Improving Access to, Use of, and Outcomes from Public Health Programs: The Importance of Building and Maintaining Trust with Patients/Clients

Abstract

The central argument in this paper is that “public trust” is critical for developing and maintaining the health and wellbeing of individuals, communities, and societies. I argue that public health practitioners and policy makers need to take “public trust” seriously if they intend to improve both the public’s health and the engagement between members of the public and public health systems. Public health practitioners implement a range of services and interventions aimed at improving health but implicit a requirement for individuals to trust the practitioners and the services/interventions, before they engage with them. I then go on to provide an overview of the theory of trust within sociology and show why it is important to understand this theory in order to promote trust in public health services. I then draw on literature in three classic areas of public health—hospitals, cancer screening, and childhood immunization—to show why trust is vital in terms of understanding and potentially improving uptake of services. The case studies in this paper reveal that public health practitioners need to understand the centrality of building and maintaining trusting relationships with patients/clients because people who distrust public health services are less likely to use them, less likely to follow advice or recommendations, and more likely to have poorer health outcomes.

Trust in dentist‐patient relationships: mapping the relevant concepts

“…In contrast to patients and dentists, the advantage of trust in dentist‐patient relationships for the oral health system was less reported owing to the nature of the topic – trust in interpersonal relationships, rather than in the institutional system . Despite different levels of trust –interpersonal vs. institutional (14) – the public health system should draw on trust in clinicians for two reasons: benefits flowing from the interpersonal trust and the role of interpersonal trust as a representation of trust in the healthcare system (5, 40). The first is the expectations that patients and clinicians in trustful relationships would contribute to better public health by supporting health promotion and advocacy activities for public health awareness and literacy (41).…”

“…Water fluoridation has also been challenged in some regional areas despite over 70 yr of its effective implementation and a body of evidence for it reducing dental caries (4). Among diverse reasons for the concerns, the lack of trust in healthcare seems to be one of the central factors (5). Not only are public healthcare schemes facing issues of mistrust, but clinical encounters are also experiencing similar problems.…”

On the responsible use of digital data to tackle the COVID-19 pandemic

“…It is equally important, however, to use these data and algorithms in a responsible manner, in compliance with data-protection regulations and with due respect for privacy and confidentiality. Failing to do so will undermine public trust, which will make people less likely to follow public-health advice or recommendations and more likely to have poorer health outcomes 10 .…”

A stitch in time saves nine: Perceptions about colorectal cancer screening after a non-cancer colonoscopy result. Qualitative study

“…Two types of trust are at play: interpersonal and institutional trust. Interpersonal trust can be defined a mutual confidence that no party will exploit anothers' vulnerability, and an acceptance of the risks associated with the type and depth of the interdependence inherent in a given relationship (43). Interpersonal trust can be developed in face-to-face encounters which involve vulnerability or information asymmetry, dependency, and uncertainty.…”

“…In the Danish CRC screening program using FIT, participation relies on institutional trust, since no face-to-face encounters take place with a HCP in the invitational procedure, in the collection of the screening sample, or in the provision of the screening result. It has been suggested that participation in CRC screening using self-sampling requires a larger 'leap of faith' for participants due to deficits in knowledge and lack of familiarity with the procedure, and most importantly a lack of access point, in the shape of a trusted HCP who can mediate between the institution (screening) and the individual (43).…”