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Original Articles and Reviews

The Role of Public Trust During Pandemics

Implications for Crisis Communication

Published Online:https://doi.org/10.1027/1016-9040/a000169

The present review examined the importance of trust when preparing for and during a pandemic. The reviewed literature suggests that trust in health agencies positively influenced people’s willingness to adopt recommended behavior. Most of these studies are atheoretical, and due to the lack of a common framework for trust and its antecedents, finding commonalities among the studies may seem difficult. The trust, confidence, and cooperation model was used to uncover the commonalities among the various studies on trust. This framework suggests that a distinction between values and past performance may be helpful to better understand the impact of trust on risk perception and behavior. Based on the reviewed literature, the following five recommendations relevant for crisis communication during pandemics were identified: A diverse set of experts should be used as communicators, medical personnel need to model the recommended behavior, a transparent information strategy should be used, the focus should be not only on trust but also on confidence, and establishing trust in health authorities before a pandemic occurs is important. Furthermore, research gaps were identified that should be addressed to better understand the role of trust when dealing with pandemics.

References

  • Alkuwari, M. G., Aziz, N. A., Nazzal, Z. A. S., A-Nuaimi, S. A. (2011). Pandemic influenza A/H1N1 vaccination uptake among health care workers in Qatar: Motivators and barriers. Vaccine, 29, 2206–2211. doi: 10.1016/J.Vaccine.2010.08.093 First citation in articleCrossrefGoogle Scholar

  • Baron-Epel, O., Bord, S., Madjar, B., Habib, S., Rishpon, S. (2012). What lies behind the low rates of vaccinations among nurses who treat infants? Vaccine, 30, 3151–3154. First citation in articleCrossrefGoogle Scholar

  • Brewer, N. T., Weinstein, N. D., Cuite, C. L., Herrington, J. E. (2004). Risk perceptions and their relation to risk behavior. Annals of Behavioral Medicine, 27, 125–130. doi: 10.1207/S15324796abm2702_7 First citation in articleCrossrefGoogle Scholar

  • Condon, B. J., Sinha, T. (2010). Who is that masked person: The use of face masks on Mexico city public transportation during the Influenza A (H1N1) outbreak. Health Policy, 95, 50–56. First citation in articleCrossrefGoogle Scholar

  • Cvetkovich, G. T., Siegrist, M., Murray, R., Tragesser, S. (2002). New information and social trust: Asymmetry and perseverance of attributions about hazard managers. Risk Analysis, 22, 359–367. First citation in articleCrossrefGoogle Scholar

  • De Bruin, E. N. M., Van Lange, P. A. M. (2000). What people look for in others: Influences of the perceiver and the perceived on information selection. Personality and Social Psychology Bulletin, 26, 206–219. First citation in articleCrossrefGoogle Scholar

  • Deurenberg-Yap, M., Foo, L. L., Low, Y. Y., Chan, S. P., Vijaya, K., Lee, M. (2005). The Singaporean response to the SARS outbreak: Knowledge sufficiency versus public trust. Health Promotion International, 20, 320–326. doi: 10.1093/heapro/dai010 First citation in articleCrossrefGoogle Scholar

  • Earle, T. C. (2010). Trust in risk management: A model-based review of empirical research. Risk Analysis, 30, 541–574. doi: 10.1111/j.1539-6924.2010.01398.x First citation in articleCrossrefGoogle Scholar

  • Earle, T. C., Cvetkovich, G. T. (1997). Culture, cosmopolitanism, and risk management. Risk Analysis, 17, 55–65. First citation in articleCrossrefGoogle Scholar

  • Earle, T. C., Siegrist, M. (2006). Morality information, performance information, and the distinction between trust and confidence. Journal of Applied Social Psychology, 36, 383–416. First citation in articleCrossrefGoogle Scholar

