Dataset on passenger acceptance during autonomous ferry public trials: Questionnaires and interviews

This paper presents a dataset from the first public trial of an urban autonomous passenger ferry. The dataset contains questionnaires designed to assess passenger acceptance in terms of perceived safety, trustworthiness, and reliability. Questionnaires and their responses are paired samples collected before and after use (N = 884). The dataset also contains transcripts of semi-structured interviews on the themes of perceived safety, trustworthiness, and reliability (N = 25). The public trial was held in Trondheim, Norway, during the period September-October 2022. The autonomous ferry used in the trial was the "milliAmpere2," which is owned and operated by the Norwegian University of Science and Technology (NTNU). The data represents a state-of-the-art data collection effort owing to on-site data collection immediately before and after interactions with an Autonomous Vehicle (AV) in a public transportation context. The dataset is suitable for producing quantitative and qualitative analyses and for developing indicators of technology acceptance and related social phenomena regarding AVs, either in the maritime context or beyond.

Linking patient-centered communication with cancer information avoidance: The mediating roles of patient trust and literacy

OBJECTIVES

This study, drawing on the pathway mediation model developed by Street and his colleagues (2009) that links communication to health outcomes, explores how patient-centered communication affects cancer information avoidance.

METHODS

Data was gathered through online access panel surveys, utilizing stratified sampling across Germany, Switzerland, the Netherlands, and Austria. The final sample included 4910 non-cancer and 414 cancer patients, all receiving healthcare from clinicians within the past year.

RESULTS

The results demonstrated that patient-centered communication is directly associated with reduced cancer information avoidance, especially among cancer patients. Additionally, this association is indirectly mediated through patient trust and healthcare literacy.

CONCLUSION

The findings provide empirical evidence that reveals the underlying mechanism linking clinician-patient communication to patient health information behavior.

PRACTICE IMPLICATIONS

The potential of clinician-patient communication in addressing health information avoidance is highlighted by these findings. Future interventions in healthcare settings should consider adopting patient-centered communication strategies. Additionally, improving patient trust and literacy levels could be effective in reducing cancer information avoidance.

The influence of waiting times and sociopolitical variables on public trust in healthcare: A cross-sectional study of the NHS in England

Objectives

This study aims to assess factors influencing public trust in the National Health Service (NHS) in England, focusing on the impact of waiting times in Accident & Emergency (A&E) departments and for GP-to-specialist cancer referrals.

Study design

A cross-sectional survey-based research design was employed, covering the period from July 2022 to July 2023.

Methods

Data were collected through YouGov surveys, yielding 7415 responses. Our analysis is based on 6952 of these responses which we were able to aggregate to 42 NHS Integrated Care Boards (ICBs) for A&E waiting times and 106 ICB sub-units for cancer referral times. Multiple regression analysis was conducted, with the dependent variable being trust in the NHS.

Results

Waiting times for A&E and cancer referrals did not significantly affect trust in the NHS. However, other sociopolitical factors displayed significant influence. Specifically, being a member of an ethnic minority group, or having voted Conservative in the 2019 general election were associated with lower trust scores. Other variables such as age and local unemployment rate were also significant predictors.

Conclusions

Our findings suggest that waiting times for healthcare services have no effect on public trust in the NHS. Instead, trust appears to be largely shaped by sociopolitical factors. Policymakers should therefore look beyond operational efficiency when seeking to bolster trust in the healthcare system.

The digital health divide: Understanding telehealth adoption across racial lines in rural Illinois

Due to long-standing barriers to healthcare access in rural areas, telehealth has been promoted as an effective means of delivering healthcare services. However, there is a general absence of quantitative data showing how geographic residence and race affect telehealth adoption. This study examines variations in telehealth adoption based on race and geographic residence in Southern Illinois using a mail survey. It finds that residents of urban Carbondale, compared to those in rural Cairo, have better access to broadband and are more likely to use telehealth. Respondents significantly differ from each other based on their geographic location of residence and race when it came to using telehealth to save money on travel and to save money on childcare. A significant barrier to telehealth adoption identified across all groups is privacy protection concern. The findings highlight the crucial role of broadband infrastructure in healthcare access and the need for trust in telehealth systems to ensure data privacy.

Trust, discrimination and preference for shared decision-making in adolescents diagnosed with depression: Implications from Chinese mental health professionals

BACKGROUND

While evidence suggests that the attitudes of healthcare providers toward medical decision-making in adolescents diagnosed with depression merit exploration, research on their preferences for Shared Decision-Making (SDM) and the factors affecting these preferences remains limited.

OBJECTIVE

To investigate Chinese mental health professionals' (MHPs) preferences for SDM in adolescents with depression and identify the relationships between their preference for SDM and trust and discrimination.

METHODS

A cross-sectional design was used in this study. Clinical Decision-making Style-Staff (CDMS-S) was applied to evaluate their preferences for SDM. Physician Trust in the Patient Scale (PTPS) was utilised to assess their trust in consumers. Social Distance Scale to Mental Illness (SDSMI) was utilised to measure their discrimination against people with mental illness.

RESULTS

A total of 581 MHPs were identified in China. MHPs rated their preference for participation in decision making (PD) as shared (1.89 ± 0.472), information (IN) as moderate (2.62 ± 0.682), and family involvement (FI) as high (3.13 ± 0.840). The preferences for three decision topics ranked from the highest to the lowest score were working-related decision (2.35 ± 0.681), general preferences in decision (1.82 ± 0.581) and medication-related decision (1.74 ± 0.826). The mean score of PTPS and SDSMI were 34.71 (SD=9.709) and 15.17 (SD=4.299), respectively. Logistic regression indicated that the preference for PD was associated with discrimination; the preference for IN was associated with trust, discrimination and SDM-related training experience; and the preference for FI was associated with both trust and discrimination.

CONCLUSIONS

While MHPs generally exhibit a favourable attitude toward SDM, this positivity is not universally observed across all contexts. There remains room for improvement in the willingness to co-develop medication regimens and share health information. Rational recognition of depression, and building trusting and friendly therapeutic relationships are key to promoting MHPs' preferences for SDM.

PRACTICAL VALUE

MHPs' preferences for SDM have a significant impact on SDM implementation, which will be promoted by implementing SDM-related training.

Purchasing in the digital age: A meta-analytical perspective on trust, risk, security, and e-WOM in e-commerce

This comprehensive meta-analysis investigates the significant factors influencing consumer decision-making in e-commerce. Predominantly focusing on the parameters of trust, perceived risk, perceived security, and electronic word-of-mouth (e-WOM), this study provides insightful revelations on their integral roles in shaping e-commerce purchasing decisions. The findings demonstrate that trust, perceived risk, perceived security, and e-WOM significantly influence consumers' e-commerce purchasing decisions. Perceived Risk plays a substantial moderating role in the relationship between Trust and e-commerce purchasing decisions, amplifying the importance of managing and minimizing risk in online transactions to cultivate consumer trust. Contrastingly, the roles of Perceived Security and e-WOM do not hold the same moderating effect on the trust-purchasing decision nexus, underscoring the direct yet unmoderated influence these factors have on e-commerce purchasing behaviors. Furthermore, The research reveals no significant size effect difference among respondents from high-income and low-income countries or between general internet users and online shoppers concerning the impact of trust on e-commerce purchasing decisions. This intriguing finding suggests the universal importance of trust in the digital purchasing landscape, irrespective of socio-economic status or the degree of e-commerce engagement. This study thus sheds new light on the complexities of e-commerce decision-making processes. It offers valuable insights for businesses aiming to enhance consumer trust and engagement in the expanding digital marketplace.

