Grant: Project Grant - PA: Pandemic Preparedness and Health Emergencies Research

Trust. It is a key factor in accessing health care, engaging with health care advice, and making healthcare decisions. For some groups, trust in healthcare and public health is lower than others and the pandemic lowered trust more broadly, resulting in some groups further losing trust in traditional healthcare sources and seeking alternate sources to make health decisions. Even though trust and trusted sources are recognized as important, there is very little agreement or consistent evidence on what actually works best to build, rebuild, and maintain trust in health care systems and organisations, and in healthcare professionals. Many different disciplines and fields concern themselves with aspects of trust building - from organizational leadership, to psychology, to social work, to political science, to patient engagement - suggesting there is a wider set of ways to build and keep trust that could be drawn from that has not yet been assembled. We need a tool that identifies what strategies exist so that we can start to build up an evidence base on which strategies actually work best, for whom, and when, to build, rebuild and maintain trust in health systems, in public health and in the health professionals working in them. We have done a wide review to identify trust strategies from a range of disciplines to capture a very broad range of trust strategy options. With this project, we will build on this foundational work by speaking with those in the health system who have positions that depend on their trustworthiness, and work to co-develop the first agreed-upon set of strategies for building, rebuilding and maintaining trust in healthcare and public health, considering acceptability and equity throughout. This new co-developed tool (taxonomy of trust strategies) will provide a missing piece in how to actually build, rebuild and keep trust in an evidence-supported, equitable and acceptable way that can strengthen trusting relationships so central to patient care.