  • Earle, T. C., Siegrist, M., Gutscher, H. (2007). Trust, risk perception and the TCC model of cooperation. In M. Siegrist, T. C. Earle, H. Gutscher (Eds.), Trust in cooperative risk management. Uncertainty and scepticism in the public mind (pp. 1–49). London, UK: Earthscan. First citation in articleGoogle Scholar

  • Eiser, J. R., Miles, S., Frewer, L. J. (2002). Trust, perceived risk, and attitudes toward food technologies. Journal of Applied Social Psychology, 32, 2423–2433. First citation in articleCrossrefGoogle Scholar

  • Ferrante, G., Baldissera, S., Moghadam, P. F., Carrozzi, G., Trinito, M. O., Salmaso, S. (2011). Surveillance of perceptions, knowledge, attitudes and behaviors of the Italian adult population (18–69 years) during the 2009–2010 A/H1N1 influenza pandemic. European Journal of Epidemiology, 26, 211–219. First citation in articleCrossrefGoogle Scholar

  • Feufel, M. A., Antes, G., Gigerenzer, G. (2010). Competence in dealing with uncertainty: Lessons to learn from the influenza pandemic (H1N1) 2009. Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz, 53, 1283–1289. doi: 10.1007/S00103-010-1165-1 First citation in articleCrossrefGoogle Scholar

  • Finucane, M. L., Alhakami, A., Slovic, P., Johnson, S. M. (2000). The affect heuristic in judgments of risks and benefits. Journal of Behavioral Decision Making, 13, 1–17. First citation in articleCrossrefGoogle Scholar

  • Fischhoff, B. (1995). Risk perception and communicating unplugged: Twenty years of process. Risk Analysis, 15, 137–145. First citation in articleCrossrefGoogle Scholar

  • Fong, E., Chang, L. Y. (2011). Community under stress: Trust, reciprocity, and community collective efficacy during SARS outbreak. Journal of Community Health, 36, 797–810. doi: 10.1007/s10900-011-9378-2 First citation in articleCrossrefGoogle Scholar

  • Frewer, L. J. (2003). Trust, transparency, and social context: Implications for social amplification of risk. In N. F. Pidgeon, R. E. Kasperson, P. Slovic (Eds.), The social amplification of risk (pp. 123–137). Cambridge, UK: Cambridge University Press. First citation in articleCrossrefGoogle Scholar

  • Frewer, L. J. (2004). The public and effective risk communication. Toxicology Letters, 149, 391–397. doi: 10.1016/j.toxlet.2003.12.049 First citation in articleCrossrefGoogle Scholar

  • Frewer, L. J., Howard, C., Hedderley, D., Shepherd, R. (1996). What determines trust in information about food-related risks? Underlying psychological constructs. Risk Analysis, 16, 473–486. doi: 10.1111/j.1539-6924.1996.tb01094.x First citation in articleCrossrefGoogle Scholar

  • Galesic, M., Garcia-Retamero, R., Gigerenzer, G. (2009). Using icon arrays to communicate medical risks: Overcoming low numeracy. Health Psychology, 28, 210–216. First citation in articleCrossrefGoogle Scholar

  • Gilles, I., Bangerter, A., Clemence, A., Green, E. G. T., Krings, F., Staerkle, C., Wagner-Egger, P. (2011). Trust in medical organizations predicts pandemic (H1N1) 2009 vaccination behavior and perceived efficacy of protection measures in the Swiss public. European Journal of Epidemiology, 26, 203–210. doi: 10.1007/s10654-011-9577-2 First citation in articleCrossrefGoogle Scholar

  • Hardin, R. (1998). Trust in government. In V. Braithwaite, M. Levi (Eds.), Trust and governance (pp. 9–27). New York, NY: Russell Sage Foundation. First citation in articleGoogle Scholar

  • Hoffrage, U., Lindsey, S., Hertwig, R., Gigerenzer, G. (2000). Communicating statistical information. Science, 290, 2261–2262. First citation in articleCrossrefGoogle Scholar

