Different roles of interpersonal trust and institutional trust in COVID-19 pandemic control

Rural healthcare workforce preparation, response, and work during the COVID-19 pandemic in Australia: Lessons learned from in-depth interviews with rural health service leaders

BACKGROUND

Low population density, geographic spread, limited infrastructure and higher costs are unique challenges in the delivery of healthcare in rural areas. During the COVID-19 pandemic, emergency powers adopted globally to slow the spread of transmission of the virus included population-wide lockdowns and restrictions upon movement, testing, contact tracing and vaccination programs. The aim of this research was to document the experiences of rural health service leaders as they prepared for the emergency pandemic response, and to derive from this the lessons learned for workforce preparedness to inform recommendations for future policy and emergency planning.

METHODOLOGY AND METHODS

Interviews were conducted with leaders from two rural public health services in Australia, one small (500 staff) and one large (3000 staff). Data were inductively coded and analysed thematically.

PARTICIPANTS

Thirty-three participants included health service leaders in executive, clinical, and administrative roles.

FINDINGS

Six major themes were identified: Working towards a common goal, Delivery of care, Education and training, Organizational governance and leadership, Personal and psychological impacts, and Working with the Local Community. Findings informed the development of a applied framework.

CONCLUSION

The study findings emphasise the critical importance of leadership, teamwork and community engagement in preparing the emergency pandemic response in rural areas. Informed by this research, recommendations were made to guide future rural pandemic emergency responses or health crises around the world.

Public attitudes toward COVID-19 prevention and control in China

Based on the data of the Chinese General Social Survey (CGSS) in 2021, this study aims to investigate the public attitudes toward COVID-19 prevention and control in China. The household survey CGSS 2021 contains 8,148 valid samples gathered from 320 communities across 19 provinces in China. The logistic regression model is adopted to examine the relationship between public attitudes and influencing factors. The results show that the vast majority of respondents firmly believe that the government has the authority to implement strict measures; their confidence in the government and in the healthcare system has increased; and they willingly choose to be vaccinated. The regression results suggest that gender, age, health condition, political affiliation, source of information, sense of fairness, socio-economic status, and place of residence are significantly associated with individuals' attitudes toward COVID-19 prevention and control. These findings highlight the importance for the government to design epidemic or pandemic policies based on data and to tailor them toward specific demographics.

Trust in Acquaintances, Strangers and Institutions among Individuals of Different Socioeconomic Statuses during Public Health Emergencies: The Moderation of Family Structure and Policy Perception

Trust plays a crucial role in effectively responding to public health emergencies. Drawing on COVID-19 survey data conducted in Hubei, China, during August 2020 with a sample size of 5494, this study investigated the influence of individuals' socioeconomic status on trust in acquaintances, strangers and institutions, and how this relationship is moderated by epidemic prevention, policy perception and family structure. The findings showed that individuals with higher socioeconomic status tend to have higher levels of trust. Those with higher income but being married demonstrate higher trust. When perceiving epidemic prevention policies as stringent, those with higher income display increased trust in acquaintances and institutions; similarly, those with lower education levels exhibit heightened trust in acquaintances and strangers. Individuals working in social organizations express higher trust in strangers; however, their trust is compromised under stringent epidemic prevention policies due to potentially heavier work burdens.

Autonomous and policy-induced behavior change during the COVID-19 pandemic: Towards understanding and modeling the interplay of behavioral adaptation

Changes in human behaviors, such as reductions of physical contacts and the adoption of preventive measures, impact the transmission of infectious diseases considerably. Behavioral adaptations may be the result of individuals aiming to protect themselves or mere responses to public containment measures, or a combination of both. What drives autonomous and policy-induced adaptation, how they are related and change over time is insufficiently understood. Here, we develop a framework for more precise analysis of behavioral adaptation, focusing on confluence, interactions and time variance of autonomous and policy-induced adaptation. We carry out an empirical analysis of Germany during the fall of 2020 and beyond. Subsequently, we discuss how behavioral adaptation processes can be better represented in behavioral-epidemiological models. We find that our framework is useful to understand the interplay of autonomous and policy-induced adaptation as a "moving target". Our empirical analysis suggests that mobility patterns in Germany changed significantly due to both autonomous and policy-induced adaption, with potentially weaker effects over time due to decreasing risk signals, diminishing risk perceptions and an erosion of trust in the government. We find that while a number of simulation and prediction models have made great efforts to represent behavioral adaptation, the interplay of autonomous and policy-induced adaption needs to be better understood to construct convincing counterfactual scenarios for policy analysis. The insights presented here are of interest to modelers and policy makers aiming to understand and account for behaviors during a pandemic response more accurately.

