Exploring Pathways for Building Trust in Vaccination and Strengthening Health System Resilience

Background: Trust is critical to generate and maintain demand for vaccines in low and middle income countries. However, there is little documentation on how health system insufficiencies affect trust in vaccination and the process of re-building trust once it has been compromised. We reflect on how disruptions to immunizations systems can affect trust in vaccination and can compromise vaccine utilization. We then explore key pathways for overcoming system vulnerabilities in order to restore trust, to strengthen the resilience of health systems and communities, and to promote vaccine utilization. Methods: Utilizing secondary data and a review of the literature, we developed a causal loop diagram (CLD) to map the determinants of building trust in immunizations. Using the CLD, we devised three scenarios to illustrate common vulnerabilities that compromise trust and pathways to strengthen trust and utilization of vaccines, specifically looking at weak health systems, harmful communication channels, and role of social capital. Spill-over effects, interactions and other dynamics in the CLD were then examined to assess leverage points to counter these vulnerabilities. Results: Trust in vaccination arises from the interactions among experiences with the health system, the various forms of communication and social capital – both external and internal to communities. When experiencing system-wide shocks such as the case in Ebola-affected countries, distrust is reinforced by feedback between the health and immunization systems where distrust often lingers even after systems are restored and spills over beyond vaccination in the broader health system. Vaccine myths or anti-vaccine movements reinforce distrust. Social capital – the collective value of social networks of community members – plays a central role in increasing levels of trust. Conclusions: Trust is important, yet underexplored, in the context of vaccine utilization. Using a CLD to illustrate various scenarios helped to explore how common health and vaccine vulnerabilities can reinforce and spill over distrust through vicious, reinforcing feedback. Restoring trust requires a careful balance between eliminating vulnerabilities and strengthening social capital and interactions among communication channels

Consumer motivations for social media usage and its impact on customers' trust and long-term relationships

New challenges and opportunities have recently arisen for companies’ relationships with customers as a result of the increasing prevalence of social media. By enabling companies to build online communities, social media allow marketers to access information about consumers, identify consumers’ needs, and gain direct consumer feedback. Thus, social media can be a very important and helpful tool for interacting and communicating with customers. In order to sustain such relationships for the long term, however, efforts must be centred around building consumer trust and commitment.This study investigates the role of social media based communities in building relationships with consumers, and the influence of such communities on consumers’ attitudes and behaviours. Specifically, the study investigates whether such influences can lead to trust, commitment, and loyalty towards the organisation. Drawing on Uses and Gratification Theory, Consumption Values Theory, and the Commitment-Trust Theory, the study examines the relationship between consumers using social media channels, trusting these channels, and trusting the organisation that owns these channels.Adopting a positivist deductive approach, quantitative data was collected via a survey strategy. A questionnaire targeting telecommunications company fan pages users in Saudi Arabia was distributed through Twitter and Facebook with help from people who have many followers/likes such as celebrities. More than 700 responses were collected, of which 522 were usable for factor analysis.Based on the results, a cognitive behavioural model was established in relation to social media uses and gratifications, perceived values of social media fan pages, organisational trust, commitment, and loyalty. Users who perceived utilitarian benefits from following a company’s fan pages were likely to trust these pages, whereas perceived hedonic and social benefits did not have an influence on trust towards organization’s fan pages. The findings additionally indicated that consumers who trusted the organization’s fan pages were likely to trust the company. Therefore, telecommunication companies’ fan page users who perceived trust were expected to be committed and loyal to the company, which would consequently, lead to more frequent and larger purchases. The findings contribute to marketing theory and suggest ways in which marketers can tailor companies’ web presence for more effective communication and relationship-building with customers

Information Asymmetry and Trust: A Framework for Studying Micro-Finance in India

The work in the area of microfinance has concentrated on the issue of transaction costs in delivering the financial services to the poor. However, the mechanisms of reducing transaction costs have been mostly in the area of building trusts within local communities and using trust as an effective surrogate for sorting the twin problems of inadequate information and high cost of transactions. The paper presents a theoretical framework to study the field of microfinance from this point of view. There has been significant literature both in Economics as well as in Behavioural Sciences in examining the role of trust in organisational settings. This paper postulates that the element could be extended to networks like self-help groups. Eventually, it tries to identify some thresholds where the concept of trust and social capital can be used as a surrogate to reduce transaction-documentation costs and when the costs become indifferent to the underlying trust in exchanges.

Towards Sustainable Health Care Organizations

Health care organizations have to develop a sustainable path for creating public value by seeking legitimacy for building and maintaining public trust with patients as social and economic institutions creating value and sustaining both health and wealth for people and communities within society. Health care organizations having at disposal decreasing resources and meeting increasing demands of citizens are following an unsustainable path. Designing sustainable health care systems and organizations is emerging as a strategic goal for developing the wealth of people and communities over time. Building sustainable organizations relies on valuing human resources, designing efficient and effective processes, using technology for better managing the relationships within and outside organizations. Sustainable health care organizations tend to rediscover the importance of human resource management and policies for effectively improving communication with patients and building trust-based relationships. While processes of accreditation contribute to legitimizing effectiveness and quality of health care services and efficient processes, introducing and using new information and communication technologies (ICTs) and informatics helps communication leading to restore trust-based relationships between health care institutions and patients for value creation within society