Reliance on sources of immunization information and vaccine uptake among older adults in a rural state: The mediating role of trust

Older adults are more vulnerable to the negative impacts of infectious diseases than younger individuals. However, regardless of the importance and effectiveness of vaccines to reduce morbidity and mortality, issues remain with vaccine hesitancy among this population. Older adults' sources of immunization information and their level of trust in those sources may play a role in their vaccination behaviors. This research aimed to better understand the role of information sources and related issues of trust as related to vaccine uptake among older adults. A community-based, cross-sectional survey was conducted with 901 older adults in North Dakota in May-July 2022. Measures included extent of reliance on specific sources of immunization information, levels of trust, and uptake for influenza, pneumonia, shingles, and COVID-19 vaccinations. Immunization information sources were grouped into medical experts, informal, and public outlets. Results indicated older adults were more likely to rely on medical experts than informal sources or public outlets for immunization information. Greater reliance on medical experts was associated with a greater likelihood of vaccine uptake for all vaccines, while reliance on public outlets was associated with a greater likelihood of vaccine uptake only for COVID primary series and boosters. Reliance on informal sources for immunization information was associated with a reduced likelihood of vaccine uptake for all vaccines except shingles. Nearly half of respondents were uncertain who to trust for vaccine information. Uncertainty who to trust for immunization information significantly mediated the associations between reliance on medical experts and uptake for most vaccines indicating that trust in medical experts fosters vaccine uptake. Increasing reliance on medical experts as sources of immunization information is vital to increasing vaccine uptake among older adults. Additionally, this population must be assisted in increasing their ability to successfully assess the trustworthiness of immunization information sources.

Investigating the factors affecting farmers' intention to adopt contract farming

Agricultural endeavors, especially in developing nations, entail inherent risks. Amidst challenges related to capital and agricultural marketing, contract farming emerges as a highly effective strategy. It not only facilitates capital accumulation but also ensures consistent product sales, establishes fair pricing, and contributes to the overall balanced development of the agricultural sector. This concern has been a longstanding global consideration, with Iran now addressing it. Recognizing the paramount importance of implementing contemporary agricultural methodologies, including contract farming, this research systematically investigates factors influencing farmers' intentions in Iran. A survey methodology is employed for systematic information collection from a statistical population of 98,777 farmers in rural Markazi Province, Iran. Using the Karjesi and Morgan table for sample size determination, a representative subset of 383 farmers is selected through stratified random sampling, ensuring proportional assignment within strata. A researcher-made questionnaire, validated by expert panels and confirmed for reliability through Cronbach's alpha coefficient, serves as the research instrument. Data analysis was conducted using SPSS 27, and structural equation modeling was performed with SmartPLS4. The findings reveal that trust (0.528), awareness (0.332), and attitude (0.168), exert the most substantial causal influence on farmers' intention to embrace contract farming. Consequently, the research findings offer practical recommendations for the adoption of contract farming, providing valuable insights to policymakers and stakeholders for implementing targeted interventions aimed at boosting farmers' willingness to participate in contractual agreements.

I want to be safe: understanding the main drivers behind vaccination choice throughout the pandemic

BACKGROUND

Despite being a major advancement in modern medicine, vaccines face widespread hesitancy and refusal, posing challenges to immunization campaigns. The COVID-19 pandemic accentuated vaccine hesitancy, emphasizing the pivotal role of beliefs in efficacy and safety on vaccine acceptance rates. This study explores the influence of efficacy and safety perceptions on vaccine uptake in Italy during the pandemic.

METHODS

We administered a 70-item questionnaire to a representative sample of 600 Italian speakers. Participants were tasked with assessing the perceived effectiveness and safety of each vaccine dose, along with providing reasons influencing their vaccination choices. Additionally, we conducted an experimental manipulation, exploring the effects of four framing messages that emphasized safety and/or efficacy on participants' willingness to receive a hypothetical fourth vaccine dose. Furthermore, participants were asked about their level of trust in the scientific community and public authorities, as well as their use of different information channels for obtaining COVID-19-related information.

RESULTS

Our study reveals a dynamic shift in vaccine efficacy and safety perceptions throughout the COVID-19 pandemic, potentially influencing vaccination compliance. Initially perceived as more effective than safe, this assessment reversed by the time of the third dose. Beliefs regarding safety, rather than efficacy, played a significant role in anticipating future vaccinations (e.g., the booster dose). Safety-focused messages positively affected vaccination intent, while efficacy-focused messages showed limited impact. We also observed a changing trend in reasons for vaccination, with a decline in infection-related reasons and an increase in social related ones. Furthermore, trust dynamics evolved differently for public authorities and the scientific community.

CONCLUSIONS

Vaccine perception is a dynamic process shaped by evolving factors like efficacy and safety perceptions, trust levels, and individual motivations. Our study sheds light on the complex dynamics that underlie the perception of vaccine safety and efficacy, and their impact on willingness to vaccinate. We discuss these results in light of bounded rationality, loss aversion and classic utility theory.

Knowledge and trust of mothers regarding childhood vaccination in Rwanda

INTRODUCTION

Knowledge and trust are some of the contributing factors to vaccine acceptance(VA) and Vaccine hesitancy (VH) is one of the top threats to global health. A significant drop in childhood vaccination has been observed in recent years. One important reason that influences mothers' choice to either postpone or avoid children's vaccinations is knowledge and trust in childhood vaccines. This study aimed to assess mothers' knowledge and trust on vaccination of their children, and to examine the association between vaccination knowledge and selected socio-demographic factors.

METHODS

A cross-sectional survey was conducted from January 2022 to March 2022 to assess the knowledge and trust of mothers regarding childhood vaccination. Data was collected with self-administered questionnaires. Multivariable logistic regression analysis was employed to assess factors associated with childhood vaccine knowledge and trust.

RESULTS

Of the 2,126 Rwandan parents who participated in the study, the proportions with good knowledge of - and good trust in childhood vaccination were 95.5% and 91.4%, respectively. The popular sources of information about childhood vaccination were health care professionals (91.8%) and mass media (28.9%). Multinomial logistic regression analysis showed that good knowledge of - and trust in childhood vaccination were associated with the relationship with child(ren), education, occupation, and monthly income. The Multinomial logistic regression also revealed that the determinants of good knowledge of - and trust in childhood vaccination were; caregiver (p = 4.0 × 10-4, adjusted Odds Ratio (aOR); 1.7, 95%C.I; 1.3 - 2.3), no formal educational status (p = 3.3 × 10-2, aOR; 1.7, 95%C.I; 1.0 - 3.0), the unemployed occupational status (p = 2.4 × 10-2, aOR; 1.2, 95%C.I; 1.0 - 1.4), and persons on more than $401 per month (p = 2.0 × 10-4, aOR; 3.5, 95%C.I; 1.8 - 6.8).

CONCLUSION

The majority of parents in Rwanda had both good knowledge of-and good trust regarding childhood vaccination. Public health strategies to promote vaccination, education programmes as well as improved communication tools between health care professionals/traditional leaders/religious leaders and parents need to be considered to achieve favourable vaccination attitudes and practices for all parents in Rwanda.

Predicting the intention to receive the COVID-19 booster vaccine based on the health belief model

COVID-19 vaccine boosters are recommended because the protection provided by previous doses eventually decreases, posing a threat to immunity. Some people, however, remain hesitant or unwilling to get vaccinated. The present study sought to investigate factors associated with the intention to receive the COVID-19 booster vaccine based on (1) the constructs of the Health Belief Model, and (2) trust in healthcare workers and science. A sample of 165 adults with two doses of the COVID-19 vaccine were recruited using convenience sampling. Data was collected using an online survey from November 2021 to January 2022. The survey included questions about participants' socio-demographic details, health beliefs, trust, history of COVID-19 vaccination, and the intention to receive a third dose of the COVID-19 vaccine. Ordinal logistic regression analysis showed that higher perceived benefits, severity, and trust in healthcare workers, and lower perceived barriers predicted higher willingness to get a third dose of the vaccine whereas perceived susceptibility and trust in science did not. Understanding the factors and health beliefs that underlie vaccine hesitancy are vital when developing effective interventions with the aim of increasing uptake of COVID-19 booster vaccines.

Public trust in general practitioners and its association with primary care contracts: a cross-sectional study of community residents in China

OBJECTIVES

This study aimed to assess the level of public trust in general practitioners (GPs) and its association with primary care contract services (PCCS) in China.

STUDY DESIGN

Cross-sectional study.

METHODS

Between September and December 2021, 4158 residents across eastern, central, and western China completed a structured self-administered questionnaire. Trust was assessed using the Chinese version of Wake Forest Physician Trust Scale. Multivariable linear regression models were established to identify predictors of trust. The effect size of PCCS on trust was estimated by the average treatment effect for the treated (ATT) through propensity score matching.

