The Be REAL Framework: Enhancing Relationship-Building Skills for Community Health Workers

Trust plays an integral part in the effective functioning of public health systems. During the COVID-19 pandemic, distrust of public health fueled vaccine hesitancy and created additional barriers to immunization. Although most Americans have received at least one COVID-19 vaccine, the percentage of fully immunized adults remains suboptimal. To reach vaccine-hesitant communities, it is vital that public health be worthy of trust. As trusted members of their communities, community health workers (CHWs) can serve as ideal messengers and conversation partners for vaccination decision-making. We developed the Be REAL framework and training materials to prepare CHWs to work with vaccine-hesitant communities nationwide. Through the four steps of "Relate," "Explore," "Assist," and "Leave (the door open)," CHWs were taught to prioritize relationship building as a primary goal. In this shift from focusing on adherence to public health recommendations (e.g., get vaccinated) to building relationships, the value of vaccine uptake is secondary to the quality of the relationship being formed. The Be REAL framework facilitates CHWs harnessing the power they already possess. The goal of the Be REAL framework is to foster true partnership between CHWs and community members, which in turn can help increase trust in the broader public health system beyond adherence to a specific recommendation.

Event-triggered robot self-assessment to aid in autonomy adjustment

Introduction: Human-robot teams are being called upon to accomplish increasingly complex tasks. During execution, the robot may operate at different levels of autonomy (LOAs), ranging from full robotic autonomy to full human control. For any number of reasons, such as changes in the robot's surroundings due to the complexities of operating in dynamic and uncertain environments, degradation and damage to the robot platform, or changes in tasking, adjusting the LOA during operations may be necessary to achieve desired mission outcomes. Thus, a critical challenge is understanding when and how the autonomy should be adjusted. Methods: We frame this problem with respect to the robot's capabilities and limitations, known as robot competency. With this framing, a robot could be granted a level of autonomy in line with its ability to operate with a high degree of competence. First, we propose a Model Quality Assessment metric, which indicates how (un)expected an autonomous robot's observations are compared to its model predictions. Next, we present an Event-Triggered Generalized Outcome Assessment (ET-GOA) algorithm that uses changes in the Model Quality Assessment above a threshold to selectively execute and report a high-level assessment of the robot's competency. We validated the Model Quality Assessment metric and the ET-GOA algorithm in both simulated and live robot navigation scenarios. Results: Our experiments found that the Model Quality Assessment was able to respond to unexpected observations. Additionally, our validation of the full ET-GOA algorithm explored how the computational cost and accuracy of the algorithm was impacted across several Model Quality triggering thresholds and with differing amounts of state perturbations. Discussion: Our experimental results combined with a human-in-the-loop demonstration show that Event-Triggered Generalized Outcome Assessment algorithm can facilitate informed autonomy-adjustment decisions based on a robot's task competency.

Predictors of COVID-19 Vaccine Acceptance: The Role of Trust and the Influence of Social Media

The study discusses the predictors of COVID-19 vaccine acceptance in Romania. We implemented a national survey using an online panel (N = 1006), representative for the online population of Romania aged 18 or higher, conducted on 13-26 October, 2020, by the national pollster QUESTIA. Results show a predictive model of people's willingness to take the COVID-19 vaccine, in which trust in the actors and institutions involved in the management of the crisis is the strongest predictor, followed by the belief in toxic or misleading narratives about vaccines and the COVID-19 pandemic, and media consumption patterns. Education is a moderator of the relationship between trust and the willingness to vaccinate. Implications for professionals in the social work fields, as well as for policy-makers are discussed. Results could be used as a starting point for developing recommendations for evidence-based health communication in the context of the COVID-19 vaccination campaign.

Iraqi Population Trusts in Electronic Healthcare Records: A Cross-sectional Study

This study investigated the perceptions of Iraqi patients regarding Electronic Healthcare Records (EHRs) in terms of trust and propensity to share and exchange medical and personal information and data within the healthcare ecosystem. During the period of April to June 2022, a researcher-assisted questionnaire was disseminated to adult Iraqi patients attending public or private healthcare facilities in a subset of Iraqi governorates. Data collection was followed by descriptive and inferential analyses. In total, 552 respondents filled out the questionnaire. The findings revealed that 71.6% of respondents were conversant with EHRs and trusted them as data collection and storage systems. In addition, 10% of respondents did not want their EHRs to be shared between healthcare professionals and institutions. However, only 3.6% of participants were willing to share all of their personal information with healthcare professionals. Female respondents were considerably more willing to share their full names with healthcare professionals than male respondents, despite the society's reputation for conservatism. The findings of this study highlighted the necessity of tailoring initiatives to enhance patients' trust in EHRs and their interactions with healthcare professionals other than medical physicians.

A Literature Review on Safety Perception and Trust during Human-Robot Interaction with Autonomous Mobile Robots That Apply to Industrial Environments

Occupational ApplicationsAutonomous mobile robots are used in manufacturing and warehousing industries, to transport material across the facility and deliver parts to work cells. Human workers might encounter or interact with these robots in aisle ways or at their workstation. It is important to consider factors that impact worker safety and trust when implementing autonomous mobile robots in the workplace. This paper reviews prior research that aims to improve the safety of human-robot interaction with autonomous mobile robots and identifies needs for future research. Researchers used a variety of questionnaires and behavioral assessment methods to measure perceived safety. Factors such as robot appearance, approach speed, and approach direction, significantly affect perceived safety. Additionally, projection of signals on the floor, turn signals, and haptic communication devices, can improve the predictability and overall safety of robot navigation.

Community resilience across Australia towards natural hazards: an application of the Conjoint Community Resiliency Assessment Measurement

Natural hazards can turn into disasters when not managed well. An important part of disaster risk reduction is to understand how well communities are prepared for natural hazards and how well they can cope with and recover from shocks in the long term. This research assesses self-reported community resilience and asks what makes a community resilient, using Australia as a case study. It reports on an Australian-wide online survey which included questions related to the Conjoint Community Resiliency Assessment Measurement, a subjective indicator, as well as questions about risk perception, well-being, and self-efficacy. Community resilience was found to be moderately high but scores for community leadership and preparedness were low. Perceived community resilience was positively correlated with age and those with high scores for self-efficacy and well-being. There was, as expected, an inverse relationship between reliance on external support during natural hazards and self-efficacy. The results complement previous studies which used different measures of community resilience.

Insights on just culture from seafarers and shipping companies in Indonesia: An exploratory study

BACKGROUND

Just culture aspires to prompt organizational learning from enhanced feedback by frontline operators. Just culture requires mechanisms to eliminate fear and sanction but not accountability when reporting safety-related issues. Adopted in sectors such as aviation, just culture remains an underdeveloped field in the maritime sector.

OBJECTIVE

This study explores how some pre-requisites for a just culture (i.e., ease of reporting, motivation to report, and trust) are perceived and potentially implemented by seafarers' and shipping company safety representatives in Indonesia.

METHODS

Semi-structured interviews were used to collect qualitative data in an exploratory study involving eleven active seafarers and four safety managers from shipping companies in Indonesia.

RESULTS

The conditions for ease of reporting seem present, at least on paper. Shipping companies receive one to two near-miss reports per month. However, incidents seem to be underreported. It appears that companies are unsuccessful in establishing the motivation and trust necessary to enhance safety event reporting.

CONCLUSION

The study suggests that the concept of a just culture is not well understood among certain Indonesian shipping companies. The main barriers to implementing a just culture relate to hierarchical structures in the industry, frequent crew changes, blame culture, and lack of anonymous reporting for safety concerns.

Let's call! Using the phone to increase vaccine acceptance

In the context of the COVID-19 pandemic, we develop and test experimentally three phone-based interventions to increase vaccine acceptance in Mozambique. The first endorses the vaccine with a simple positive message. The second adds the activation of social memory on the country's success in eradicating wild polio with vaccination campaigns. The third further adds a structured interaction with the participant to develop a critical view toward misleading information and minimize the sharing of fake news. We find that combining the endorsement with the stimulation of social memory and the structured interaction increases vaccine acceptance and trust in institutions.

