From the Guidelines
The SARAR method is a highly effective approach to addressing medical mistrust, as it engages patients through its five core principles: Self-esteem, Associative strength, Resourcefulness, Action planning, and Responsibility, which is supported by the most recent evidence from 2021 1. To implement this approach when working with patients who exhibit medical mistrust, healthcare providers should first acknowledge the legitimacy of patients' concerns and validate their experiences, which helps build self-esteem. Next, connect patients with others who share similar experiences through support groups or community health workers, leveraging associative strength. Encourage resourcefulness by involving patients in their care decisions and providing clear information about treatment options, including specific medication details and treatment timelines. Develop concrete action plans collaboratively with patients, outlining step-by-step approaches to their healthcare needs with specific follow-up schedules. Finally, foster responsibility by empowering patients to take ownership of their health while ensuring they understand the healthcare team remains supportive. This method works because it addresses the root causes of mistrust—historical mistreatment, communication barriers, and power imbalances—by creating a participatory environment where patients feel valued and involved rather than dictated to, as also highlighted in the context of patient-clinician communication 2. The SARAR approach transforms the traditional hierarchical medical relationship into a partnership, which is particularly effective for communities with histories of medical exploitation or discrimination. Some key points to consider when implementing the SARAR method include:
- Understanding the unique sources of mistrust within the community, as mistrust is a universally identified barrier to participation in clinical research 1
- Building trust through authentic relationships with key community leaders and healthcare providers, as patients report a high level of trust in their healthcare providers 1
- Recognizing that patients are more likely to agree to participate in trials if they have had positive interactions with the healthcare system and if their provider recommends that they take part in research 1
From the Research
SARAR Method and Medical Mistrust
- The SARAR method is not explicitly mentioned in the provided studies, however, the studies do discuss the importance of patient-centered communication and open communication in reducing medical mistrust and improving patient outcomes 3, 4.
- Medical mistrust is a significant barrier to healthcare, particularly among marginalized populations, and can lead to poor health outcomes and decreased trust in healthcare providers 3, 5, 6.
- Patient-centered communication, which involves soliciting patients' concerns and priorities and being responsive to their healthcare needs, can help reduce medical mistrust and improve patient outcomes 3.
- Open communication after medical errors can also reduce emotional impacts, healthcare avoidance, and loss of trust in healthcare providers 4.
- The measurement of medical mistrust varies by health topic and sample population, and researchers should be aware of these differences when choosing measures for a given research question or intervention 5.
- Motivational interviewing, a method for encouraging behavioral changes, has been shown to be effective in medical care settings, particularly in areas such as HIV viral load, dental outcomes, and substance use 7.
- However, there is no direct evidence on the SARAR method and its relation to medical mistrust in the provided studies.