RESULTS

The study participants had a mean Wake Forest Physician Trust Scale score of 36.82 (standard deviation = 5.45). Enrollment with PCCS (β = 0.14, P < 0.01), Han ethnicity (β = 0.03, P < 0.05), lower educational attainment (β = -0.06, P < 0.01), higher individual monthly income (β = 0.03, P < 0.05), better self-rated health (β = 0.04, P < 0.05), chronic conditions (β = 0.07, P < 0.01), and higher familiarity with primary care services (β = 0.12, P < 0.01) and PCCS (β = 0.21, P < 0.01) were associated with higher trust in GPs. The ATT of PCCS exceeded 1 (P < 0.05).

CONCLUSIONS

PCCS are associated with higher levels of trust in GPs. PCCS may become an effective tool to attract public trust in GPs, although the relationship between the two may be bi-directional.

Factors affecting the adoption of metaverse in healthcare: The moderating role of digital division, and meta-culture

This research aims to find out the factors affecting the adoption of Metaverse in healthcare. This study explores the effect of perceived ease of use, perceived usefulness, and trust on adopting Metaverse in healthcare by keeping digital division and metaculture as moderating variables. The philosophical foundation is rooted in the positivism paradigm, the methodology is quantitative, and the approach used is deductive. Data was collected in Pakistan and China through judgmental sampling from 384 respondents. Partial Least Square Structural Equation Modelling (PLS-SEM) was used to analyze the collected data. The findings validate the relationship between perceived ease of use and the adoption of metaverse with β-value 0.236, t-value 5.207 and p-value 0.000, the relationship between perceived usefulness and the adoption of metaverse with β-value 0.233, t-value 4.017 and p-value 0.000, and the relationship between trust and adoption of a metaverse with β-value 0.192, t-value 3.589 and p-value 0.000. Results also show that the digital divide moderates the relation between perceived ease of use and adopting the metaverse having β-value 0.078, t-value 1.848 and p-value 0.032. Similarly, the findings also show that the digital divide does not moderate the relationships of perceived usefulness and trust with adopting the metaverse. Moreover, the meta culture also does not moderate the relationships of perceived ease of use, usefulness, and trust with adopting the metaverse. The study contributes to theoretical research on adopting a metaverse in healthcare by examining various factors necessary for its development. It also provides guidelines for the developers and adopters of suitable metaverse technology.

Connectome-based prediction of decreased trust propensity in older adults with mild cognitive impairment: A resting-state functional magnetic resonance imaging study

Trust propensity (TP) relies more on social than economic rationality to transform the perceived probability of betrayal into positive reciprocity expectations in older adults with normal cognition. While deficits in social rationality have been observed in older adults with mild cognitive impairment (MCI), there is limited research on TP and its associated resting-state functional connectivity (RSFC) mechanisms in this population. To measure TP and related psychological functions (affect, motivation, executive cognition, and social cognition), MCI (n = 42) and normal healthy control (NHC, n = 115) groups completed a one-shot trust game and additional assessments of related psychological functions. RSFC associated with TP was analyzed using connectome-based predictive modeling (CPM) and lesion simulations. Our behavioral results showed that the MCI group trusted less (i.e., had lower TP) than the NHC group, with lower TP associated with higher sensitivity to the probability of betrayal in the MCI group. In the MCI group, only negative CPM models (RSFC negatively correlated with TP) significantly predicted TP, with a high salience network (SN) contribution. In contrast, in the NHC group, positive CPM models (RSFC positively correlated with TP) significantly predicted TP, with a high contribution from the default mode network (DMN). In addition, the total network strength of the NHC-specific positive network was lower in the MCI group than in the NHC group. Our findings demonstrated a decrease in TP in the MCI group compared to the NHC group, which is associated with deficits in social rationality (social cognition, associated with DMN) and increased sensitivity to betrayal (affect, associated with SN) in a trust dilemma. In conclusion, our study contributes to understanding MCI-related alterations in trust and their underlying neural mechanisms.

Trust-building in temporary public health partnerships: a qualitative study of the partnership formation process of a Covid-19 test, trace and protect service

BACKGROUND

Public health initiatives require coordinated efforts from healthcare, social services and other service providers. Organisational theory tells us that trust is essential for reaching collaborative effectiveness. This paper explores the drivers for initiating and sustaining trust in a temporary public health partnership, in response to a sudden health threat.

METHODS

This qualitative study analysed the formation process of a multisector partnership for a Covid-19 contact tracing service. Data was collected through 12 interviews, two focus groups, one feedback workshop, and an online survey with workforce members from all seven partner organisations. Purposive maximum variation sampling was used to capture the reflections and experiences of workforce members from all seven partner organisations. A deductive code scheme was used to identify drivers for building and sustaining trust in inter-organisational collaboration.

RESULTS

Relational mechanisms emanating from the commitment to the common aim, shared norms and values, and partnership structures affected trust-building. Shared values and the commitment to the common aim appeared to channel partners' behaviour when interacting, resulting in being perceived as a fair, reliable and supportive partner. Shared values were congruent with the design of the partnership in terms of governance structure and communication lines reflecting flat hierarchies and shared decision-making power. Tensions between partner organisations arose when shared values were infringed.

CONCLUSIONS

When managing trust in a collaboration, partners should consider structural components like governance structure, organisational hierarchy, and communication channels to ensure equal power distribution. Job rotation, recruitment of candidates with the desired personality traits and attitudes, as well as training and development, encourage inter-organisational networking among employees, which is essential for building and strengthening relationships with partner organisations. Partners should also be aware of managing relational dynamics, channelling behaviours through shared values, objectives and priorities and fostering mutual support and equality among partner organisations.

'I've just got to take that risk and have faith . . .': The challenge of gaining and maintaining trust in patients undergoing knee surgery with a regional anaesthetic

Traditionally, the focus of the operating theatre has been on conducting safe, efficient surgery with unconscious patients. However, the care of awake patients is now a prominent feature of modern perioperative practise as the volume of surgery performed under regional anaesthesia increases. The aim of this novel study was to understand the experience of being a conscious patient during regional anaesthesia and knee surgery in the perioperative environment. Data were gathered through observation and ethnographic interview and analysis followed a constant comparative grounded theory approach. The concepts of Trust and Faith are identified as recurrent themes highlighted in the data. This article identifies the need to understand patients' expectations regarding the clinical encounter and how subsequent treatment will develop, so that, reasons for any deviation can be discussed openly and an explanation provided. Each clinical encounter takes place within a relationship based upon an uneven distribution of power, enacted through the interaction itself, with the health care professional in a dominant role. It is the responsibility of health care staff to recognise and negate this power imbalance and reinforce trusting relationships so information and treatment options are not presented as a 'fait accompli' but negotiated through jargon free easy to understand language.

Identifying trusted local sources and predicting behavior change pathways according to COVID-19 vaccination status: Results of a 2022 statewide survey of Alaskan adults

BACKGROUND

Low rates of COVID-19 vaccination remain a substantial public health challenge. Despite early successes, vaccinations of Alaskans trail the US average, drawing attention to the need for better-designed and targeted vaccine confidence interventions. Our objective was to assess levels of community trust and theory-driven predictors of vaccination status to inform the design of future programs.

METHODS

We conducted a cross-sectional, telephone-based survey of 940 Alaskan adults between May and June 2022. Data were collected on vaccination status (including initial vaccination and receipt of booster shots), trust in local community members, demographic characteristics, and thematic questions designed using the Capability, Opportunity, Motivation - Behavior (COM-B) model to examine possible predictors (barriers/facilitators) of vaccination status.

FINDINGS

Among those who are not fully vaccinated and boosted, we observe significantly lower trust placed in many immediate community members, especially health workers (e.g., doctors, nurses, specialty care physicians, health administrators). Firefighters and emergency medical technicians enjoy the most community trust, followed by medical professionals. Among those who received only a primary vaccine series, we find that perceptions of whether close friends are vaccinated, a sense of professional responsibility, and age were the strongest predictors vaccination status. Among the unvaccinated, we find significant predictive power from the same variables, as well as perceptions of whether family members are vaccinated, perceived risks from non-vaccination and whether vaccination is a healthy choice.