  • Kahan, D. M. (2010). Fixing the communications failure. Nature, 463, 296–297. First citation in articleCrossrefGoogle Scholar

  • Kahan, D. M., Braman, D., Cohen, G. L., Gastil, J., Slovic, P. (2010). Who fears the HPV vaccine, who doesn’t, and why? An experimental study of the mechanisms of cultural cognition. Law and Human Behavior, 34, 501–516. First citation in articleCrossrefGoogle Scholar

  • Kahneman, D., Tversky, A. (1984). Choices, values, and frames. American Psychologist, 39, 341–350. First citation in articleCrossrefGoogle Scholar

  • Katz, R., May, L., Sanza, M., Johnston, L., Petinaux, B. (2012). H1N1 preventive health behaviors in a university setting. Journal of American College Health, 60, 46–56. doi: 10.1080/07448481.2011.570398 First citation in articleCrossrefGoogle Scholar

  • Keller, C., Siegrist, M. (2009). Effect of risk communication formats on risk perception depending on numeracy. Medical Decision Making, 29, 483–490. First citation in articleCrossrefGoogle Scholar

  • Liao, Q. Y., Cowling, B., Lam, W. T., Ng, M. W., Fielding, R. (2010). Situational awareness and health protective responses to pandemic influenza A (H1N1) in Hong Kong: A cross-sectional study. Plos One, 5, e13350. doi: 10.1371/journal.pone.0013350 First citation in articleCrossrefGoogle Scholar

  • Liao, Q. Y., Cowling, B. J., Lam, W. W. T., Fielding, R. (2011). The influence of social-cognitive factors on personal hygiene practices to protect against influenzas: Using modelling to compare Avian A/H5N1 and 2009 pandemic A/H1N1 influenzas in Hong Kong. International Journal of Behavioral Medicine, 18, 93–104. doi: 10.1007/s12529-010-9123-8 First citation in articleCrossrefGoogle Scholar

  • Lichtenstein, S., Slovic, P., Fischhoff, B., Layman, M., Combs, B. (1978). Judged frequency of lethal events. Journal of Experimental Psychology: Human Learning and Memory, 4, 551–578. First citation in articleCrossrefGoogle Scholar

  • Luhmann, N. (1989). Vertrauen – Ein Mechanismus der Reduktion sozialer Komplexität [Trust – a mechanism for reducing social complexity] Vol. 3, Stuttgart, Germany: Enke. First citation in articleGoogle Scholar

  • Meijnders, A., Midden, C., Olofsson, A., Öhman, S., Matthes, J., Bondarenko, O., … Rusanen, M. (2009). The role of similarity cues in the development of trust in sources of information about GM food. Risk Analysis, 29, 1116–1128. First citation in articleCrossrefGoogle Scholar

  • Metlay, D. S. (1999). Institutional trust and confidence: A journey into conceptual quagrime. In G. T. Cvetkovich, R. E. Löfstedt (Eds.), Social trust and the management of risk (pp. 100–116). London, UK: Earthscan. First citation in articleGoogle Scholar

  • Metzger, W. (1963). Psychologie: Die Entwicklung ihrer Grundannahmen seit der Einführung des Experiments [Psychology: The development of its basic assumptions since the introduction of experiments]. Darmstadt, Germany: Steinkopff. First citation in articleCrossrefGoogle Scholar

  • Nakayachi, K., Cvetkovich, G. T. (2010). Public trust in government concerning tobacco control in Japan. Risk Analysis, 30, 143–152. First citation in articleCrossrefGoogle Scholar

  • Peters, R. G., Covello, V. T., McCallum, D. B. (1997). The determinants of trust and credibility in environmental risk communication: An empirical study. Risk Analysis, 17, 43–54. First citation in articleCrossrefGoogle Scholar

  • Plous, S. (1991). Biases in the assimilation to technological breakdowns: Do accidents make us safer? Journal of Applied Social Psychology, 21, 1058–1082. First citation in articleCrossrefGoogle Scholar