Contextualising social capital in online brand communities

Online brand communities (OBC) are growing in number and becoming an increasingly important interface where marketers can effectively facilitate the relationship between their brand and consumers. A qualitative study using a four-month netnography over three OBCs followed by focus groups with OBC members explored the dynamics of social capital in these communities. Findings indicate that social capital is an important driver in the success of OBCs, and all the elements of social capital including a shared language, shared vision, social trust and reciprocity are evident. Moreover, results from this study indicate that these elements are crucial in developing the network ties that are integral to building loyalty and brand equity

Bridge over Troubled Water: Linking Capacities of Sport and Non-Sport Organizations

Community Sport Development Programs (CSDPs) that use an intersectoral capacity building approach have shown potential in reaching individuals in disadvantaged situations. This study has investigated how the application of capacity building principles in disadvantaged communities results in higher sport participation rates in these communities. A multiple case design was used, including six similar disadvantaged communities in Antwerp, Belgium; four communities implemented the CSDP, two communities served as control communities without CSDP. In total, 52 face-to-face interviews were held with sport, social, health, cultural, and youth organizations in these communities. Four key findings were crucial to explain the success of the CSDP according to the principles of capacity building. First, the CSDP appeared to be the missing link between sport organizations on the one hand and health, social, youth, and cultural organizations on the other hand. Second, shifting from a sport-oriented staff to a mix of sport staff, social workers and representatives of people in disadvantaged situations helped increase trust through a participatory approach. Third, CSDPs assisted sport clubs to deal with financial, organizational, and cultural pressures that arose from the influx of new members in disadvantaged situations. Finally, the CSDPs developed well-planned and integrated strategies focusing on reinforcing the existing local organizations already using sport to reach their goals. These capacity building principles were key in attaining higher sport participation for people living in disadvantaged communities

Provider and service-user perspectives of volunteer health-worker service provision in Ayeyarwady Region, Myanmar: a qualitative study.

OBJECTIVES: To explore perspectives and reported experiences of service users, community providers and policymakers related to volunteer health-worker services provision in a rural area of Myanmar. METHODS: A qualitative interview study was conducted in rural communities with 54 service users and 17 community providers in Ayeyarwady Region, Myanmar, and with 14 national managers and policymakers in Yangon Myanmar. Topics included reasons for seeking health services, views and experiences, and comparison with experiences of other services. Data were analysed thematically using deductive and inductive coding. RESULTS: Accessibility and affordability were important to all participants. Service users described the particular relevance of trust, familiarity and acceptability in choosing a provider. Perceived quality and effectiveness were necessary for trust to develop. Perceived value of volunteers was a cross-cutting dimension, which was interpreted differently by different participants. CONCLUSIONS: Results suggest that volunteers are appropriate and valued, and support 'availability', 'accessibility' and 'acceptability' as dimensions of health services access in this setting. However, social complexities should be considered to ensure effective service delivery. Further research into trust-building, developing quality perceptions and resulting service-user choices would be useful to inform effective policy and planning

Trust in Community-Engaged Research Partnerships: A Methodological Overview of Designing a Multisite Clinical and Translational Science Awards (CTSA) Initiative

Community-engaged research (CEnR) builds on the strengths of the Clinical and Translational Science Awards (CTSA) framework to address health in underserved and minority communities. There is a paucity of studies that identify the process from which trust develops in CEnR partnerships. This study responds to the need for empirical investigation of building and maintaining trust from a multistakeholder perspective. We conducted a multi-institutional pilot study using concept mapping with to better understand how trust, a critical outcome of CEnR partnerships, can act as “social capital.” Concept mapping was used to collect data from the three stakeholder groups community, health-care, and academic research partners across three CTSAs. Concept mapping is a mixed-methods approach that allows participants to brainstorm and identify factors that contribute to a concept and describe ways in which those factors relate to each other. This study offers important insights on developing an initial set of trust measures that can be used across CTSAs to understand differences and similarities in conceptualization of trust among key stakeholder groups, track changes in public trust in research, identify both positive and negative aspects of trust, identify characteristics that maintain trust, and inform the direction for future research

Doing public health differently: How can public health departments engage with local communities through social media interventions?

Objectives This paper evaluates a collaborative intervention between public health professionals and local social media administrators, in which the social media site Facebook was used with a view to strengthening engagement with and, dissemination of, core messages and building trust and resilience within local communities during the COVID-19 pandemic. Study design A qualitative design was used, exploring the research question: how does collaboration between public health professionals and local social network group administrators create community engagement during a global crisis? Methods Fourteen semi-structured interviews were conducted with public health staff and online group administrators. Data was analysed using framework analysis. Results Collaboration between public health professionals and local group administrators created both opportunities and challenges. Local group administrators had wide reach and trust within the local community, but message credibility was enhanced through local authority involvement. Such collaborations contain inherent tensions due to perceived risks to social capital and independence but can be successful if receiving strong risk-tolerant support from the local authority. Findings are discussed in the context of Bourdieu's theory of social capital to examine how public health information can be delivered by trusted social media actors in communication tailored to the local community. Conclusions Social media provides new channels of communication for delivery of public health messages, enabling new ways of working which create long-term engagement and community building. Although the intervention was developed quickly in response to the COVID-19 pandemic, participants felt it could be mobilised to address a wider range of issues