CONCLUSIONS

These findings will help inform the design and targeting of future vaccine promotion interventions to adult populations in Alaska. Interventions that leverage reflective motivation and social opportunity domains of the COM-B framework may be most effective. Local community members including firefighters and emergency medical technicians, as well as medical professionals may be perceived as the most trustworthy and influential messengers among those who are not fully vaccinated and boosted.

COVID-19 Vaccine decision-making: trust among the transgender and disability communities in India

BACKGROUND

Historical marginalisation and ongoing trust deficits in health and government systems shape present-day vaccine perceptions among marginalised communities. This paper sought to understand the role of trust in decision-making about COVID-19 vaccine uptake in the transgender and disability communities in India.

METHODS

Using a participatory approach we interviewed 24 community representatives, identifying themselves as transgender individuals or as persons with disability, and 21 key informants such as vaccine programme managers, vaccine providers, and community advocates. We undertook an inductive thematic analysis of the data using a socio-ecological model.

RESULTS

Fear of side effects in relation to specific needs of the two communities and mistrust of systems involved in vaccination shaped four different pathways for vaccine decision-making. Mistrust of systems was influenced by past negative experiences with the health system, creating contexts in which information and misinformation are shared and interpreted. Participants negotiated their doubts about safety and mistrust of systems by interacting with different sources of influence showing patterns of decision-making that are dynamic, context-dependent, and intersectional.

CONCLUSION

These findings will help in determining the content, strategies and approaches to equitable vaccine communication for these two communities. The two communities ought to be included in vaccine trials. Vaccine information must respond to the specific needs of these two communities which could be enabled by collaboration and engagement with community members and influencers. Finally, long-term investment towards the needs of marginalised communities is vital to dismantle cycles of marginalisation and distrust and in turn improve vaccine acceptance and uptake.

The anatomical structure of sex differences in trust propensity: A voxel-based morphometry study

Trust is a key component of human relationships. Sex differences in trust behavior have been elucidated by parental investment theory and social role theory, attributing men's higher trust propensity to their increased engagement in physically and socially risky activities aimed at securing additional resources. Although sex differences in trust behavior exist and the neuropsychological signatures of trust are known, the underlying anatomical structure of sex differences is still unexplored. Our study aimed to investigate the anatomical structure of sex differences in trust behavior toward strangers (i.e., trust propensity, TP) by employing voxel-based morphometry (VBM) in a sample of healthy young adults. We collected behavioral data for TP as measured with participants in the role of trustors completing the one-shot trust game (TG) with anonymous partners as trustees. We conducted primary region of interest (ROI) and exploratory whole-brain (WB) VBM analyses of high-resolution structural images to test for the association between TP and regional gray matter volume (GMV) associated with sex differences. Confirming previous studies, our behavioral results demonstrated that men trusted more than women during the one-shot TG. Our WB analysis showed a greater GMV related to TP in men than women in the precuneus (PreC), whereas our ROI analysis in regions of the default-mode network (dorsomedial prefrontal cortex [dmPFC], PreC, superior temporal gyrus) to simulate the partner's trustworthiness, central-executive network (ventrolateral PFC) to implement a calculus-based trust strategy, and action-perception network (precentral gyrus) to performance cost-benefit calculations, as proposed by a neuropsychoeconomic model of trust. Our findings advance the neuropsychological understanding of sex differences in TP, which has implications for interpersonal partnerships, financial transactions, and societal engagements.

The correlation of trust as part of the therapeutic alliance in physical therapy and their relation to outcomes for patients with chronic low back pain

BACKGROUND

Previous qualitative research has listed trust as a component of the therapeutic alliance in physical therapy.

OBJECTIVE

Quantitatively correlate trust and therapeutic alliance in physical therapy care for patients with chronic low back pain. The secondary aim was to investigate the relation of trust and therapeutic alliance with outcomes over the course of treatment.

METHODS

The Primary Care Assessment Survey was used to measure trust and the Working Alliance Inventory-Short Revised tool measured therapeutic alliance. The patient recorded these measures after the initial visit and at discharge. Self-report patient outcome measures for pain, function, and global rating of change were also measured at the same time points.

RESULTS

A strong correlation (rs = 0.747 and rs = 0.801) was found between trust scores and therapeutic alliance measures post-initial visit and at discharge, respectively. In addition, there were moderate to strong correlations between trust and therapeutic alliance scores with the various improved outcome measures of pain, function, and global rating of change.

CONCLUSION

There appears to be a connection between trust and therapeutic alliance along with improved patient outcomes related to higher trust and therapeutic alliance scores in a cohort with chronic low back pain.

All you Need is Trust? Public Perspectives on Consenting to Participate in Genomic Research in the Sri Lankan District of Colombo

Engagement with genomic medicine and research has increased globally during the past few decades, including rapid developments in Sri Lanka. Genomic research is carried out in Sri Lanka on a variety of scales and with different aims and perspectives. However, there are concerns about participants' understanding of genomic research, including the validity of informed consent. This article reports a qualitative study aiming to explore the understanding, knowledge, and attitudes of the Sri Lankan public towards genomic medicine and to inform the development of an effective and appropriate process for informed consent in that setting. Purposive sampling was employed. Participants were recruited from a sub-group of the public in Colombo, Sri Lanka who had either consented or refused to donate genetic material for a biobank. Data were collected using face-to-face semi-structured interviews. Interview data were transcribed verbatim and translated into English. Conventional content analysis was used. The analysis developed three key themes: a) 'Scientific literacy' describes an apparent lack of scientific knowledge that seems to affect a participant's ability to understand the research, b) 'Motivation' describes narratives about why participants chose (not) to take part in the research, despite not understanding it, and c) 'Trust' describes how trust served to mitigate the apparent ethical deficit created by not being fully informed. In this article, we argue that informed trust is likely an acceptable basis for consent, particularly in settings where scientific literacy might be low. However, researchers must work to be worthy of that trust and ensure that misconceptions are actively addressed.

Value Representations of Spite Sensitivity in Psychosis on the Minnesota Trust Game

BACKGROUND

Spite sensitivity provides a valuable construct to understand persecutory ideation and its underlying neural mechanisms. We examined the relationship between persecution and spite sensitivity in psychosis to identify their neural substrates.

METHODS

In a 3T magnetic resonance imaging scanner, 49 participants with psychosis played the Minnesota Trust Game, in which they decided whether to take a small amount of money or trust a partner to choose between fair and unfair distributions of money. In some conditions, the partner benefited from the unfair option, while in others, the partner lost money. Participants who were untrusting in the second condition (suspiciousness) showed heightened sensitivity to spite. Behavioral measures included mistrust during the 2 conditions of the game, which were compared with Brief Psychiatric Rating Scale persecution and computational modeling. Functional connectivity and blood oxygen level-dependent analyses were also conducted on a priori regions during spite-sensitive decisions.

RESULTS

Behavioral results replicated previous findings; participants who experienced more persecutory ideation trusted less, specifically in the suspiciousness condition. Functional connectivity findings showed that decreased connectivity between the orbitofrontal cortex-insula and the left frontoparietal network was associated with increased persecutory ideation and estimated spite-guilt (a marker of spite sensitivity). Additionally, we found differences between conditions in caudate nucleus, medial prefrontal cortex, and lateral orbitofrontal cortex activation.

CONCLUSIONS

These findings provide a new perspective on the origin of positive symptoms by identifying primary brain circuits that are related to both spite sensitivity and persecutory ideation.

The development of working alliance in early stages of care from the perspective of patients attending a chiropractic teaching clinic

BACKGROUND

The clinician-patient relationship has consistently been found to predict treatment success in both physical and mental health settings. This relationship has been operationalised in the literature as "Working Alliance," which consists of three key components: patient-clinician agreement on the goals of care, agreement on the tasks required to achieve those goals, and the establishment of a strong bond. While research has demonstrated the impact of working alliance in physical health settings, it often measures working alliance early in patients' care journeys. However, no primary research has investigated how early working alliance develops between patients and chiropractors. Evidence suggests that musculoskeletal practitioners may require further training to feel confident in establishing working alliance. Therefore, this study aims to explore the development of working alliance in the early stages of chiropractic care from the patients' perspective to inform evidence-based practice.