What Affects Perceived Trustworthiness of Online Medical Information and Subsequent Treatment Decision Making? Randomized Trials on the Role of Uncertainty and Institutional Cues

Background. Online, algorithmically driven prognostic tools are increasingly important in medical decision making. Institutions developing such tools need to be able to communicate the precision and accuracy of the information in a trustworthy manner, and so many attempt to communicate uncertainties but also use institutional logos to underscore their trustworthiness. Bringing together theories on trust, uncertainty, and psychological distance in a novel way, we tested whether and how the communication of uncertainty and the presence of institutional logos together affected trust in medical information, the prognostic tool itself, and treatment decisions. Methods. A pilot and 2 online experiments in which UK (experiment 1) and worldwide (experiment 2) participants (Ntotal = 4,724) were randomized to 1 of 12 arms in a 3 (uncertainty cue) × 4 (institutional cue) between-subjects design. The stimulus was based on an existing medical prognostic tool. Results. Institutional trust was consistently associated with trust in the prognostic tool itself, while uncertainty information had no consistent effect. Institutional trust predicted the amount of weight participants reported placing on institutional endorsements in their decision making and the likelihood of switching from passive to active treatment in a hypothetical scenario. There was also a significant effect of psychological distance to (perceived hypotheticality of) the scenario. Conclusions/Implications. These results underline the importance of institutions demonstrating trustworthiness and building trust with their users. They also suggest that users tend to be insensitive to communications of uncertainty and that communicators may need to be highly explicit when attempting to warn of low precision or quality of evidence. The effect of the perceived hypotheticality of the scenario underscores the importance of realistic decision-making scenarios for studies and the role of familiarity with the decision dilemma generally.

Highlights

In a world where information for medical decision making is increasingly going to be provided through digital, online tools, institutions providing such tools need guidance on how best to communicate about their trustworthiness and precision.We find that people are fairly insensitive to cues designed to communicate uncertainty around the outputs of such tools. Even putting "ATTENTION" in bold font or explicitly pointing out the weaknesses in the data did not appear to affect people's decision making using the tool's outputs. Institutions should take note, and further work is required to determine how best to communicate uncertainty in a way that elicits appropriate caution in lay users.People were much more sensitive to institutional logos associated with the outputs. Generalized institutional trust (rather than trust in the specific institution whose logo was shown) was associated with how trustworthy, accurate, and reliable the tool, its algorithm, and the numbers it produced were perceived to be. This underscores the role of societal trust in institutions at large.Finally, as a note to researchers, we found a significant effect of how hypothetical or believable participants felt the experimental scenario was. This is a variable that seems rarely controlled for in studies and yet played as much of a role as some of our variables of interest, so we suggest that it is measured in future experiments.

The positive association of education with the trust in science and scientists is weaker in highly corrupt countries

One of the most prominent correlates of trust in science and scientists is education level, possibly because educated individuals have higher levels of science knowledge and thinking ability, suggesting that trusting science and scientists relies more on reflective thinking abilities. However, it is relatively more reasonable for highly educated individuals to suspect authority figures in highly corrupt countries. We tested this prediction in two nationally representative and probabilistic cross-cultural data sets (Study 1: 142 countries, N = 40,085; Study 2: 47 countries, N = 69,332), and found that the positive association between education and trust in scientists (Study 1) and science (Study 2) was weaker or non-existent in highly corrupt countries. The results did not change after statistically controlling for age, sex, household income, and residence. We suggest future research to be more considerate of the societal context in understanding how education status correlates with trust in science and scientists.

From lab to society: Fostering clinical translation of molecular systems engineering

Over the last decade, bioengineering has seen a sustained growth in scientific publications, patents, and clinical trials. As the field attempts to bridge the gap between discovery and clinical application, a broader societal dialogue is needed to build public trust and address potential ethical, societal, and regulatory challenges. In this essay, we discuss societal aspects linked to the clinical use of biomedical engineering approaches and technologies, with a specific focus on molecular systems engineering. Drawing on data from interviews with 24 scientists, we identified four key aspects for fostering societal support for translational efforts in this domain: (1) effective science communication and internal awareness; (2) open societal dialogue; (3) fair and equitable access to new technologies; and (4) adequate science and technology policies. We conclude that molecular systems engineering would benefit from anticipating future challenges with the view of building a robust bond of trust with lay publics, regulators, and society at large.

Learning from an equitable, data-informed response to COVID-19: Translating knowledge into future action and preparation

Introduction

The COVID-19 pandemic revealed numerous barriers to effectively managing public health crises, including difficulties in using publicly available, community-level data to create learning systems in support of local public health decision responses. Early in the COVID-19 pandemic, a group of health care partners began meeting to learn from their collective experiences. We identified key tools and processes for using data and learning system structures to drive equitable public health decision making throughout different phases of the pandemic.

Methods

In fall of 2021, the team developed an initial theory of change directed at achieving herd immunity for COVID-19. The theoretical drivers were explored qualitatively through a series of nine 45-min telephonic interviews conducted with 16 public health and community leaders across the United States. Interview responses were analyzed into key themes to inform potential future practices, tools, and systems. In addition to the interviews, partners in Dallas and Cincinnati reflected on their own COVID-19 experiences.

Results

Interview responses fell broadly into four themes that contribute to effective, community driven responses to COVID-19: real-time, accessible data that are mindful of the tension between community transparency and individual privacy; a continued fostering of public trust; adaptable infrastructures and systems; and creating cohesive community coalitions with shared alignment and goals. These themes and partner experiences helped us revise our preliminary theory of change around the importance of community collaboration and trust building and also helped refine the development of the Community Protection Dashboard tool.

Conclusions

There was broad agreement amongst public health and community leaders about the key elements of the data and learning systems required to manage public health responses to COVID-19. These findings may be informative for guiding the use of data and learning in the management of future public health crises or population health initiatives.

It's More Than a Matter of Trust: What Parents and Young Children Need to Know to Prevent Intrafamilial Child Sexual Abuse

Programs aimed at preventing child sexual abuse typically focus on skilling up young children and, to a lesser extent, parents by imparting a range of protective messages. Many sexual abuse prevention programs include a focus on identifying or vetting "safe" or "trustworthy" people. The authors qualitatively analyzed the content of narratives from individuals with childhood experience of intrafamilial sexual abuse, an under-represented voice in the development of child sexual abuse prevention programs. The analysis of impediments to protection indicated that, within the family context, reductionistic judgments of familiar individuals' perceived safety or trustworthiness impaired child safety. In addition to adults and children being unable to recognize sexually abusive behavior and warning signs, child-victim survivor narratives highlighted the barriers for prevention in family environments characterized by maltreatment, a lack of child rights or that were unsupported by external authorities. Implications for the content of messages young children and their parents need to prevent child sexual victimization in the context of everyday family life are discussed.

Trustworthy artificial intelligence and the European Union AI act: On the conflation of trustworthiness and acceptability of risk

In its AI Act, the European Union chose to understand trustworthiness of AI in terms of the acceptability of its risks. Based on a narrative systematic literature review on institutional trust and AI in the public sector, this article argues that the EU adopted a simplistic conceptualization of trust and is overselling its regulatory ambition. The paper begins by reconstructing the conflation of "trustworthiness" with "acceptability" in the AI Act. It continues by developing a prescriptive set of variables for reviewing trust research in the context of AI. The paper then uses those variables for a narrative review of prior research on trust and trustworthiness in AI in the public sector. Finally, it relates the findings of the review to the EU's AI policy. Its prospects to successfully engineer citizen's trust are uncertain. There remains a threat of misalignment between levels of actual trust and the trustworthiness of applied AI.

