(01)00083-9"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2004.08.023"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2006.05.012"},{"key":"e_1_3_4_17_2","volume-title":"Bureau of Justice Statistics Special Report: Women Offenders","author":"Greenfeld LA","year":"1999","unstructured":"Greenfeld LA, , Snell TL. Bureau of Justice Statistics Special Report: Women Offenders. Washington, D.C.: U.S. Department of Justice, Office of Justice Program; 1999."},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/1747-597X-10-5"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1359-1789(99)00010-5"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1037\/tra0000022"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(02)00142-9"},{"key":"e_1_3_4_22_2","volume-title":"Ending Discrimination against People with Mental and Substance Use Disorders: The Evidence for Stigma Change","author":"National Academies of Science, Engineering, and Medicine","year":"2016","unstructured":"National Academies of Science, Engineering, and Medicine. Ending Discrimination against People with Mental and Substance Use Disorders: The Evidence for Stigma Change. Washington, D.C.: The National Academies Press; 2016."},{"key":"e_1_3_4_23_2","volume-title":"CMS Announces New Medicaid Policy to Combat the Opioid Crisis by Increasing Access to Treatment Options","author":"Centers for Medicare & Medicaid Services.","year":"2017","unstructured":"Centers for Medicare & Medicaid Services. CMS Announces New Medicaid Policy to Combat the Opioid Crisis by Increasing Access to Treatment Options. Baltimore, MD: Centers for Medicare and Medicaid Services. 2017."},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-008-0575-3"}],"container-title":["Substance Abuse"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1080\/08897077.2018.1544184","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1080\/08897077.2018.1544184","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1080\/08897077.2018.1544184","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T11:41:59Z","timestamp":1780486919000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1080\/08897077.2018.1544184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4]]},"references-count":23,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1080\/08897077.2018.1544184"],"URL":"https:\/\/doi.org\/10.1080\/08897077.2018.1544184","relation":{},"ISSN":["0889-7077","1547-0164"],"issn-type":[{"value":"0889-7077","type":"print"},{"value":"1547-0164","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4]]}}}