METHODS

Participants for this qualitative study were recruited from a teaching clinic at a specialised healthcare professions training university in the United Kingdom between September 2022 and April 2023. A total of 25 adult patients completed semi-structured interviews during the early stages of their care. The interview transcripts were analysed using Reflexive Thematic Analysis, from a critical realist stance.

RESULTS

The findings highlight that an early working alliance entails the gradual development of patients' confidence in their decision to seek help from trainee chiropractors to alleviate their symptoms. The four themes describe the impact of the clinical context on patients' expectations, the trainee chiropractors' qualities that participants considered important for early working alliance, the role of explanations, and the interplay between pain and early working alliance.

CONCLUSIONS

Establishing an early trainee chiropractor-patient working alliance involves a process of building patients' confidence in the trainee chiropractors' expertise, identifying the correct goals of care, and recognising the value of the proposed treatment plan. Factors shaping this process include the context of the care journey, patients' perceptions of trainee chiropractors' qualities, their bodily sensations, their expectations, their past experiences, and their satisfaction with trainee chiropractors' explanations.

Trust in federal COVID-19 vaccine oversight and parents' willingness to vaccinate their children against COVID-19: a cross-sectional study

BACKGROUND

Over half of the youth population in the United States, aged 6 months to 17 years, have not received the Coronavirus Disease 2019 (COVID-19) vaccine. Given parents' central role in vaccinating their children, we examined associations between parents' trust of the federal oversight of COVID-19 vaccine safety and their willingness to vaccinate their children against COVID-19.

METHODS

This cross-sectional study included 975 parents of minor children residing in Philadelphia who completed the online survey between September 2021 and February 2022. Trust was measured using a four-point Likert scale ranging from 'do not trust' to 'fully trust' for two variables: (1) trust in federal oversight of COVID-19 vaccine safety for children and (2) trust in federal oversight of COVID-19 vaccine safety for the general public. A multiple logistic regression evaluated associations between trust and parents' willingness to vaccinate their children, which was measured on a five-point Likert scale ranging from 'strongly disagree' to 'strongly agree.' The analysis was adjusted for race/ethnicity, age, sexual orientation, gender, education, insurance, and parents' vaccination status.

RESULTS

Analyses included 975 parents whose children had not previously been vaccinated against COVID-19 (mean age 36.79, standard deviation 6.4; 42.1% racial/ethnic minorities; 93.2% heterosexual; and 73.7% with a college degree). Greater trust regarding federal oversight of COVID-19 vaccine safety for children [adjusted odds ratio (aOR) = 1.52, 95% confidence interval (CI): 1.13-2.04] and for the public (aOR = 1.58, 95% CI: 1.17-2.14) were each associated with increased willingness to have their child vaccinated against COVID-19. Unvaccinated parents had decreased willingness compared to parents who had received at least one dose of the vaccine (aOR = 0.14, 95% CI: 0.04-0.41). College-graduate parents exhibited increased willingness compared to those without a college degree (aOR = 2.07, 95% CI: 1.52-2.81). Non-heterosexual parents showed increased willingness compared to heterosexual parents (aOR = 2.30, 95% CI: 1.20-4.76).

CONCLUSIONS

Trust in federal COVID-19 vaccine oversight was associated with parental willingness to vaccinate their children against COVID-19 among parents whose children have not yet been vaccinated. Identifying and addressing causes of mistrust are crucial next steps to promote child vaccination. Intervention efforts to address trust gaps should remain a public health priority.

High-Performing Teamlets in Primary Care: A Qualitative Comparative Analysis

PURPOSE

In efforts to improve patient care, collaborative approaches to care have been highlighted. The teamlet model is one such approach, in which a primary care clinician works consistently with the same clinical staff member. The purpose of this study is to identify the characteristics of high-performing primary care teamlets, defined as teamlets with low rates of ambulatory care sensitive emergency department (ACSED) visits and ambulatory care sensitive hospital admissions (ACSAs).

METHODS

Twenty-six individual qualitative interviews were performed with physicians and their teamlet staff member across 13 teamlets. Potentially important characteristics related to high-performing primary care teamlets were identified, calibrated, and analyzed using qualitative comparative analysis (QCA).

RESULTS

Key characteristics identified by the QCA that were often present in teamlets with low rates of ACSED visits and, to a lesser extent, ACSAs were staff proactiveness in anticipating physician needs and physician-reported trust in their staff member.

CONCLUSION

This study suggests that physician trust in their staff and proactiveness of staff in anticipating physician needs are important in promoting high-performing teamlets in primary care. Additional studies are indicated to further explore the relationship between these characteristics and high-performing teamlets, and to identify other characteristics that may be important.

Why consumers have impulsive purchase behavior in live streaming: the role of the streamer

To explore the influencing factors of consumers' impulsive purchase behavior in live streaming, based on the Stimulus-Organism-Response framework, we construct the model of how streamers influence consumers' impulsive purchase behavior by consulting literature. Collected data by means of a questionnaire, and made an empirical study by using the structural equation model to explore the mechanism of streamer affecting consumers' impulsive purchase behavior. The results show that streamer characteristics (personal charisma, professionalism) and streamer performance (interactivity, entertainment) affect consumers' impulsive purchase behavior by affecting consumers' trust and flow experience. The empirical results have important theoretical and practical significance.

Consent as a compositional act - a framework that provides clarity for the retention and use of data

BACKGROUND

Informed consent is one of the key principles of conducting research involving humans. When research participants give consent, they perform an act in which they utter, write or otherwise provide an authorisation to somebody to do something. This paper proposes a new understanding of the informed consent as a compositional act. This conceptualisation departs from a modular conceptualisation of informed consent procedures.

METHODS

This paper is a conceptual analysis that explores what consent is and what it does or does not do. It presents a framework that explores the basic elements of consent and breaks it down into its component parts. It analyses the consent act by first identifying its basic elements, namely: a) data subjects or legal representative that provides the authorisation of consent; b) a specific thing that is being consented to; and c) specific agent(s) to whom the consent is given.

RESULTS

This paper presents a framework that explores the basic elements of consent and breaks it down into its component parts. It goes beyond only providing choices to potential research participants; it explains the rationale of those choices or consenting acts that are taking place when speaking or writing an authorisation to do something to somebody.

CONCLUSIONS

We argue that by clearly differentiating the goals, the procedures of implementation, and what is being done or undone when one consent, one can better face the challenges of contemporary data-intensive biomedical research, particularly regarding the retention and use of data. Conceptualising consent as a compositional act enhances more efficient communication and accountability and, therefore, could enable more trustworthy acts of consent in biomedical science.

Trust and acceptability of data-driven clinical recommendations in everyday practice: A scoping review

BACKGROUND

Increasing attention is being given to the analysis of large health datasets to derive new clinical decision support systems (CDSS). However, few data-driven CDSS are being adopted into clinical practice. Trust in these tools is believed to be fundamental for acceptance and uptake but to date little attention has been given to defining or evaluating trust in clinical settings.

OBJECTIVES

A scoping review was conducted to explore how and where acceptability and trustworthiness of data-driven CDSS have been assessed from the health professional's perspective.

METHODS

Medline, Embase, PsycInfo, Web of Science, Scopus, ACM Digital, IEEE Xplore and Google Scholar were searched in March 2022 using terms expanded from: "data-driven" AND "clinical decision support" AND "acceptability". Included studies focused on healthcare practitioner-facing data-driven CDSS, relating directly to clinical care. They included trust or a proxy as an outcome, or in the discussion. The preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) is followed in the reporting of this review.

RESULTS

3291 papers were screened, with 85 primary research studies eligible for inclusion. Studies covered a diverse range of clinical specialisms and intended contexts, but hypothetical systems (24) outnumbered those in clinical use (18). Twenty-five studies measured trust, via a wide variety of quantitative, qualitative and mixed methods. A further 24 discussed themes of trust without it being explicitly evaluated, and from these, themes of transparency, explainability, and supporting evidence were identified as factors influencing healthcare practitioner trust in data-driven CDSS.