The de-perimeterisation of information security: The Jericho Forum, zero trust, and narrativity

This article analyses the transformation of information security induced by the Jericho Forum, a group of security professionals who argued for a new 'de-perimeterised' security model. Having focused on defensive perimeters around networks, early 2000s information security faced a growing set of pressures: the maintainability of firewalls given increasing traffic volume and variety, the vulnerability of interior network domains, and the need to cope with and enable new working arrangements and ways of doing business. De-perimeterisation was a radical rethinking of the nature of security and created the conditions for the rise of 'Zero Trust' architectures. This shift has radical implications for the architectures of digital infrastructures that undergird many aspects of contemporary life, the risks to which people and societies are exposed, and the nature of work and business in a digital economy. We develop a semiotic analysis of the Jericho Forum's interventions. Using insights from material semiotics, security theory and the theory of narrativity, we argue that de-perimeterisation can be understood as a shift in security logic, or, a shift in how security can (be made to) make sense. We examine a cluster of images used by the Jericho Forum, and analyse how they challenged the coherence of perimeter-based thinking and provided the materials for constructing a new model. We argue that a focus on the narrative dimension of security provides a window into fundamental semantic transformations, reciprocal historical relations between semantics and technical change, the agencement of security technologies, and determinations of value (what is worth securing).

Patient perspectives on factors influencing active surveillance adherence for low-risk prostate cancer: A qualitative study

BACKGROUND

Prostate cancer is the most common cancer among men in the United States. Treatment guidelines recommend active surveillance for low-risk prostate cancer, which involves monitoring for progression, to avoid or delay definitive treatments and their side effects. Despite increased uptake, adherence to surveillance remains a challenge.

METHODS

We conducted semi-structured, qualitative, virtual interviews based on the Theoretical Domains Framework (TDF), with men (15) who were or had been on active surveillance for their low-risk prostate cancer in 2020. Interviews were transcribed and coded under TDF's behavioral theory-based domains. We analyzed domains related to adherence to surveillance using constructivist grounded theory to identify themes influencing decision processes in adherence.

RESULTS

The TDF domains of emotion, beliefs about consequences, environmental context and resources, and social influences were most relevant to surveillance adherence-. From these four TDF domains, three themes emerged as underlying decision processes: trust in surveillance as treatment, quality of life, and experiences of self and others. Positive perceptions of these three themes supported adherence while negative perceptions contributed to non-adherence (i.e., not receiving follow-up or stopping surveillance). The relationship between the TDF domains and themes provided a theoretical process describing factors impacting active surveillance adherence for men with low-risk prostate cancer.

CONCLUSIONS

Men identified key factors impacting active surveillance adherence that provide opportunities for clinical implementation and practice improvement. Future efforts should focus on multi-level interventions that foster trust in surveillance as treatment, emphasize quality of life benefits and enhance patients' interpersonal experiences while on surveillance to optimize adherence.

Explaining Chinese Consumers' Continuous Consumption Intention toward Prepared Dishes: The Role of Perceived Risk and Trust

With the rapid development and the increasing importance of the consumer market of prepared dishes in China, it is imperative to study the formation mechanism of Chinese consumers' continuous consumption intention (CCI) toward prepared dishes for promoting the sustainable development of Chinese prepared dishes industry. The aim of this study is to study the formation mechanism and the role of perceived risk and trust in it. Based on the Expectation Confirmation Model, this study constructed a model of continuous consumption intention of prepared dishes by introducing perceived risk and trust. 381 adult consumers were surveyed and the data was analyzed by an Exploratory Factor Analysis and the Partial Least Squares Structure Equation Model. The results showed that: (1) The confirmation of expectation had a significant positive impact on trust and satisfaction, a significant negative impact on the perceived risk (PR). Trust and satisfaction had a significant positive, while PR had a significant negative, impact on CCI. (2) The dimensions of PR included social, health, quality, psychological and purchasing risk, among which quality risk had a significant negative impact on CCI. (3) All dimensions of trust (ability, integrity, benevolence and government trust) had a significant positive impact on CCI, among which integrity trust played the most important role. (4) Overall, trust had a significant negative impact on PR. Benevolence trust could mitigate all dimensions of PR, integrity trust could mitigate all dimensions of PR except health risk, and ability trust, government trust could only mitigate quality risk. Therefore, the enterprises should pay high attention to the quality of their products and the establishment and maintenance of consumer trust, and the government should establish an authoritative image.

Risk, Trust, and Emotion in Online Pharmacy Medication Purchases: Multimethod Approach Incorporating Customer Self-Reports, Facial Expressions, and Neural Activation

BACKGROUND

Online pharmacies are used less than other e-commerce sites in Germany. Shopping behavior does not correspond to consumption behavior, as online purchases are predominantly made for over-the-counter (OTC) medications.

OBJECTIVE

The objective of this study was to understand the purchasing experiences of online pharmacy customers in terms of critical factors for online pharmacy adoption.

METHODS

This study examined the perceived risk, perceived trust, and emotions related to purchasing medications online and, consequently, the purchase intention toward online pharmacies. In a within-subjects design (N=37 participants), 2 German online pharmacies with different perceptions of risk and trust were investigated for their main business, namely OTC and prescription drugs. The results of a preliminary study led to 1 online pharmacy with high and 1 with significantly low self-reported risk by the prestudy sample. Emotions were measured with a multimethod approach during and after the purchase situation as follows: (1) neural evaluation processes using functional near-infrared spectroscopy, (2) the automated direct motor response during the use of the online pharmacy via facial expression analysis (FaceReader), and (3) subjective evaluations through self-reports. Following the shopping experiences at both pharmacies for both product types, risk, trust, and purchase intention toward the pharmacies were assessed using self-assessments.

RESULTS

The 2 online pharmacies were rated differently in terms of risk, trust, emotions, and purchase intention. The high-risk pharmacy was also perceived as having lower trust and vice versa. Significantly stronger negative emotional expressions on customers' faces and different neural activations in the ventromedial prefrontal cortex and dorsomedial prefrontal cortex were measured when purchasing prescription drugs from the high-risk pharmacy than from the low-risk pharmacy, combined with OTC medications. In line with this, customers' self-ratings indicated higher negative emotions for the high-risk pharmacy and lower negative emotions for the low-risk pharmacy. Moreover, the ratings showed lower purchase intention for the high-risk pharmacy.

CONCLUSIONS

Using multimethod measurements, we showed that the preceding neural activation and subsequent verbal evaluation of online pharmacies are reflected in the customers' immediate emotional facial expressions. High-risk online pharmacies and prescription drugs lead to stronger negative emotional facial expressions and trigger neural evaluation processes that imply perceived loss. Low-risk online pharmacies and OTC medications lead to weaker negative emotional facial expressions and trigger neural evaluation processes that signify certainty and perceived reward. The results may provide an explanation for why OTC medications are purchased online more frequently than prescription medications.

The Role of Trust in Disaster Risk Reduction: A Critical Review

In recent years, there has been a growing interest in the concept of trust within the domain of natural disaster management. Trust can be defined as a state of vulnerability where one party relies on another party with the expectation that the latter will carry out entrusted responsibilities without exploiting this inherent vulnerability. This comprehensive literature review is dedicated to the examination of research concerning community and institutional trust in the field of disaster risk reduction (DRR). Particular emphasis is placed on elucidating the influence of trust throughout the distinct phases of natural disaster management, namely prevention, preparedness, response, and recovery. The critical examination of the pertinent body of the literature demonstrates that trust plays a central role across the different phases of DRR, being positively associated with effective community responses and resilience. Hence, it becomes imperative to actively foster the development of trust at both institutional and community levels within the realm of DRR. This endeavor is essential for adequately preparing communities to confront natural disasters, crafting effective protocols to enhance community responsiveness and mitigate adverse consequences, and advancing strategies for successful reconstruction and recovery.

