College of Graduate Studies: Theses & Dissertations
Term of Award
Spring 2027
Degree Name
Doctor of Psychology in Clinical Psychology (Psy.D.)
Document Type and Release Option
Dissertation (open access)
Copyright Statement / License for Reuse
This work is licensed under a Creative Commons Attribution 4.0 License.
Department
Department of Psychology
Committee Chair
Thresa Yancey
Committee Member 1
Jeffrey Klibert
Committee Member 2
Karen Naufel
Abstract
Healthcare and mental healthcare disparities among rural communities in the United States remain a persistent and growing public health concern, driven by both structural barriers and sociocultural factors that continue to compromise rural community members’ utilization of healthcare services. Though structural barriers to rural healthcare are well-documented, there are continued gaps in the literature related to the understanding of sociocultural mechanisms contributing to these disparities. The present study investigated the influence of medical distrust, mental health literacy, and perceived public stigma on attitudes toward seeking professional psychological help among rural adults living within the United States. A sample of 240 rural-identifying adults (ages 19 to 80; M = 49.5, SD = 14.3) was recruited via an online data collection service. Participants completed validated self-report measures of medical distrust, mental health literacy, perceived public stigma, and attitudes toward seeking professional psychological help. The current study sought to examine prevalence of and interactions between sociocultural factors (i.e., public stigma, mental health literacy, medical distrust, attitudes toward seeking professional psychological help) that influence care-seeking behaviors among rural community members. Additionally, the study sought to examine how various demographic identities (i.e., racial/ethnic identity, self-reported income) and their intersections interacted with existing sociocultural factors to influence help-seeking behaviors among rural community members. As hypothesized, medical distrust was significantly and inversely associated with help-seeking attitudes. Mental health literacy significantly moderated this relationship, with higher literacy attenuating the negative effect of medical distrust on help-seeking attitudes. Contrary to predictions, perceived public stigma did not moderate the relationship between mental health literacy and help-seeking attitudes. These findings highlight the importance of trust-building and community-based psychoeducational programming as intervention strategies for improving mental health service engagement among rural populations and highlight the need for culturally responsive approaches.
Recommended Citation
Cudd, G.A. (2026). Medical Distrust and Willingness to Engage in Mental Healthcare: The Moderating Roles of Mental Health Literacy and Stigma Among Rural Populations [Doctoral dissertation, Georgia Southern University]. Georgia Southern Commons.
Research Data and Supplementary Material
Yes