CONCLUSION

There is a growing body of research on data-driven CDSS, but few studies have explored stakeholder perceptions in depth, with limited focused research on trustworthiness. Further research on healthcare practitioner acceptance, including requirements for transparency and explainability, should inform clinical implementation.

The role of trust in the use of artificial intelligence for chemical risk assessment

Risk assessment of chemicals is a time-consuming process and needs to be optimized to ensure all chemicals are timely evaluated and regulated. This transition could be stimulated by valuable applications of in silico Artificial Intelligence (AI)/Machine Learning (ML) models. However, implementation of AI/ML models in risk assessment is lagging behind. Most AI/ML models are considered 'black boxes' that lack mechanistical explainability, causing risk assessors to have insufficient trust in their predictions. Here, we explore 'trust' as an essential factor towards regulatory acceptance of AI/ML models. We provide an overview of the elements of trust, including technical and beyond-technical aspects, and highlight elements that are considered most important to build trust by risk assessors. The results provide recommendations for risk assessors and computational modelers for future development of AI/ML models, including: 1) Keep models simple and interpretable; 2) Offer transparency in the data and data curation; 3) Clearly define and communicate the scope/intended purpose; 4) Define adoption criteria; 5) Make models accessible and user-friendly; 6) Demonstrate the added value in practical settings; and 7) Engage in interdisciplinary settings. These recommendations should ideally be acknowledged in future developments to stimulate trust and acceptance of AI/ML models for regulatory purposes.

Optimal Veterinary Team Utilization Leads to Team Retention

Retaining and attracting talent in VetMed has become an increasingly difficult challenge and applies to all roles in the veterinary practice. Culture, leadership, training and development, and full role utilization are key factors in retaining current talent, as well as attracting future team members. These elements must work synergistically together to create an environment that team members do not want to leave while also being able to deliver exceptional patient care (fulfilling each team member's sense of purpose).

Parent's perceptions of paediatric care in two radiology departments within Johannesburg, South Africa

BACKGROUND

A referral to the Radiology department may be a very frightening, and at times a stressful experience for a child and their parents. The radiographer plays an important role as a healthcare professional to simultaneously produce high-quality diagnostic X-ray images and facilitate a high standard of care in a limited timeframe.

METHODS

The purpose of this qualitative, phenomenological study was thus to explore and describe parents' perceptions of paediatric care in two Radiology departments within Gauteng. A total of 12 semi-structured individual interviews were conducted with parents, until data saturation was achieved.

RESULTS

Braun and Clarke's six-step thematic analysis was used which unveiled three themes: 1) Recognition of overall positive, high standard of care received by paediatrics who underwent an X-ray examination 2) Limitations prohibiting a caring environment 3) The need for parent-centered paediatric care through the implementation of Family Centered Care (FCC).

CONCLUSION

Overall, there was positive feedback from the parents' perspectives and general satisfaction with the quality of care received by the child whilst in the Radiology department. Although there were some negative categories particularly referring to an unknown environment, parents overall appreciated the qualities of caring and effective communication that the radiographers displayed during their visit.

IMPLICATIONS FOR PRACTICE

The lack of literature regarding parents' perceptions of paediatric care within the context of radiography led to the current study. Recommendations for future best practice would be incorporating the concept of FCC within the curriculum of the radiography degree to improve overall patient and parent satisfaction.

Trust in provider and stigma during second-trimester abortion

OBJECTIVE

To determine whether trust in the provider and sociodemographics are associated with individual-level abortion stigma.

METHODS

We performed a cross sectional and exploratory study design using secondary analysis of a randomized trial that enrolled participants undergoing second trimester abortion. We collected baseline survey data from 70 trial participants to assess stigma (Individual Level of Abortion Stigma scale, ILAS; range 0-4), trust in provider (Trust in Physician scale; range 1-5), anxiety, depression, and sociodemographics. We performed multiple linear regression, for which ILAS score was the outcome of interest. Univariate associations were used to inform the regression model.

RESULTS

The mean abortion stigma score was at the low end of the ILAS at 1.21 (range 0.2-2.8, SD 0.66). Age, race, income, BMI, parity, gestational age at time of abortion, and reasons for ending the pregnancy were not significantly associated with the ILAS score. Higher trust in provider scores were (m 4.0, SD 0.49) and inversely related to the ILAS score, even after adjustment for confounders (β -0.02, CI -0.03 to -0.004, p = 0.013). Screening positive for anxiety or depression was associated with a higher ILAS score ((β 0.48, CI 0.10, 0.90, p = 0.015); (β = 0.27 CI -0.097, 0.643)), while cohabitation was associated with lower ILAS score (β -0.44, CI -0.82 to -0.57, p = 0.025).

CONCLUSIONS

Trust in an abortion provider, anxiety, depression, and cohabitation are associated with abortion stigma among people seeking second trimester abortion care. Interventions that improve trust in a provider may be an area of focus for addressing abortion stigma. Future research should confirm these findings in larger populations and across diverse locations and demographics and to conduct qualitative research to understand what patients perceive as trust-promoting behaviors and words during abortion encounters.

Trust and attitude toward information presented using augmented reality and other technological means

In recent years, augmented reality (AR) technology has grown, and its use has become widespread among smartphone users. People are consuming more and more digital information from various sources and in different presentation modes. Therefore, in this study, we investigate the extent to which different presentation modes relate to the level of trust in information, while considering demographic variables, as well as personality traits and thinking styles. The participants in our experiments were asked to indicate whether certain statements that were presented in various presentation methods (image + text, image + audio, AR + text, AR + audio) were true or false. The results indicate that users are more likely to trust statements that are accompanied by AR than statements that are accompanied by a static image. In addition, younger participants have greater trust in audio-presented information than text-presented information. As AR is expected to grow considerably in popularity in the next few years, users should be cautious of the potential impact on their trust in digital information while using AR.

Trust in the ICU: What every clinician should know

Trust is an essential element in the relationship between patients and intensive care unit (ICU) clinicians. Without a foundation of trust, communication is difficult, conflict is more likely, and even clinical outcomes can be affected. The ICU is a particularly challenging environment for trust to flourish. Illness occurs suddenly, emotions can be charged, the environment is impersonal, and there is rarely a prior relationship between patients and their caregivers. Therefore, intensivists must have some understanding of the factors that impact patient and family trust, as well as the actions they can take to improve it.

An Ethical Framework for Allergy and Immunology

Ethical dilemmas routinely occur in the clinical practice of allergy and immunology. These ethical questions stem from the range of conditions and the different populations cared for by Allergists/Immunologists. Hence, medical ethics is not an esoteric concept, but a practical skill physicians exercise regularly. Moreover, an ethics-centered approach may improve patient safety and outcomes. This article will describe key principles of bioethics and illustrate an ethical framework that physicians can use in their conversations with patients. Utilization of this ethical framework is demonstrated through applying it to four unique clinical scenarios encountered by Allergists/Immunologists from different practice settings. The ethical framework for allergy and immunology is a technique to navigate ethically complex decisions that arise in routine clinical practice.

Trust in embedding co-design for innovation and change: considering the role of senior leaders and managers

PURPOSE

In this viewpoint article, the authors recognize the increased focus in health systems on co-design for innovation and change. This article explores the role of leaders and mangers in developing and enhancing a culture of trust in their organizations to enable co-design, with the potential to drive innovation and change in healthcare.

DESIGN/METHODOLOGY/APPROACH

Using social science analyses, the authors argue that current co-design literature has limited focus on interactions between senior leaders and managers, and healthcare staff and service users in supporting co-designed innovation and change. The authors draw on social and health science studies of trust to highlight how the value-based co-design process needs to be supported and enhanced. We outline what co-design innovation and change involve in a health system, conceptualize trust and reflect on its importance within the health system, and finally note the role of senior leaders and managers in supporting trust and responsiveness for co-designed innovation and change.

FINDINGS

Healthcare needs leaders and managers to embrace co-design that drives innovation now and in the future through people - leading to better healthcare for society at large. As authors we argue that it is now the time to shift our focus on the role of senior managers and leaders to embed co-design into health and social care structures, through creating and nurturing a culture of trust.