COVID-19 Vaccine for Children: Determinants and Beliefs Contributing to Vaccination Decision of Parents in Germany 2021/2022

To reduce the number of COVID-19 cases, vaccines were rapidly made available worldwide. For a strategically targeted response to the COVID-19 pandemic, population vaccination coverage was to be maximized. The target groups also included healthy children. In this context, it is important to understand the determinants and beliefs that lead parents to favor or oppose COVID-19 immunization in children. This study aimed to investigate parents' COVID-19 vaccination willingness in Germany for children aged 5-11 years in 2021/2022. For this purpose, the determinants and beliefs behind parents' vaccination decisions were examined. Descriptive analysis and bivariate correlations were performed on COVID-19 vaccination willingness and parents' mental health status, general vaccination attitudes, and SARS-CoV-2 politics perceptions. In total, 2401 participants fully participated in this cross-sectional study. The COVID-19 vaccination uptake (71.4%) outweighed the vaccination refusal (19.4%). Correlations revealed higher vaccine acceptance in parents presenting full vaccination certificates (90.9%), COVID-19 immunizations (99.9%), or increased COVID-19 fear (93.6%). Vaccination-refusal was associated with higher perceived pressure by COVID-19 vaccination campaigns (87.7%), higher experienced restrictions due to COVID-19 protective measures in parents' social environment (83.6%), and engagement against COVID-19 protective measures (51.6%). Besides general anxiety, no significant correlations were observed between parents' mental health variables and vaccination willingness. Although several factors are ultimately associated with vaccination willingness, future vaccination campaigns should prioritize reducing pressure, increasing trust, and considering parents' differentiation between familiar and unfamiliar pathogens during their vaccination decision-making process.

High vaccine confidence and strong approval of the mandatory immunization schedule among Bulgarian general practitioners in 2022

In a context of recently decreasing childhood immunization coverage and low uptake of COVID-19 vaccines in Bulgaria, this study measures vaccine hesitancy among general practitioners (GPs) in the country, as they are central to forming patients' attitudes. In 2022, a face-to-face survey was conducted through a simple random sample from an exhaustive national database of Bulgarian GPs. This study measured attitudes on vaccine importance, safety, and effectiveness, and attitudes toward the Bulgarian immunization schedule. Information was collected on demographic and GP practice characteristics and possible predictors of vaccine confidence in order to test for associations with attitudes toward immunization. GP attitudes toward vaccines and the immunization schedule in Bulgaria were generally positive. Among 358 respondents, 351 (98%,95%CI96-99%) strongly agreed/agreed that vaccines are important, 352 (98%,95%CI96-99%) that vaccines are effective, and 341 (95%,95%CI93-97%) that vaccines are safe. 347 respondents (97%,95%CI95-98%) affirmed that "it's good that vaccines from the children's immunization schedule are mandatory", and 331 (92%,95%CI89-95%) agreed with the statement "Bulgaria's childhood immunization has my approval". Trust in information from official institutions was among the strongest predictors of vaccine confidence. Respondents' vaccine confidence levels are within the ranges reported by GPs in other European countries and above those reported within the general Bulgarian population. GPs' vaccine confidence is highly associated with trust in official institutions. It is important to maintain trust in official institutions and to support GPs in communicating vaccine knowledge with patients so that vaccine hesitancy in the general population is countered.

Access Control, Key Management, and Trust for Emerging Wireless Body Area Networks

Wireless Body Area Networks (WBANs) are an emerging industrial technology for monitoring physiological data. These networks employ medical wearable and implanted biomedical sensors aimed at improving quality of life by providing body-oriented services through a variety of industrial sensing gadgets. The sensors collect vital data from the body and forward this information to other nodes for further services using short-range wireless communication technology. In this paper, we provide a multi-aspect review of recent advancements made in this field pertaining to cross-domain security, privacy, and trust issues. The aim is to present an overall review of WBAN research and projects based on applications, devices, and communication architecture. We examine current issues and challenges with WBAN communications and technologies, with the aim of providing insights for a future vision of remote healthcare systems. We specifically address the potential and shortcomings of various Wireless Body Area Network (WBAN) architectures and communication schemes that are proposed to maintain security, privacy, and trust within digital healthcare systems. Although current solutions and schemes aim to provide some level of security, several serious challenges remain that need to be understood and addressed. Our aim is to suggest future research directions for establishing best practices in protecting healthcare data. This includes monitoring, access control, key management, and trust management. The distinguishing feature of this survey is the combination of our review with a critical perspective on the future of WBANs.

Parent Perceptions of Trainees in Pediatric Care: Cross-Sectional Study

BACKGROUND

Clinical experience and progressive autonomy are essential components of medical education and must be balanced with patient comfort. While previous studies have suggested that most patients accept trainee involvement in their care, few studies have focused specifically on the views of parents of pediatric patients or examined groups who may not report acceptance.

OBJECTIVE

This study aims to understand parental profiles of resident and medical student involvement in pediatric care and to use latent class analysis (LCA) methodology to identify classes of responses associated with parent demographic characteristics.

METHODS

We used data from a national cross-sectional web-based survey of 3000 parents. The survey used a 5-point Likert scale to assess 8 measures of parent perceptions of residents and medical students. We included participants who indicated prior experience with residents or medical students. We compared responses about resident involvement in pediatric care with responses about student involvement, used LCA to identify latent classes of parent responses, and compared demographic features between the latent classes.

RESULTS

Of the 3000 parents who completed the survey, 1543 met the inclusion criteria for our study. Participants reported higher mean scores for residents than for medical students for perceived quality of care, comfort with autonomously performing an examination, and comfort with autonomously giving medical advice. LCA identified 3 latent classes of parent responses: Trainee-Hesitant, Trainee-Neutral, and Trainee-Supportive. Compared with the Trainee-Supportive and Trainee-Neutral classes, the Trainee-Hesitant class had significantly more members reporting age <30 years, household income < US $50,000, no college degree, and lesser desire to receive future care at a teaching hospital (all P<.05).

CONCLUSIONS

Parents may prefer greater clinical autonomy for residents than medical students. Importantly, views associated with the Trainee-Hesitant class may be held disproportionately by members of historically and currently socially marginalized demographic groups. Future studies should investigate underlying reasons for trainee hesitancy in these groups, including the possibility of mistrust in medicine.

Can Treating Oneself Kindly Inspire Trust? The Role of Interpersonal Responsibility

Self-compassion, as a personal psychological resource, has been proved to play an important role in coping with suffering. Based on self-determination theory, the present study attempts to establish that self-compassion can promote trust, and the sense of interpersonal responsibility mediates this relationship. Study 1 used cross-sectional data in a community sample of 322 adults to reveal that self-compassion was positively related to trust, and the mediating effects of the sense of interpersonal responsibility were significant. Study 2 used the latent cross-lagged panel model among 1304 college students at three-time points set at six-month intervals to replicate the results and proved the longitudinal mediating effects across groups. Finally, a casual chain design was used to test the mediation effect in Studies 3 and 4. The results indicated that self-compassion induced by writing task resulted in a sense of responsibility in Study 3 (N = 145), and the manipulated sense of responsibility promoted both trust behaviors and beliefs in Study 4 (N = 125). Through four studies, this study highlights a novel but unexpected viewpoint that treating oneself in a self-compassionate way can not only help individuals cope with various challenges but also motivate them to obtain interpersonal benefits. These findings can help motivate community workers and mental health researchers to increase social capital by focusing on self-compassion and interpersonal responsibility.

Centring the voices of survivors of child sexual abuse in research: an act of hermeneutic justice

Survivors of child sexual abuse (CSA) are known to hold silence and create distance between themselves and service providers for self-protection, as groomed behaviour or to protect the listener from vicarious trauma. Silence for many survivors has also been reinforced as a beneficial action by previous experiences of disclosing and being rejected, challenged, or disbelieved. How can researchers be sure the same dynamic is not playing out in research interviews? Generating reliable research data is an imperative and an act of epistemic justice that enables CSA survivors to testify to the suffering caused by abuse and subsequent trauma distress and to contribute to social discourse for change. Fricker, however, notes that the precursor to testimonial justice is hermeneutic justice. Hermeneutic justice pivots on the dual action of accurate understanding and interpretation, but CSA experiences may be beyond the comprehension of untraumatised listeners because their own frame of reference renders them unable or unwilling (even if unconsciously) to entertain the truth of such human depravity and cruelty. If survivors are not understood, their testimonies can be misconstrued or oftentimes excluded from the generation of epistemic knowledge, leaving the survivors unable to make sense of, and process, their experiences. These are crucial issues for researchers in the field of CSA and other crimes of sexual and gendered abuse. This study considers the operationalisation of a participatory research approach held within a lived experience research paradigm. Such methodologies advocate for peer involvement, which is becoming more widely recognised as supporting testimonial justice and the accurate understanding and interpretation of survivors' testimonies. The issue of validating the methodology and methods is considered, exploring a rigorous data audit and researcher reflexivity as contributors to trustworthy data. Peer and participant safety when researching through lived experience is addressed. Data from a doctoral research study are used to illustrate this article.

