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How Healthcare Structures and Communication Delivery Influence Trust: a Parallel-Group Randomized Controlled Trial

Cantarutti, S. ORCID: 0000-0002-5601-2030 & Pothos, E. M. ORCID: 0000-0003-1919-387X (2021). How Healthcare Structures and Communication Delivery Influence Trust: a Parallel-Group Randomized Controlled Trial. Journal of Public Health, 31(6), pp. 831-836. doi: 10.1007/s10389-021-01620-z


Background: According to recent polling, public trust in the healthcare sector remains low relative to other industries globally. The implications of low healthcare trust permeate throughout the industry in a number of ways, most visibly by discouraging therapy compliance.

Methods: This study investigated four putative determinants of trust in healthcare-related scenarios: individuals vs. collective groups as communicators of healthcare advice; expert vs. laypeople as providers of healthcare communication; public vs. private healthcare sector; and positive vs. negative information. 274 participants were recruited via Prolific Academic and were presented with four statements in random order, related to a positive reflection of the public healthcare sector, a negative reflection of the public healthcare sector, a positive reflection of the private healthcare sector, and a negative reflection of the private healthcare sector. According to these reflection, participants were repeatedly asked to rate the system on its trustworthiness. Trust outcomes were constructed using a four-dimension framework, consisting of benevolence, reliability, competence, and predictability.

Results: Claims relating to the public sector had a significantly stronger impact on benevolence and reliability than claims relating to the private sector; claims from individuals had a significantly stronger impact on all trust variables than claims from collectives; and claims from laypeople had a significantly greater impact on reliability and competence ratings than claims from experts.

Conclusions: The findings in this study offer insight into the patterns with which trust decisions are made in healthcare contexts. More importantly, this research offers a novel perspective of how different factors interact to affect the various facets of trust. These results provide a foundation for future study in this evolving area, and offer insights into designing effective communication strategies that cultivate greater levels of individual trust in the healthcare sector.

Publication Type: Article
Additional Information: Copyright: The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit
Publisher Keywords: determinants of trust; healthcare; dimensions of trust
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Departments: School of Health & Psychological Sciences > Psychology
SWORD Depositor:
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