ORIGINALITY/VALUE

Building public trust in the health system and interpersonal trust within the health system is an ongoing process that relies upon personal behavior of managers and senior leaders, organizational practices within the system, as well as political processes that underpin these practices. By implementing managerial, leadership and individual practices on all levels, senior managers and leaders provide a mechanism to increase both trust and responsiveness for co-design that supports innovation and change in the health system.

The association of family doctor contract service and patient trust in doctor: evidence from twenty-five village clinics of three counties in rural China

BACKGROUND

China is implementing the family doctor (FD) system to reform the primary healthcare (PHC). The family doctor contract service (FDCS) policy plays a crucial role in this system implementation, aiming to transform the doctor-patient relationship and enhance PHC quality. This study aims to investigate the impact of FDCS on the doctor-patient relationship in PHCs using field research methodology.

METHOD

The field research methodology was employed to address the research questions. Quantitative methods were utilized for data collection and analysis. A structure questionnaire was used to collect data based on the research questions. Our investigation encompassed twenty-five village clinics across three counties in China. A total of 574 subjects helped us to finish this investigation in the study. The collected data was analyzed using statistical analysis including ordinary least squares (OLS) model and propensity scores matching model (PSM) to estimate the relationship.

RESULT

The findings from ordinary least squares (OLS) regression revealed that FDCS had a positive influence on patient trust in doctors within PHCs, with patients who participated the FDCS exhibiting higher levels of trust compared to those who did not participate. Propensity score matching (PSM) analysis further confirmed these results by accounting for selection bias.

CONCLUSIONS

The implementation of family doctor contract service has brought about significant transformation in the doctor-patient relationship within rural Chinese PHCs. In essence, it has revolutionized the service model of doctor in PHC, playing a pivotal role in improving primary health quality and enhance the service capability of doctors in PHC. This transformative process has been crucial for carrying out hierarchical diagnosis and treatment policy, which aims to adjust the medical service structure and optimizing the health service system. Therefore, it is imperative for government authorities and health administration departments to ensure continuous support for this essential service through appropriate formulation.

In masks we trust: explicit and implicit reactions to masked faces vary by political orientation

Previous studies in the context of the COVID-19 pandemic indicated that wearing a medical-style mask affects whether a stranger's face is judged as more trustworthy, socially desirable, or likely to be ill. However, given political controversies around mask use, these effects might vary by political orientation. In a pre-registered online experiment, we measured evaluations of trustworthiness, social desirability and perceived illness in masked and unmasked faces by 1241 British and US participants. We included questions on political orientation, along with the implicit online-VAAST approach/avoid task to test reaction times to masked/unmasked faces. There was a medium-sized effect of masks on trustworthiness and a significant interaction with political orientation, in that conservatives found masked faces less trustworthy than did liberals. Participants were quicker to approach masked than unmasked faces, but conservatives were relatively slower than liberals. The effects on trustworthiness suggest that differential moralization of novel social norms can affect how their adherents are evaluated in terms of their suitability for social interactions. Furthermore, the congruence between implicit and explicit methods implies that such differences can have deep-seated effects on reactions.

Can endorsement by religious leaders move the needle on vaccine hesitancy?

Existing research, including work specific to COVID-19, suggests that endorsement by medical practitioners increases vaccine uptake. Yet, vaccine hesitancy persists despite health professionals continuing to widely endorse multiple vaccines to combat COVID-19 since late 2020. Could endorsement by other trusted leaders reduce vaccine hesitancy? Although some studies suggest that trust in religious leaders can influence individuals' health attitudes and behaviors, the evidence is mixed. Our study explores the potential added value of messaging by religious leaders across religious traditions - specifically, it asks whether their endorsement of the COVID-19 vaccine might increase vaccine uptake in an environment where health professionals are already endorsing vaccines. To investigate this question, we conducted an online survey experiment with 6,000 respondents across five countries with different dominant religions (Buddhism, Christianity, and Islam). Respondents were randomly assigned to either a control group that only included endorsement by medical practitioners or a treatment group that added either endorsement by religious leaders or, for comparative purposes, endorsement by political leaders. We found that endorsement by religious leaders reduced vaccine hesitancy only in one country. These findings corroborate existing research that medical practitioners are the best line of defense to combat vaccine hesitancy. They also suggest the limitations of endorsement by non-experts.

One year later: What role did trust in public officials and the medical profession play in decisions to get a booster and to overcome vaccine hesitancy?

Physicians may have an important role to play in promoting boosters as well as reducing COVID-19 vaccine hesitancy, but the relationship between hesitancy and trust in the medical profession and these behaviors has been underexplored. A representative online panel of 1,967 US adults that included oversamples of minoritized and rural populations were surveyed in April 2021 and June 2022 regarding their booster and vaccine status and intentions, their views of the medical profession, and their levels of trust in their own doctors, and national and state/local officials. Eighty percent of those vaccinated in 2021 had received a booster by 2022, while fewer than half of those initially reluctant to get a vaccine had gotten one by Wave 2 of the survey. Mean factor scores were calculated for response to a validated scale measuring trust in the medical profession. Linear and logistic regression models estimated the relationship between these factors scores and trust in other officials for those vaccinated as well initial hesitaters/refusers in Wave 1, controlling for population factors. Trust in one's own physician was associated with those vaccinated/eager to be vaccinated getting a booster, while trust in the medical profession was associated with getting a vaccine among those who had previously refused or were hesitant. Trust in other experts was not significantly associated with these behaviors, but wide confidence intervals suggest a need for future research. Innovative strategies, including mobilizing the medical community is needed to address reluctance, uncertainty, and distrust of therapeutic agents in pandemic response.

"I too have a responsibility for my partner's life": Communal coping among Malawian couples living with HIV and cardiometabolic disorders

RATIONALE

HIV and cardiometabolic disorders including hypertension and diabetes pose a serious double threat in Malawi. Supportive couple relationships may be an important resource for managing these conditions. According to the theory of communal coping, couples will more effectively manage illness if they view the illness as "our problem" (shared illness appraisal) and are united in shared behavioral efforts.

METHODS

This study qualitatively investigated communal coping of 25 couples living with HIV and hypertension or diabetes in Zomba, Malawi. Partners were interviewed separately regarding relationship quality, shared illness appraisal, communal coping, and dyadic management of illness.

RESULTS

Most participants (80%) were living with HIV, and more than half were also living with hypertension. Most participants expressed high levels of unity and the view that illness was "our problem." In some couples, partners expected but did not extend help and support and reported little collaboration. Communal coping and dyadic management were strongly gendered. Some women reported a one-sided support relationship in which they gave but did not receive support. Women were also more likely to initiate support interactions and offered more varied support than men. In couples with poor relationship quality and weak communal coping, dyadic management of illness was also weak. Partner support was particularly crucial for dietary changes, as women typically prepared meals for the entire family. Other lifestyle changes that could be supported or hindered by a partner included exercise, stress reduction, and medication adherence.

CONCLUSION

We conclude that gendered power imbalances may influence the extent to which couple-level ideals translate into actual communal coping and health behaviors. Given that spouses and families of patients are also at risk due to shared environments, we call for a shift from an illness management paradigm to a paradigm of optimizing health for spouses and families regardless of diabetes or hypertension diagnosis.

COVID-19 risk communication gaps, needs, and strategies related to pandemic preparedness plans among vulnerable, Black American subgroups: A qualitative study

OBJECTIVE

Improving current and future risk communication plans is critical to mitigate the COVID-19 pandemic and begin to prepare for future pandemics. Minority groups, particularly African Americans, have been limited in engagement to prepare these plans which has been demonstrated to be disadvantageous. We report findings from a qualitative study that describes gaps, needs, and strategies to improve communication among vulnerable, Black American subgroups during the COVID-19 pandemic.

METHODS

Sixty-two Black Americans in uniquely, vulnerable subgroups participated in qualitative, semi-structured interviews from May to September 2020. Thematic analyses were used to identify themes.