Trust, individualism, and the logics of care in middle America during the first year of the COVID-19 pandemic

Polarization and turf-wars have characterized the COVID-19 response in the United States. While COVID-19 narratives can be binary and divisive, how people cared for each other throughout the first year of the pandemic is more nuanced. This article describes how and why constructs of fear, individualism, wellbeing, and personal risk-taking became imbued in behaviors that thwarted the risk of the collective. This work is based on informal conversations, public forums, and 86 in-depth interviews during the 2020 summer in a small tourist town in northwest Iowa. Some believed engaging in public health prevention was not their responsibility and instead privileged their personal enjoyment, finances, or mental health over others, de-emphasizing personal risk and stating God will protect them. Others were deeply committed to public health prevention, by staying home, masking, and social distancing. In both cases, people used shame to promote their views (e.g., shame on you for masking/unmasking!) as well as fear (e.g., I do/don't fear coronavirus because I am virtuous). However, most engaged in logics of care, navigating what public health precautions to follow to protect themselves and those they loved most. Yet, such decisions were navigated through a culture of individualism and ideals of personal responsibility that cultivated a mistrust in public health. Understanding how and why such individualism took hold in American publics is a crucial inflection point for policy-making as well as cultural interpretation of why and how people construct risk and responsibility.

Meaningful Communication but not Superficial Anthropomorphism Facilitates Human-Automation Trust Calibration: The Human-Automation Trust Expectation Model (HATEM)

OBJECTIVE

The objective was to demonstrate anthropomorphism needs to communicate contextually useful information to increase user confidence and accurately calibrate human trust in automation.

BACKGROUND

Anthropomorphism is believed to improve human-automation trust but supporting evidence remains equivocal. We test the Human-Automation Trust Expectation Model (HATEM) that predicts improvements to trust calibration and confidence in accepted advice arising from anthropomorphism will be weak unless it aids naturalistic communication of contextually useful information to facilitate prediction of automation failures.

METHOD

Ninety-eight undergraduates used a submarine periscope simulator to classify ships, aided by the Ship Automated Modelling (SAM) system that was 50% reliable. A between-subjects 2 × 3 design compared SAM appearance (anthropomorphic avatar vs. camera eye) and voice inflection (monotone vs. meaningless vs. meaningful), with the meaningful inflections communicating contextually useful information about automated advice regarding certainty and uncertainty.

RESULTS

Avatar SAM appearance was rated as more anthropomorphic than camera eye, and meaningless and meaningful inflections were both rated more anthropomorphic than monotone. However, for subjective trust, trust calibration, and confidence in accepting SAM advice, there was no evidence of anthropomorphic appearance having any impact, while there was decisive evidence that meaningful inflections yielded better outcomes on these trust measures than monotone and meaningless inflections.

CONCLUSION

Anthropomorphism had negligible impact on human-automation trust unless its execution enhanced communication of relevant information that allowed participants to better calibrate expectations of automation performance.

APPLICATION

Designers using anthropomorphism to calibrate trust need to consider what contextually useful information will be communicated via anthropomorphic features.

Adolescents' trust and reciprocity toward friends, unknown peers, and community members

Using a newly developed version of the Trust Game among 196 adolescents aged 11-20 years, this study examined whether adolescents distinguish between trust and reciprocity to unknown peers, friends, and community members. We also tested for effects of age, gender, and individual differences in attending to others' emotions, emotional support to friends, societal contributions, and institutional and interpersonal trust beliefs. Results indicated that adolescents showed the least trust and reciprocity to unknown peers, more to a community member, and most to friends. Reciprocity increased with age, and individual differences in societal contributions and interpersonal trust were positively related to trust and reciprocity. This study was the first to show that community members are a specific target in adolescents' social world.

Public Engagement through Inclusive Deliberation: The Human Genome International Commission and Citizens' Juries

In this paper, I take seriously calls for public engagement in human genome editing decision-making by endorsing the convening of a "Citizens Jury" in conjunction with the International Commission on the Clinical Use of Human Germline Genome Editing's next summit scheduled for March 6-8, 2023. This institutional modification promises a more inclusive, deliberative, and impactful form of engagement than standard bioethics engagement opportunities, such as comment periods, by serving both normative and political purposes in the quest to offer moral guidance on gene editing. In examining evidence from the Australian Citizens' Jury on Genome Editing convened in 2021, I argue that Citizens' Juries should work in tandem with governing institutions to preserve the role of expertise while ensuring that the diverse views of the public are incorporated into their final reports as well. First, early inclusivity allows "the people" to hold agenda setting power through helping to set resource priorities. This also makes a downstream deliberative event, such as the called for Global Citizens' Assembly, both more likely to occur and more influential on policy. Second, Jury's diverse composition promises substantive contributions to the Commission's work. Third, Citizens' Juries could help to cultivate the Commission's trustworthiness.

'If you had taken the lead…' - a qualitative study of patients with chronic conditions and their perspective in clinical encounters with medical students

OBJECTIVES

To explore what patients with chronic conditions emphasize as important in the patient-medical student conversation, and how the patients' experiences relate to trust.

METHODS

Twenty-one video-recorded sessions of patients' feedback in simulation-based communication courses for medical students were observed, transcribed, analyzed inductively and organized into three themes.

RESULTS

In the patients' feedback, three aspects were emphasized as important relating to trust: a) when the medical student relates medical information to the patient's lifeworld, b) when the student leads the patient throughout the conversation, and c) when the patient gets emotional support from the student. The patients felt that being met this way by the students grows trust and allows them to lean into the uncertainties they experience while still feeling safe.

DISCUSSION

The patients emphasize three aspects of importance in conversations with the medical students that grow trust. We argue that these aspects cannot be found in the traditional authority-led practice but can be found in leadership, which imply empathy and willingness to learn from patients. We suggest that students should learn that to effectively communicate with patients infers such leadership. By doing so, medical students can walk alongside their patients to build a relationship and nurture trust.

Trusted sources for COVID-19 testing and vaccination: lessons for future health communication

BACKGROUND

Promoting COVID-19 vaccination (both the primary series and boosters) remains a priority among healthcare professionals and requires understanding the various sources people trust for acquiring COVID-19 information.

METHOD

From October 2021 to May 2022, we interviewed 150 people who called 2-1-1 helplines in Connecticut and North Carolina about their COVID-19 testing and vaccination experiences in order to (1) better understand where people obtain trusted COVID-19 health information and (2) identify how public health professionals can share emergency health information in the future. We used a mixed methods approach in which semi-structured qualitative interviews and survey data were collected in parallel and analyzed separately.

RESULTS

Participants were mostly female (74.0%), Black (43.3%) or White (38.0%), and had a high school degree or higher (88.0%). Most had prior COVID-19 testing experience (88.0%) and were vaccinated (82.7%). A variety of information sources were rated as being very trustworthy including medical professionals and social service organizations. We found that repetition of information from multiple sources increased trust; however, perceived inconsistencies in recommendations over time eroded trust in health communication, especially from government-affiliated information sources. Observations such as seeing long lines for COVID-19 testing or vaccination became internalized trusted information.

CONCLUSIONS

Public health professionals can leverage the reach and strong community ties of existing, reputable non-government organizations, such as physician groups, schools, and pharmacies, to distribute COVID-19 information about vaccination and testing.