Racial/ethnic differences in the associations between trust in the U.S. healthcare system and willingness to test for and vaccinate against COVID-19

BACKGROUND

Trust in the healthcare system may impact adherence to recommended healthcare practices, including willingness to test for and vaccinate against COVID-19. This study examined racial/ethnic differences in the associations between trust in the U.S. healthcare system and willingness to test for and vaccinate against COVID-19 during the first year of the pandemic.

METHODS

This cross-sectional study used data from the REACH-US study, a nationally representative online survey conducted among a diverse sample of U.S. adults from January 26, 2021-March 3, 2021 (N = 5,121). Multivariable logistic regression estimated the associations between trust in the U.S. healthcare system (measured as "Always", "Most of the time", "Sometimes/Almost Never", and "Never") and willingness to test for COVID-19, and willingness to receive the COVID-19 vaccine. Racial/ethnic differences in these associations were examined using interaction terms and multigroup analyses.

RESULTS

Always trusting the U.S. healthcare system was highest among Hispanic/Latino Spanish Language Preference (24.9%) and Asian (16.7%) adults and lowest among Multiracial (8.7%) and Black/African American (10.7%) adults. Always trusting the U.S. healthcare system, compared to never, was associated with greater willingness to test for COVID-19 (AOR: 3.20, 95% CI: 2.38-4.30) and greater willingness to receive the COVID-19 vaccine (AOR: 2.68, 95% CI: 1.97-3.65).

CONCLUSIONS

Trust in the U.S. healthcare system was associated with greater willingness to test for COVID-19 and receive the COVID-19 vaccine, however, trust in the U.S. healthcare system was lower among most marginalized racial/ethnic groups. Efforts to establish a more equitable healthcare system that increases trust may encourage COVID-19 preventive behaviors.

Compliance with COVID-19 preventative health measures in the United Kingdom: a latent profile analysis

Governments have adopted unprecedented measures to assist in slowing the spread of the COVID-19 pandemic, but compliance varies among individuals. This UK study uses latent profile analysis to identify four classes of individuals on factors believed to influence compliance. Those who sought health information from authoritative sources and actively sought information from multiple sources were most compliant. Profile differences in compliance and vaccination status were also primarily driven by trust in healthcare institutions over trust in government. These findings contribute to understanding compliance profiles and emphasise the importance of authoritative information and trust in healthcare systems.

Different roles of interpersonal trust and institutional trust in motivating older adults to receive COVID-19 vaccines in Singapore

Since the approvals of several vaccines against COVID-19 by the World Health Organization, a large body of research has studied the determinants of individuals' intention to be vaccinated against COVID-19 in a variety of societies. Vaccine intention is a complex construct rooted in the social context that informs the decision-making process. The underlying reasons for older adults' intention to receive the vaccination is even more important to health authorities in societies with large proportions of older adults. In this paper, we interview 27 women over age 55 in Singapore about their COVID-19 vaccine decision-making. Using a social-ecological framework of trust, we identify factors at both individual and institutional levels that build or undermine trust and underlie older women's decisions to receive COVID-19 vaccinations in an authoritarian regime. Findings show that both interpersonal trust and institutional trust contribute to vaccine uptake, however, trust can also contribute to delays in vaccination. Moreover, a sizable minority of respondents report that they were vaccinated not because of institutional trust, but because they felt compelled to do so. The results shed light on directions for future vaccination campaigns.

Stanford Vax Crew: A Model for Agile, Community-Centered Vaccination Campaigns

Stanford Vax Crew, one of the largest medical-student-led vaccination programs in the United States, serves as a case study of a successful community-university partnership that adapted its existing operations to enable COVID-19 vaccine distribution. It offers a model for agile, community-centered vaccination campaigns that harness diverse stakeholder strengths to promote vaccine access and uptake in underserved communities. This case study aims to outline the history and structure of the community-university partnership model developed through Stanford Vax Crew, describe key observations of factors that contributed to the scalability of the model, and provide experience-based recommendations for future community-university collaborations.

