| Summary: | Objective: To examine whether group‐based medical mistrust predicts willingness to enroll in a rheumatology clinical trial and, among those unwilling, to identify logistical factors that most influence their decision. Methods: We conducted a single‐center, cross‐sectional survey at an academic rheumatology clinic between November 2024 and February 2025. Adults (≥18 years) with physician‐confirmed rheumatic disease completed the 12‐item Group‐Based Medical Mistrust Scale (GBMMS; range 12–60, higher = more mistrust), rated 11 logistical factors on a 7‐point scale (1 = extremely unlikely to influence, 7 = extremely likely), and answered a yes or no item on trial willingness. We assessed GBMMS internal consistency, compared mean mistrust by willingness using Welch's t‐test, and fit a univariable logistic regression with GBMMS predicting willingness. Among those unwilling, we ranked logistical factors by mean importance. Results: Forty‐seven patients participated (79% women; mean age 49.2 ± 13.6 years); 66% reported willingness to enroll. Mean mistrust did not differ by willingness (willing 24.7 ± 11.6 vs unwilling 25.3 ± 13.4; t26 = 0.13, P = 0.893), and GBMMS did not predict willingness (odds ratio 0.996, 95% confidence interval 0.95–1.05; P = 0.89). Among the 16 patients unwilling to participate, the highest‐rated influences were the prospect of stopping disease progression (mean 5.38), physician encouragement (mean 4.56), travel or transportation (mean 4.13), and shared language with the doctor (mean 4.13). Conclusion: Group‐based medical mistrust did not predict self‐reported willingness to join a rheumatology clinical trial. Instead, expectation of concrete disease improvement and personal endorsement by one's treating rheumatologist emerged as the strongest drivers of participation. Recruitment strategies that emphasize realistic potential benefits, incorporate physician‐delivered invitations, and address logistics may improve enrollment.
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