Factors Associated With Postoperative Decisional Regret in Patients Undergoing Gastrointestinal Cancer Surgery: A Prospective Cohort Study

BACKGROUND

Surgery is recommended as the first-line treatment option to cure resectable gastrointestinal (GI) cancer. However, patients occasionally feel postoperative regret after surgery. To date, it is not clear which factors are associated with patient regret after GI cancer surgery. The aim of this study was to investigate factors related to postoperative decision regret in patients undergoing surgery for GI cancer.

METHODS

The present prospective study used questionnaires to analyze postoperative decision regret in patients undergoing GI cancer surgery in our institution between February and July 2020. Decision regret that patients felt after surgery was quantitatively measured using the decision regret scale (DRS). Multivariable linear regression models were used to examine factors related to postoperative decision regret.

RESULTS

Among 70 patients analyzed, the median (interquartile range) DRS score was 10.0 (.0-25.0). Multivariable analysis showed that preoperative Trust in Physician Scale score (partial regression coefficient (B) = -.77; 95% confidence interval (CI) = -1.13 to -.41; P < .001) and postoperative complications (B = 9.17; 95% CI = 2.20 to 16.15; P = .0011) were significantly associated with DRS score.

DISCUSSION

Preoperative trust in physician and postoperative complications were significantly associated with postoperative decision regret in patients undergoing surgery for GI cancer. Although patients may regret their choice of surgery when postoperative complications occur, trust in their physician may help reduce feelings of regret.

Order Online or Call it in? Conceptualization and Measurement of Preferences for Computer versus Human Interaction

Technology is increasingly integrated into everyday life and consequently, traditional social exchanges between human agents have evolved to include human-computer interaction, providing scientists new directions for understanding and predicting consumer behavior. Despite progress, there are conceptual and empirical limitations in current measures applied to consumer/user preferences. This paper documents the development and validation of the 10-item preference for computer versus human interaction (PCHI) scale across three distinct samples and incorporating items that (a) include direct comparisons between computers and humans, (b) are independent of specific contexts or technologies, and (c) capture major theoretical domains of social, consumer, and human factors psychology. Results support the hypothesized three-factor structure (efficiency, ease of use, and trust) and demonstrate the utility of this measure to predict everyday consumer decisions beyond extant measures. Additionally, the PCHI offers marketing, user experience, and other practitioners a brief instrument for developing interventions, training protocols, and modeling attitudes.

Adoption of Wearable Insulin Biosensors for Diabetes Management: A Cross-Sectional Study

BACKGROUND

Wearable insulin biosensors represent a novel approach that combines the benefits of real-time glucose monitoring and automated insulin delivery, potentially revolutionizing how individuals with diabetes manage their condition.

STUDY PURPOSE

To analyze the behavioral intentions of wearable insulin biosensors among diabetes patients, the factors that drive or hinder their usage, and the implications for diabetes management and healthcare outcomes.

METHODS

A cross-sectional survey design was adopted in this study. The validated questionnaire included 10 factors (Performance expectancy, effort expectancy, social influence, facilitating conditions, behavioral intention, trust, perceived privacy risk, and personal innovativeness) affecting the acceptance of wearable insulin sensors. A total of 248 diabetic patients who had used wearable sensors participated in the study.

RESULTS

Performance expectancy was rated the highest (Mean = 3.84 out of 5), followed by effort expectancy (Mean = 3.78 out of 5), and trust (Mean = 3.53 out of 5). Statistically significant differences (p < 0.05) were observed with respect to socio-demographic variables including age and gender on various influencing factors and adoption intentions. PE, EE, and trust were positively associated with adoption intentions.

CONCLUSION

While wearable insulin sensors are positively perceived with respect to diabetes management, issues like privacy and security may affect their adoption.

Spirometry services in England post-pandemic and the potential role of AI support software: a qualitative study of challenges and opportunities

BACKGROUND

Spirometry services to diagnose and monitor lung disease in primary care were identified as a priority in the NHS Long Term Plan, and are restarting post-COVID-19 pandemic in England; however, evidence regarding best practice is limited.

AIM

To explore perspectives on spirometry provision in primary care, and the potential for artificial intelligence (AI) decision support software to aid quality and interpretation.

DESIGN AND SETTING

Semi-structured interviews with stakeholders in spirometry services across England.

METHOD

Participants were recruited by snowball sampling. Interviews explored the pre- pandemic delivery of spirometry, restarting of services, and perceptions of the role of AI. Transcripts were analysed thematically.

RESULTS

In total, 28 participants (mean years' clinical experience = 21.6 [standard deviation 9.4, range 3-40]) were interviewed between April and June 2022. Participants included clinicians (n = 25) and commissioners (n = 3); eight held regional and/or national respiratory network advisory roles. Four themes were identified: 1) historical challenges in provision of spirometry services; 2) inequity in post- pandemic spirometry provision and challenges to restarting spirometry in primary care; 3) future delivery closer to patients' homes by appropriately trained staff; and 4) the potential for AI to have supportive roles in spirometry.

CONCLUSION

Stakeholders highlighted historic challenges and the damaging effects of the pandemic contributing to inequity in provision of spirometry, which must be addressed. Overall, stakeholders were positive about the potential of AI to support clinicians in quality assessment and interpretation of spirometry. However, it was evident that validation of the software must be sufficiently robust for clinicians and healthcare commissioners to have trust in the process.

Trust and distrust in low-income Michigan residents during the early COVID-19 pandemic: A qualitative study

BACKGROUND

Trust and distrust have shaped health behaviour during the COVID-19 pandemic. Since the start of the pandemic, misinformation and polarization eroded trust across the United States. In states like Michigan, pandemic restrictions led to significant unrest. Michiganders also faced disproportionate morbidity and mortality from COVID-19 during this period.

OBJECTIVE

The objective of this qualitative study was to understand the individual experiences of trust in low-income Michiganders during the early COVID-19 pandemic.

PARTICIPANTS

Twenty-four participants at or below 200% of the federal poverty line who resided in Michigan were recruited for this study.

APPROACH

Interviews were conducted during the winter of 2020 using a formal interview guide that addressed sources of information, perceptions of risk and exposure, protective behaviours and impacts of the pandemic at home, work and in receiving healthcare.

RESULTS

Thematic analysis showed that themes of trust and distrust emerged in multiple facets of our participants' experiences, including in the context of information sources, the behaviours of others, health, financial security, employment and overall safety. Trust and distrust in low-income communities often stemmed from significant financial and economic vulnerabilities and instability in access to healthcare that was exacerbated in the pandemic. Furthermore, participant trust was shaped by internal (e.g., relationships with others) and external (e.g., source of information, social inequity) factors that influenced their perceptions and experiences during the pandemic.

CONCLUSION

Trust has played an important role in many aspects of the experiences of low-income communities during the COVID-19 pandemic. This is important for clinicians to consider as COVID-19 becomes endemic, and trust continues to impact patients' approaches to vaccines, testing and treatment options.

PATIENT OR PUBLIC CONTRIBUTION

This study was designed and conducted with the assistance and input of the members of the DECIDERS Steering Committee, a diverse statewide network of community members in Michigan. The DECIDERS team allows community members to have a voice in the design and conduct of health research, and collaborates with researchers to improve health across the state of Michigan.

Trust and confidence in using telehealth in people with chronic kidney disease: A cross-sectional study

Consumer trust and confidence in telehealth is pivotal to successful service implementation and effective consultations. This cross-sectional study measured trust and confidence in telephone and video consultations and associated with experience in telehealth modalities among people with chronic kidney disease at a metropolitan hospital in Australia. Self-report data were collected using validated trust and confidence in telehealth scales and 5-point Likert responses. Non-parametric tests were used to compare trust and confidence in telephone and video consultations (Wilcoxon Matched Pairs) and associations with telehealth experience (Mann-Whitney). Of the 156 survey participants, 96.2% had used telephone consultations and 28.9% had used video. Overall trust and confidence in using telehealth were high. Confidence (range 1-5) in using telephone consultations (mean 3.75 ± 0.71) was significantly higher than video consultation (mean 3.64 ± 0.74), p = 0.039. Trust in telephone consultations (mean 3.93 ± 0.64) was significantly higher than in video consultations (mean 3.67 ± 0.66), p < 0.001. There was a significant association between experience with telephone consultations and reported levels of trust and confidence in telephone consultations. Experience with video was significantly related to trust in video consultations, but not confidence. Given the substantial difference in experience between telehealth modalities, trust and confidence may change as further exposure occurs.