Social media trust predicts lower COVID-19 vaccination rates and higher excess mortality over 2 years

Trust plays a crucial role in implementing public health interventions against the COVID-19 pandemic. We examined the prospective associations of interpersonal, institutional, and media trust with vaccination rates and excess mortality over time in two multinational studies. In study 1, we investigated the country-level relationships between interpersonal trust, vaccination rates, and excess mortality across 54 countries. Interpersonal trust at the country level was calculated by aggregating data of 80,317 participants from the World Values Survey in 2017-20. Data on vaccination rates and excess mortality were obtained from the World Health Organization. Our findings indicated that higher levels of interpersonal trust were linked to higher vaccination rates and lower excess mortality rates in both 2020 and 2021. In study 2, we collected data from 18,171 adults in 35 countries/societies, stratified by age, gender, and region of residence. At the country/society level, interpersonal trust and trust in local healthcare facilities, local healthcare services, and healthcare professionals were associated with higher vaccination rates and lower excess mortality, whereas social media trust was associated with lower vaccination rates and higher excess mortality across three time points over 2 years. Our findings are robust when controlling for country-level covariates of the government stringency index, population density, and medical resources (i.e. critical care beds) in both studies.

Trust and vaccine hesitancy during the COVID-19 pandemic: A cross-national analysis

Previous studies of vaccine hesitancy in the context of COVID-19 have reported mixed results in terms of the role played by political and institutional trust. This study addresses this ambiguity with a global analysis of the relationship between trust and vaccine hesitancy, disentangling the effects of generalized trust orientations, trust in specific institutions and conspiracy mentality. It first draws upon a cross-national survey of 113 countries to demonstrate that trust in government is a predictor of vaccine hesitancy across global regions. It further draws on original surveys fielded in seven countries (France, Germany, Spain, Argentina, Croatia, Brazil, India), which deploy a diverse range of measures, to disentangle the individual-level predictors of vaccine hesitancy. Our findings confirm the robust effects of trust in government across countries, but when including other trust measures in the same models, the most robust effects are those of trust in health institutions and conspiracy mentality. Weaker associations are observed for right-wing ideology and online political engagement, while the consumption of traditional media tends to predict the willingness of individuals to be vaccinated.

Trust Dynamics of Community Health Workers in Frontier Food Banks and Pantries: a Qualitative Study

BACKGROUND

Medical mistrust has had devastating consequences during the COVID-19 pandemic, particularly in rural communities. Community Health Workers (CHWs) have been shown to build trust, but there is little research on trust-building by CHWs in rural communities.

OBJECTIVE

This study aims to understand the strategies that CHWs use to build trust with participants of health screenings in frontier Idaho.

DESIGN

This is a qualitative study based on in-person, semi-structured interviews.

PARTICIPANTS

We interviewed CHWs (N=6) and coordinators of food distribution sites (FDSs; e.g., food banks and pantries) where CHWs hosted a health screening (N=15).

APPROACH

Interviews were conducted with CHWs and FDS coordinators during FDS-based health screenings. Interview guides were initially designed to assess facilitators and barriers to health screenings. Trust and mistrust emerged as dominant themes that determined nearly every aspect of the FDS-CHW collaboration, and thus became the focus of interviews.

KEY RESULTS

CHWs encountered high levels of interpersonal trust, but low institutional and generalized trust, among the coordinators and clients of rural FDSs. When working to reach FDS clients, CHWs anticipated confronting mistrust due to their association with the healthcare system and government, especially if CHWs were perceived as "outsiders." Hosting health screenings at FDSs, which were trusted community organizations, was important for CHWs to begin building trust with FDS clients. CHWs also volunteered at FDS locations to build interpersonal trust before hosting health screenings. Interviewees agreed that trust building was a time- and resource-intensive process.

CONCLUSIONS

CHWs build interpersonal trust with high-risk rural residents, and should be integral parts of trust building initiatives in rural areas. FDSs are vital partners in reaching low-trust populations, and may provide an especially promising environment to reach some rural community members. It is unclear whether trust in individual CHWs also extends to the broader healthcare system.

