Abstract: SA-PO0952
Medical Mistrust and Sex Differences in the In-Clinic and Out-of-Clinic Social Networks of Patients Undergoing Hemodialysis
Session Information
- Diversity and Equity in Kidney Health
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 900 Diversity and Equity in Kidney Health
Authors
- Gade, Varenya R., Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, United States
- McDonald, Paige, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, United States
- Chang, Emily, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, United States
- Granados, A. Javier, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, United States
- Gillespie, Avrum, Temple University Health System Inc, Philadelphia, Pennsylvania, United States
Background
A patient's social network inside hemodialysis clinic (other patients and staff) and outside (family, friends) may affect the patient's trust in their doctor. We investigated the network size, composition, homophily (sameness among members) and heterophily (difference among members) and its associations with the participants' trust in the healthcare system.
Methods
We performed an ego-centric social network analysis of patients on hemodialysis across two hemodialysis facilities, in RStudio. Participants were asked about their trust in doctors as well as their outside networks' perspectives. Network variables included network size and diversity. Homophily within networks was measured using E-I indices with -1 = complete homophily, and +1 complete heterophily. Network interconnectedness was measured by checking if a patient had at least one person in their outside network connected to their internal network.
Results
The study included 117 patients (46.55% female) and their 1,224 network members (62.41% female). Males had significantly smaller networks than women (mean 9.65 vs. 11.59, p = 0.02) and had more heterophily in their networks (Men Mean E-I ratio 0.1 ± 0.31 vs. Women = -0.36 ± 0.32, p = 0.01). Female patients' networks had a greater proportion of family members connected with other patients and hemodialysis staff than male patients' networks (Female, 0.34 ± 0.48 vs. Male, 0.16 ± 0.37; p = 0.04). Patients with less trust in doctors had more network members who trusted doctors (heterophily) (Mean E-I ratio for; a lot [-0.054 ± 0.62] vs. moderate [-0.0056 ± 0.639] vs. a little [0.57 ± 0.73] vs. not at all [0.75 ± 0.5, p = 0.005). Trust in doctors did not differ significantly between sexes. Network size was not associated with trust in doctors (a lot [10.8 ± 4.35] vs. moderate [10.7 ± 4.58] vs. a little [8 ± 4.16] vs. not at all [7.8 ± 4.15], p = 0.10).
Conclusion
Patients' social networks differ in size, composition, and interconnectedness, with sex influencing network size and connectivity between hemodialysis network and outside network. Patients with higher medical mistrust actually have more people who trust doctors in their network. Additional research is necessary to understand how social networks can be used to improve trust in healthcare.