Vaccine Nationalism Counterintuitively Erodes Public Trust in Leaders

Global access to resources like vaccines is key for containing the spread of infectious diseases. However, wealthy countries often pursue nationalistic policies, stockpiling doses rather than redistributing them globally. One possible motivation behind vaccine nationalism is a belief among policymakers that citizens will mistrust leaders who prioritize global needs over domestic protection. In seven experiments (total N = 4,215 adults), we demonstrate that such concerns are misplaced: Nationally representative samples across multiple countries with large vaccine surpluses (Australia, Canada, United Kingdom, and United States) trusted redistributive leaders more than nationalistic leaders-even the more nationalistic participants. This preference generalized across different diseases and manifested in both self-reported and behavioral measures of trust. Professional civil servants, however, had the opposite intuition and predicted higher trust in nationalistic leaders, and a nonexpert sample also failed to predict higher trust in redistributive leaders. We discuss how policymakers' inaccurate intuitions might originate from overestimating others' self-interest.

Trust and distrust toward online health information in nurse-patient communication and implications for eHealth literacy

BACKGROUND

In Norwegian hospitals, patients with newly diagnosed inflammatory joint disease are offered consultations with nurses, to address health issues related to their diagnosis and treatment. This study examines how issues of trust manifest in the communication between nurses and patients in clinical encounters; of particular interest are the accounts of trust and distrust toward online health information (OHI) linked to patients' eHealth literacy.

METHODS

Video-recorded observational data were collected from 16 primary nurse-patient consultations and 10 follow up consultations in a Norwegian hospital setting. Rhetorical discourse analysis was applied to examine the conversations, focusing on the rhetorical devices that were expressed by the nurses and the patients, such as justifications, contrasting, character work, and reported speech.

RESULTS

The nurses acknowledged patients' references to online search activities related to health information while expressing their own reservations about OHI. The nurses explicitly and implicitly advised patients on specific eHealth literacy strategies, namely, to consult trustworthy sources, such as patient organizations; to trust the medical knowledge conveyed by health personnel; to distrust non-professional health advice online; and to avoid self-diagnosis based on health information sought on the Internet.

CONCLUSIONS

Through the use of rhetorical devices, the nurses implicitly addressed eHealth literacy strategies in their communication with patients, including the importance of critically assessing the trustworthiness of health information. This complex communicative task requires a sensitivity toward patients' eHealth literacy levels.

What generative AI means for trust in health communications

ABSTRACTLarge language models are fundamental technologies used in interfaces like ChatGPT and are poised to change the way people access and make sense of health information. The speed of uptake and investment suggests that these will be transformative technologies, but it is not yet clear what the implications might be for health communications. In this viewpoint, we draw on research about the adoption of new information technologies to focus on the ways that generative artificial intelligence (AI) tools like large language models might change how health information is produced, what health information people see, how marketing and misinformation might be mixed with evidence, and what people trust. We conclude that transparency and explainability in this space must be carefully considered to avoid unanticipated consequences.

Trusting information systems in everyday work events - effects on cognitive resources, performance, and well-being

In today's data-intensive work environments, information systems are crucial for supporting workers. However, workers often do not rely on these systems but resort to workarounds. We argue that trust is essential for workers' reliance on information systems, positively affecting workers' cognitive resources, performance, and well-being. Moreover, we argue that the organisational context (accountability, distractions) and user-related factors qualify trust-outcome associations by affecting workers' trust calibration. In a preregistered study, we asked N = 291 employed users of information systems to re-experience prior everyday usage events (event reconstruction method) and assess event-specific trust in the system, work outcomes, and context conditions. Results confirmed the assumed association between trust in the information system and workers' ratings of both performance and well-being. Moreover, workers' technology competence and need for cognition - but not contextual conditions - qualified trust-outcome associations. Our results offer specific suggestions for achieving successful use of information systems at work.

Understanding the evolution of trust in a participatory health research partnership: A qualitative study

INTRODUCTION

Advancements in evaluating the impact of participatory health research (PHR) have been made through comprehensive models like the community-based participatory research (CBPR) conceptual model, which provides a useful framework for exploring how context and partnership processes can influence health research design and interventions. However, challenges in operationalising aspects of the model limit our understanding and evaluation of the PHR process. Trust is frequently identified as an important component of the CBPR model, which supports the development of key partnership outcomes, such as partnership synergy. However, trust continues to be limited to a binary view (as present or absent), which is problematic given its inherently dynamic and temporal nature.

STUDY AIM

The aim of this qualitative study is to understand the evolution of trust in the national public and patient involvement (PPI) network in Ireland.

SETTING AND PARTICIPANTS

Participants from the PPI network (n = 15/21) completed a semistructured interview discussing the evolution of trust by reviewing four social network maps derived from a previous longitudinal study.

ANALYSIS

Following Braun and Clarke, we used reflexive thematic analysis, to iteratively develop, analyse and interpret our mediated reflection of the data.

RESULTS

Participants described the evolution of trust as a function of three contextual factors: (1) the set-up and organisation of the network, (2) how people work together and (3) reflection on the process and outcomes. Their descriptions across these themes seemed to vary depending on partnership type with National Partners and Site Leads having more opportunities to demonstrate trust (e.g., via leadership roles or more resources), compared to Local. Thus, visibility and the opportunity to be visible, depending on the set-up and organisation of the network and how people work together, seemingly play an important role in the evolution of trust over time. Based on these findings, we provide important questions for reflection across themes that could be considered for future PHR partnerships.

DISCUSSION

Given that the opportunity and visibility to build and maintain trust over time may not be equally available to all partners, it is important to find ways to invest in and commit to equitable relationships as the key to the success (i.e., longevity) of partnerships. We reflect on/offer important implications for those engaging in PHR partnerships and those who fund such research.

PATIENT OR PUBLIC CONTRIBUTION

A Research Advisory Group comprising four research partners (representing academic, service and community organisations) from the PPI Ignite Network provided input and approval for the research objectives of this study as well as previously published work informing this study. Informal consultation occurred with members of this group to discuss findings from this study, assisting with the way findings are presented and described, to be accessible for diverse audiences. Two Research Advisory Group members were involved in the interpretation of the results, and one is a co-author of this manuscript (Zoe Hughes).

The irrepressible influence of vocal stereotypes on trust

There is a reciprocal relationship between trust and vocal communication in human interactions. On one hand, a predisposition towards trust is necessary for communication to be meaningful and effective. On the other hand, we use vocal cues to signal our own trustworthiness and to infer it from the speech of others. Research on trustworthiness attributions to vocal characteristics is scarce and contradictory, however, being typically based on explicit judgements which may not predict actual trust-oriented behaviour. We use a game theory paradigm to examine the influence of speaker accent and prosody on trusting behaviour towards a simulated game partner, who responds either trustworthily or untrustworthily in an investment game. We found that speaking in a non-regional standard accent increases trust, as does relatively slow articulation rate. The effect of accent persists over time, despite the accumulation of clear evidence regarding the speaker's level of trustworthiness in a negotiated interaction. Accents perceived as positive for trust can maintain this benefit even in the face of behavioural evidence of untrustworthiness.

Modeling the influence of attitudes, trust, and beliefs on endoscopists' acceptance of artificial intelligence applications in medical practice

Introduction

The potential for deployment of Artificial Intelligence (AI) technologies in various fields of medicine is vast, yet acceptance of AI amongst clinicians has been patchy. This research therefore examines the role of antecedents, namely trust, attitude, and beliefs in driving AI acceptance in clinical practice.