Cultural differences, intergenerational contacts, and the spread of Covid-19: Evidence from Swiss language regions

The Covid-19 pandemic displayed large variations between and within countries in the speed of contagion and in observed fatality rates. This work sheds light on the role of social ties in old age, exploiting the high cultural variation between German-speaking and Latin- (French- and Italian-) speaking regions in Switzerland. We show that older adults in Latin-speaking regions exhibit a larger social network and more intergenerational contacts than their German-speaking counterparts. These differences are consistent with the heterogeneous incidence of the disease across language regions. Even controlling for several determinants of the contagion, we find large differences in the incidence of Covid-19 among older adults, in both the first and second waves of the pandemic. These findings also hold when exploiting language variations within the three Swiss bilingual cantons. We rule out the possibility that our results are driven by differences in canton-specific policies or in citizens' compliance with containment measures.

Empathy moderates the relationship between cognitive load and prosocial behaviour

Cognitive load reduces both empathy and prosocial behaviour. However, studies demonstrating these effects have induced cognitive load in a temporally limited, artificial manner that fails to capture real-world cognitive load. Drawing from cognitive load theory, we investigated whether naturally occurring cognitive load from the ongoing COVID-19 pandemic moderated the relationship between empathy and prosocial behaviour (operationalised as support for public health measures). This large study in an Australian sample (N = 600) identified negative relationships between pandemic fatigue, empathy for people vulnerable to COVID-19, and prosocial behaviour, and a positive relationship between empathy and prosocial behaviour. Additionally, we found that the negative effect of the pandemic on prosocial behaviour depended on empathy for vulnerable others, with pandemic fatigue's effects lowest for those with the highest empathy. These findings highlight the interrelationships of cognitive load and empathy, and the potential value of eliciting empathy to ease the impact of real-world cognitive load on prosocial behaviour.

The Consequences of the Pandemic for Subjective Well-Being: Data for Improving Policymaking

The pandemic has affected people's lives and emotions in profound ways, which governments ignore at their peril. Among the often disregarded consequences of the pandemic, especially in developing countries, are its toll on subjective well-being and its implications for health policymaking. This paper uses a battery of surveys with over 1800 observations collected in 2019 and 2020, which inform on many aspects of subjective well-being before and during the pandemic in Cali, Colombia. The results show a dramatic and widespread reduction in life satisfaction in several dimensions of well-being beyond health, and not just among those directly affected by COVID-19. This analysis focuses on differences in well-being by gender and health status, providing information about gender variances and differences in subjective well-being between those who experienced and those who did not experience physical illness (including the COVID-19 infection) during the pandemic. This analysis aims at contributing to the body of research that studies the consequences of the pandemic for life satisfaction and well-being, in the context of a city experiencing profound social unrest during the pandemic.

Individual uniqueness in trust profiles and well‐being: Understanding the role of cultural tightness–looseness from a representation similarity perspective

This paper provides a unique perspective for understanding cultural differences: representation similarity-a computational technique that uses pairwise comparisons of units to reveal their representation in higher-order space. By combining individual-level measures of trust across domains and well-being from 13,823 participants across 15 nations with a measure of society-level tightness-looseness, we found that any two countries with more similar tightness-looseness tendencies exhibit higher degrees of representation similarity in national interpersonal trust profiles. Although each individual's trust profile is generally similar to their nation's trust profile, the greater similarity between an individual's and their society's trust profile predicted a higher level of individual life satisfaction only in loose cultures but not in tight cultures. Using the framework of representation similarity to explore cross-cultural differences from a multidimensional, multi-national perspective provide a comprehensive picture of how culture is related to the human activities.

Conspiratorial thinking as a precursor to opposition to COVID-19 vaccination in the US: a multi-year study from 2018 to 2021

Despite widespread availability of safe and effective COVID-19 vaccines in the US, only about 66% of the eligible US population had taken the recommended initial doses of the COVID-19 vaccines as of April 2022. Explanations for this hesitancy have focused on misinformation about the vaccines, lack of trust in health authorities, and acceptance of conspiracy theories about the pandemic. Here we test whether those with a conspiratorial mindset, which distrusts a wide range of institutions, were poised to reject COVID vaccines before the pandemic even began. To answer that question, we reinterviewed members of a national US panel that we had previously surveyed beginning in 2018. As hypothesized, having a conspiratorial mindset in 2019 predicted COVID-vaccination hesitancy in 2021 better than prior trust in health authorities or acceptance of vaccine misinformation. Those with the mindset were also more likely to consume media that bolstered belief in pandemic conspiracies. Research is needed on the determinants of conspiratorial mindset and ways to minimize the likelihood that consequential health decisions will be influenced by it.

