Canadian researchers look to build trust in gov't to help public health

Many democratic governments – not to mention dictatorships – enjoy little public trust. Now, researchers at the School of Public Health Sciences at the University of Waterloo in Ontario, Canada have developed a tool that helps lawmakers to gauge how trustworthy they appear to the public. It could also help improve the acceptance of public health policies by explaining their design and intentions to the voters. 

People in diverse communities are less likely to support and adopt new policies in various fields if they don’t have faith in their government, said Dr. Samantha Meyer, a researcher whose health sciences department is the first interdisciplinary body in Canada dedicated to health promotion – preparing the next generation of leaders to respond to the complex adaptive systems that affect health and health care. “I’ve always been interested in understanding why people do or do not engage in health services,” she said. 

“Before COVID-19, we had started a project looking at trust in healthcare and how it shaped health behaviors. When we began collecting data during the COVID-19 pandemic, we found that the determining factors to action weren’t connected with trust in health care but trust in government,” Mayer added. Low trust in government was linked to a belief in conspiracy theories and vaccine hesitancy during the COVID-19 pandemic. 

Informing action to rebuild trust

The tools currently used to measure trust are limited in their use for informing action to (re)build trust and have limitations related to reliability and validity. Public trust in the government is critical to adopting new health policies amid a reported decline in confidence in countries tracked by the Organization for Economic Co-operation and Development (OECD). The OECD found that only 51% of citizens in OECD countries trusted their national government.

The study entitled “Development and Validation of the Trust in Government Measure (TGM),” was published in the journal BMC Public Health. 

The researchers worked with market researchers using an online survey to test the validity of the trust in government measures. Close to 900 Canadians completed the survey in both English and French and the researchers found that this tool could be used to gauge trust in government as a barometer of public support for health initiatives. 

A key feature of the study was that it oversampled participants from historically disadvantaged groups to determine what type of variation there is between different communities to understand, design, and communicate public health initiatives in ways that build trust across multiple and diverse communities.

Government interventions to improve trust need to be rooted in data collected using valid measures that account for dimensions of trust, rather than single items, so that one can identify items within these measures that shift in response to government action and/or negatively impact trust. The team looked at current limitations and developed the Trust in Government Measure (TGM) that changed discussions regarding trust in social institutions. Mayer explained that the tool, which can be accessed by contacting her, was developed and validated by interviewing and surveying participants representing LGBT, black, indigenous, low-income, youth, and new immigrant communities, but the team has plans to validate their tool for use within individual populations.

“This tool is not meant just to determine how to foster trust in governments; it’s about making sure that a government is acting and communicating in a manner that demonstrates its trustworthiness. It’s a two-way street,” Meyer stressed.