Methods

We utilized online surveys to gather data from clinicians in the field of gastroenterology.

Results

A total of 164 participants responded to the survey. Participants had a mean age of 44.49 (SD = 9.65). Most participants were male (n = 116, 70.30%) and specialized in gastroenterology (n = 153, 92.73%). Based on the results collected, we proposed and tested a model of AI acceptance in medical practice. Our findings showed that while the proposed drivers had a positive impact on AI tools' acceptance, not all effects were direct. Trust and belief were found to fully mediate the effects of attitude on AI acceptance by clinicians.

Discussion

The role of trust and beliefs as primary mediators of the acceptance of AI in medical practice suggest that these should be areas of focus in AI education, engagement and training. This has implications for how AI systems can gain greater clinician acceptance to engender greater trust and adoption amongst public health systems and professional networks which in turn would impact how populations interface with AI. Implications for policy and practice, as well as future research in this nascent field, are discussed.

A Conference (Missingness in Action) to Address Missingness in Data and AI in Health Care: Qualitative Thematic Analysis

BACKGROUND

Missingness in health care data poses significant challenges in the development and implementation of artificial intelligence (AI) and machine learning solutions. Identifying and addressing these challenges is critical to ensuring the continued growth and accuracy of these models as well as their equitable and effective use in health care settings.

OBJECTIVE

This study aims to explore the challenges, opportunities, and potential solutions related to missingness in health care data for AI applications through the conduct of a digital conference and thematic analysis of conference proceedings.

METHODS

A digital conference was held in September 2022, attracting 861 registered participants, with 164 (19%) attending the live event. The conference featured presentations and panel discussions by experts in AI, machine learning, and health care. Transcripts of the event were analyzed using the stepwise framework of Braun and Clark to identify key themes related to missingness in health care data.

RESULTS

Three principal themes-data quality and bias, human input in model development, and trust and privacy-emerged from the analysis. Topics included the accuracy of predictive models, lack of inclusion of underrepresented communities, partnership with physicians and other populations, challenges with sensitive health care data, and fostering trust with patients and the health care community.

CONCLUSIONS

Addressing the challenges of data quality, human input, and trust is vital when devising and using machine learning algorithms in health care. Recommendations include expanding data collection efforts to reduce gaps and biases, involving medical professionals in the development and implementation of AI models, and developing clear ethical guidelines to safeguard patient privacy. Further research and ongoing discussions are needed to ensure these conclusions remain relevant as health care and AI continue to evolve.

Parasocial Interactions in Digital Tourism: Attributes of Live Streamers and Viewer Engagement Dynamics in South Korea

This study investigates the use of live streaming as a strategic tool in the tourism industry, with a focus on the attributes of live streamers that influence viewer engagement, particularly in the context of South Korea's digital landscape. The purpose of this research is to understand how the attractiveness, trustworthiness, and expertise of live streamers can affect the parasocial relationships-characterized by perceived friendship and trust-between viewers and streamers and how these relationships subsequently influence viewer loyalty and cooperation intentions. A quantitative research methodology was employed, utilizing a structured online survey distributed by a leading market research agency in South Korea. The survey targeted a diverse demographic to ensure a comprehensive analysis of digital consumer behavior in the tourism sector. Data were analyzed using IBM SPSS Statistics 28.0 and IBM SPSS Amos 28.0, employing structural equation modeling to test the hypothesized relationships. The results revealed that while attractiveness and trustworthiness impact perceived friendship, only expertise significantly affects trust for a travel live streamer. Furthermore, perceived friendship plays a crucial role in fostering loyalty to and cooperation with the streamer, having practical implications for the tourism industry in terms of crafting marketing strategies and training digital ambassadors. Th study extends parasocial interaction theory to the digital travel domain, providing original insights into virtual tourist behavior and highlighting live streaming's significant contribution to viewer engagement. This research has limitations in its geographical focus on South Korea, suggesting the need for cross-cultural studies to validate the findings. Overall, this study offers valuable contributions to the academic literature and practical guidance for the tourism industry, emphasizing the importance of digital personalities in post-pandemic tourism recovery strategies.

Measuring trust: a text analysis approach to compare, contrast, and select trust questionnaires

Introduction

Trust has emerged as a prevalent construct to describe relationships between people and between people and technology in myriad domains. Across disciplines, researchers have relied on many different questionnaires to measure trust. The degree to which these questionnaires differ has not been systematically explored. In this paper, we use a word-embedding text analysis technique to identify the differences and common themes across the most used trust questionnaires and provide guidelines for questionnaire selection.

Methods

A review was conducted to identify the existing trust questionnaires. In total, we included 46 trust questionnaires from three main domains (i.e., Automation, Humans, and E-commerce) with a total of 626 items measuring different trust layers (i.e., Dispositional, Learned, and Situational). Next, we encoded the words within each questionnaire using GloVe word embeddings and computed the embedding for each questionnaire item, and for each questionnaire. We reduced the dimensionality of the resulting dataset using UMAP to visualize these embeddings in scatterplots and implemented the visualization in a web app for interactive exploration of the questionnaires (https://areen.shinyapps.io/Trust_explorer/).

Results

At the word level, the semantic space serves to produce a lexicon of trust-related words. At the item and questionnaire level, the analysis provided recommendation on questionnaire selection based on the dispersion of questionnaires' items and at the domain and layer composition of each questionnaire. Along with the web app, the results help explore the semantic space of trust questionnaires and guide the questionnaire selection process.

Discussion

The results provide a novel means to compare and select trust questionnaires and to glean insights about trust from spoken dialog or written comments.

Older Adults' Trust and Distrust in COVID-19 Public Health Information: Qualitative Critical Incident Study

BACKGROUND

The COVID-19 infodemic has imposed a disproportionate burden on older adults who face increased challenges in accessing and assessing public health information, but little is known about factors influencing older adults' trust in public health information during COVID-19.

OBJECTIVE

This study aims to identify sources that older adults turn to for trusted COVID-19 public health information and factors that influence their trust. In addition, we explore the relationship between public health information sources and trust factors.

METHODS

Adults aged 65 years or older (N=30; mean age 71.6, SD 5.57; range 65-84 years) were recruited using Prime Panels. Semistructured phone interviews, guided by critical incident technique, were conducted in October and November 2020. Participants were asked about their sources of COVID-19 public health information, the trustworthiness of that information, and factors influencing their trust. Interview data were examined with thematic analysis.

RESULTS

Mass media, known individuals, and the internet were the older adults' main sources for COVID-19 public health information. Although they used social media for entertainment and personal communication, the older adults actively avoided accessing or sharing COVID-19 information on social media. Factors influencing their trust in COVID-19 public health information included confirmation bias, personal research, resigned acceptance, and personal relevance.

CONCLUSIONS

These findings shed light on older adults' use of information sources and their criteria for evaluating the trustworthiness of public health information during a pandemic. They have implications for the future development of effective public health communication, policies, and interventions for older adults during health crises.

Trust and trustworthy artificial intelligence: A research agenda for AI in the environmental sciences

Demands to manage the risks of artificial intelligence (AI) are growing. These demands and the government standards arising from them both call for trustworthy AI. In response, we adopt a convergent approach to review, evaluate, and synthesize research on the trust and trustworthiness of AI in the environmental sciences and propose a research agenda. Evidential and conceptual histories of research on trust and trustworthiness reveal persisting ambiguities and measurement shortcomings related to inconsistent attention to the contextual and social dependencies and dynamics of trust. Potentially underappreciated in the development of trustworthy AI for environmental sciences is the importance of engaging AI users and other stakeholders, which human-AI teaming perspectives on AI development similarly underscore. Co-development strategies may also help reconcile efforts to develop performance-based trustworthiness standards with dynamic and contextual notions of trust. We illustrate the importance of these themes with applied examples and show how insights from research on trust and the communication of risk and uncertainty can help advance the understanding of trust and trustworthiness of AI in the environmental sciences.