Essential for society but not equally deserving of preferential treatment? A discrete-choice experiment regarding COVID-19 healthcare

Workers' risks of contracting COVID-19 vary according to individual behaviors, occupations and job characteristics. Therefore, persons may consider different groups of workers more or less deserving of COVID-19 healthcare. To evaluate such preferences, we conducted an online conjoint experiment on the precedence of ICU treatment and COVID-19 vaccination. Our results demonstrate that working in essential occupations increases the likelihood of being considered deserving of vaccination and ICU treatment. We also find differences in how essential workers are prioritized, yet these differences cannot be clearly attributed to risk exposure or occupational prestige. Furthermore, we show that age, asthma, household context and compliance with COVID-19 measures significantly affect respondents' choices, while weight matters only for vaccination priority. Our results therefore contribute to research regarding the characteristics that are salient to fair distributions of scarce resources among workers during a health crisis.

Does pro-sociality or trust better predict staying home behavior during the Covid-19?

Voluntary compliance of preventive and mitigation measures due to social concerns can play a crucial role in slowing down the spread of the Covid-19. The existing economic models for disease spread however do not direct a lot of focus on the possible role of pro-social behavior and general trust in predicting preventive behaviors amid the Covid-19. Therefore, this study analyzes whether pro-sociality and general trust measured in the short run (2020 and 2019) and in the long run (2015 and 2010) predict attitudes towards the stay home behavior and the intended stay home behavior in case the government mandates it due to the Covid-19 in the Netherlands. The results suggest that these preferences positively influence attitudes towards staying home behavior. However, trust in comparison to pro-sociality is a stable and robust predictor of stay home attitudes both in the short as well as long run. On the other hand, neither trust nor pro-sociality influences the intended stay home behavior in case the government mandates the lockdown, and it is most likely due to the timing of the survey coinciding with a significant drop in the Covid-19 infections and easing out of the lockdown restrictions by the Dutch government.

Institutional Trust as a Protective Factor during the COVID-19 Pandemic in China

Previous research has demonstrated that institutional trust protects subjective well-being during pandemics. However, the potential mediation mechanisms underlying this linkage remain unclear. This study constructs a mediating model to investigate the effect of institutional trust on subjective well-being and the mediating roles of belief in a just world and fear of COVID-19 in the Chinese context. To this end, we survey a sample of 881 participants. The results show that institutional trust, belief in a just world, fear of COVID-19, and subjective well-being (i.e., life satisfaction, positive affect, and negative affect) are significantly interrelated. The results also indicate a significant impact of institutional trust on life satisfaction, positive affect, and negative affect. Belief in a just world and fear of COVID-19, independently and in sequence, mediate the relationship between institutional trust and subjective well-being.

Commentary on "Different roles of interpersonal trust and institutional trust in COVID-19 pandemic control"

An increasing number of epidemiologic studies have identified trust as a social determinant of COVID-19 mortality. Trust influences public compliance with policies aimed at containing the pandemic through physical distancing, wearing masks, and vaccine uptake. However, whilst some forms of trust are public assets (e.g., trust in government), others might be liabilities (e.g., trust in close friends and family members). Contributing to this body of work, Lou et al. (2022) examined associations of trust with COVID-19 fatality rates and willingness to get tested for COVID-19. Using correlation analyses, behavioral experiments, and agent-based modeling, they found institutional trust predicted lower COVID-19 fatality rates and greater willingness to get tested. In contrast, interpersonal trust predicted the speed with which COVID-19 was controlled in the early stages of the pandemic and people's willingness to obey norms preventing the spread of the virus (e.g., decreased nonessential outdoor activity). Investigations such as this offer useful knowledge to public health officials on ways to mitigate a pandemic. This commentary examines the pivotal role of social science in pandemic control, which up to now has been underfunded and overshadowed by the race to develop vaccines. We also highlight the importance of theory, particularly in research on trust, to producing evidence that is replicable and meaningful for policy application.

Does losing money truly hurt? The shared neural bases of monetary loss and pain

Both monetary loss and pain have been studied for decades, but evidence supporting the relationship between them is still lacking. We conducted a meta‐analysis to explore the overlapping brain regions between monetary loss and pain, including physical pain and social pain. Regardless of the type of pain experienced, activation of the anterior insula was a shared neural representation of monetary loss and pain. The network representation pattern of monetary loss was more similar to that of social pain than that of physical pain. In conclusion, our research provided evidence of the common neural correlates of monetary loss and pain.