RESULTS

Participants were 16 essential workers, 16 parents, 15 young adults, and 15 individuals with underlying medical conditions. Emerging themes were: (1) Poor communication and miscommunication fueled fear and confusion; (2) Information sources and channels: How do I choose one?; (3) Communication needs were simple yet complex; (4) All information sources are not trusted information sources; (5) Preferred yet trusted channels and types of information; and (6) Dissemination of COVID Research: Why and How. Subgroups varied in information sources and processes for choosing the source, communication needs, and channels and types of information needed. They shared why they did and did not trust certain sources along with the importance of COVID research dissemination to promote informed decision-making throughout the pandemic.

DISCUSSION

This study found that Black American subgroups had diverse, yet trusted and non-trusted messages, messengers, and strategies for communication and wanted research results disseminated. We describe multi-level stakeholders and strategies to help improve risk communication for pandemics, and potentially preparedness and health outcomes.

The monitoring requests on young driver's fatigue and take-over performance in prolonged conditional automated driving

INTRODUCTION

L3 automated vehicles can perform all dynamic driving tasks unless a take-over occurs due to operational limits. This issue is potentially important for young drivers who are vulnerable road users since they have skill deficits and easily evolve into aberrant driving. However, drivers lacking active involvement may be fatigued and drowsy. Previous research indicated that performing a voluntary non-driving-related task (NDRT) could keep drivers alert, but there was no difference in take-over performance with or without NDRT. Providing a monitoring request (MR) before a possible take-over request (TOR) exhibited better take-over performance in temporary automated driving. Therefore, the study aimed to investigate the effects of MR and voluntary NDRT on young drivers' fatigue and performance.

METHOD

Twenty-five young drivers experienced 60 min automated driving on a highway with low traffic density and a TOR prompted due to a collision event. A within-subjects was designed that comprised three conditions: NONE, TOR-only, and MR + TOR. Drivers were allowed to perform a self-paced phone NDRT during automated driving.

RESULTS

The PERCLOS and blink frequency data showed that playing phones could keep drivers vigilant. The take-over performance on whether taking phone had no difference, but with MRs condition exhibited better take-over performance including the shorter reaction time and the longer TTC. Subjective evaluations also showed the advantages of MRs with more safety, trust, acceptance, and lower workload.

CONCLUSIONS

Taking MRs had a positive effect on relieving fatigue and improving take-over performance. Furthermore, MRs could potentially improve the safety and acceptance of automated driving.

PRACTICAL APPLICATIONS

The MR design can be used in the automotive industry to ensure the safest interfaces between fatigue drivers and automation systems.

Trust in Shared-Space Collaborative Robots: Shedding Light on the Human Brain

BACKGROUND

Industry 4.0 is currently underway allowing for improved manufacturing processes that leverage the collective advantages of human and robot agents. Consideration of trust can improve the quality and safety in such shared-space human-robot collaboration environments.

OBJECTIVE

The use of physiological response to monitor and understand trust is currently limited due to a lack of knowledge on physiological indicators of trust. This study examines neural responses to trust within a shared-workcell human-robot collaboration task as well as discusses the use of granular and multimodal perspectives to study trust.

METHODS

Sixteen sex-balanced participants completed a surface finishing task in collaboration with a UR10 collaborative robot. All participants underwent robot reliability conditions and robot assistance level conditions. Brain activation and connectivity using functional near infrared spectroscopy, subjective responses, and performance were measured throughout the study.

RESULTS

Significantly, increased neural activation was observed in response to faulty robot behavior within the medial and right dorsolateral prefrontal cortex (PFC). A similar trend was observed for the anterior PFC, primary motor cortex, and primary visual cortex. Faulty robot behavior also resulted in reduced functional connectivity strengths throughout the brain.

DISCUSSION

These findings implicate regions in the prefrontal cortex along with specific connectivity patterns as signifiers of distrusting conditions. The neural response may be indicative of how trust is influenced, measured, and manifested for human-robot collaboration that requires active teaming.

APPLICATION

Neuroergonomic response metrics can reveal new perspectives on trust in automation that subjective responses alone are not able to provide.

Improving the Effectiveness of Eigentrust in Computing the Reputation of Social Agents in Presence of Collusion

The introduction of trust-based approaches in social scenarios modeled as multi-agent systems (MAS) has been recognized as a valid solution to improve the effectiveness of these communities. In fact, they make interactions taking place in social scenarios much fruitful as possible, limiting or even avoiding malicious or fraudulent behaviors, including collusion. This is also the case of multi-layered neural networks (NN), which can face limited, incomplete, misleading, controversial or noisy datasets, produced by untrustworthy agents. Many strategies to deal with malicious agents in social networks have been proposed in the literature. One of the most effective is represented by Eigentrust, often adopted as a benchmark. It can be seen as a variation of PageRank, an algorithm for determining result rankings used by search engines like Google. Moreover, Eigentrust can also be viewed as a linear neural network whose architecture is represented by the graph of Web pages. A major drawback of Eigentrust is that it uses some additional information about agents that can be a priori considered particularly trustworthy, rewarding them in terms of reputation, while the non pre-trusted agents are penalized. In this paper, we propose a different strategy to detect malicious agents which does not modify the real reputation values of the honest ones. We introduce a measure of effectiveness when computing reputation in presence of malicious agents. Moreover, we define a metric of error useful to quantitatively determine how much an algorithm for the identification of malicious agents modifies the reputation scores of the honest ones. We have performed an experimental campaign of mathematical simulations on a dynamic multi-agent environment. The obtained results show that our method is more effective than Eigentrust in determining reputation values, presenting an error which is about a thousand times lower than the error produced by Eigentrust on medium-sized social networks.

Trust in Medical Research: A Comparative Study among Patients at a Regional Referral Hospital and Community Members in Lira District, Northern Uganda

Events such as the Tuskegee syphilis study shaped how the public perceives and trusts medical research globally. However, few studies have examined trust in medical research in developing countries. We tested the hypothesis that levels of trust may be lower among community members compared to hospitalized persons in Uganda. We enrolled 296 participants in rural northern Uganda, and 148(50%) were from the community, 192(65%) were female. Mean level of trust for medical research was higher among hospitalized persons compared to community members (p = 0.0001). Previous research participation (p = 0.03), and willingness to participate in future research (p = 0.001) were positively associated with trust. Medical personnel should engage more with the communities in which they practice fostering trust in medical research.

Unpredictable volatility and trust: The VISA model of person perception

By accounting for perceptions of volatility and predictability of key character dimensions (e.g., the predictable volatility of sociability), I advance our understanding of person perception and interpersonal relationships. I incorporate volatility into person perception theory by introducing the volatility, integrity, sociability, and ability (VISA) model. I illustrate the importance of unpredictable volatility and the VISA model by analyzing the use of humor, and I propose three moderators of the effects of humor on trust: content, context, and intent. In doing so, I develop a foundation for future person perception research and bridge the impression formation (warmth and competence), trust (ability, benevolence, and integrity), and status (competence, generosity, and commitment) literature.

Trust-based health decision-making recruits the neural interoceptive saliency network which relates to temporal trajectories of Hemoglobin A1C in Diabetes Type 1

Experimental approaches in neuroeconomics generally involve monetary utility. Utility in the health domain is relevant in diabetes because constant daily life decisions are critical for self-consequential long-term outcomes. We used fMRI to investigate self-consequent decision-making in the health and economic domains in Type 1 Diabetes Mellitus and controls (N = 50). We focused on two critical phases of decision-making: Investment and Feedback (Positive or Negative). Patients showed larger BOLD activation of limbic, and reward/dopaminergic regions in particular in the health trust game. Importantly, the worse the trajectory of metabolic control (increasing HbA1C), the higher the BOLD activity in regions of the interoceptive saliency network. This was manifested by positive correlations between brain activity during investment in anterior cingulate cortex and insula and HbA1c blood level progression. We conclude that the neural correlates of health-consequent decision-making domain involve limbic and reward related dopaminergic regions in Type 1 Diabetes Mellitus. Furthermore, the temporal trajectory of HbA1C blood levels is correlated with neural risk processing in the saliency network. Evidence for differential risk processing in the health versus the neuroeconomic context, and the discovery of a role for the saliency interoceptive network in metabolic control trajectories suggests a new perspective on the development of personalized interventions.