  • Podlesek, A., Roskar, S., Komidar, L. (2011). Some factors affecting the decision on non-mandatory vaccination in an influenza pandemic: Comparison of pandemic (H1n1) and seasonal influenza vaccination. Zdravstveno Varstvo, 50, 227–238. First citation in articleGoogle Scholar

  • Poortinga, W., Pidgeon, N. F. (2003). Exploring the dimensionality of trust in risk regulation. Risk Analysis, 23, 961–972. doi: 10.1111/1539-6924.00373 First citation in articleCrossrefGoogle Scholar

  • Poortinga, W., Pidgeon, N. F. (2004). Trust, the asymmetry principle, and the role of prior beliefs. Risk Analysis, 24, 1475–1486. First citation in articleCrossrefGoogle Scholar

  • Prati, G., Pietrantoni, L., Zani, B. (2011a). Compliance with recommendations for pandemic influenza H1N1 2009: The role of trust and personal beliefs. Health Education Research, 26, 761–769. doi: 10.1093/her/cyr035 First citation in articleCrossrefGoogle Scholar

  • Prati, G., Pietrantoni, L., Zani, B. (2011b). A Social-Cognitive model of pandemic influenza H1N1 risk perception and recommended behaviors in Italy. Risk Analysis, 31, 645–656. doi: 10.1111/J.1539-6924.2010.01529.X First citation in articleCrossrefGoogle Scholar

  • Prematunge, C., Corace, K., McCarthy, A., Nair, R. C., Pugsley, R., Garber, G. (2012). Factors influencing pandemic influenza vaccination of healthcare workers – A systematic review. Vaccine, 30, 4733–4743. First citation in articleCrossrefGoogle Scholar

  • Quinn, S. C., Kumar, S., Freimuth, V. S., Kidwell, K., Musa, D. (2009). Public willingness to take a vaccine or drug under emergency use authorization during the 2009 H1N1 pandemic. Biosecurity and Bioterrorism-Biodefense Strategy Practice and Science, 7, 275–290. doi: 10.1089/bsp. 2009.0041 First citation in articleCrossrefGoogle Scholar

  • Renn, O., Levine, D. (1991). Credibility and trust in risk communication. In R. E. Kasperson, P. J. M. Stallen (Eds.), Communicating risks to the public (pp. 175–218). Dordrecht, The Netherlands: Kluwer. First citation in articleCrossrefGoogle Scholar

  • Rousseau, D. M., Sitkin, S. B., Burt, R. S., Camerer, C. (1998). Not so different after all: A cross-discipline view of trust. Academy of Management Review, 23, 393–404. First citation in articleCrossrefGoogle Scholar

  • Rozin, P., Royzman, E. B. (2001). Negativity bias, negativity dominance, and contagion. Personality and Social Psychology Review, 5, 296–320. First citation in articleCrossrefGoogle Scholar

  • Seale, H., Mak, J. P. I., Razee, H., MacIntyre, C. R. (2012). Examining the knowledge, attitudes and practices of domestic and international university students towards seasonal and pandemic influenza. BMC Public Health, 12, 307. doi: 10.1186/1471-2458-12-307 First citation in articleCrossrefGoogle Scholar

  • Siegrist, M., Connor, M., Keller, C. (2012). Trust, confidence, procedural fairness, outcome fairness, moral conviction, and the acceptance of GM field experiments. Risk Analysis, 32, 1394–1403. First citation in articleCrossrefGoogle Scholar

  • Siegrist, M., Cousin, M.-E., Frei, M. (2008). Biased confidence in risk assessment studies. Human and Ecological Risk Assessment, 14, 1226–1234. First citation in articleCrossrefGoogle Scholar

  • Siegrist, M., Cvetkovich, G. T. (2000). Perception of hazards: The role of social trust and knowledge. Risk Analysis, 20, 713–719. First citation in articleCrossrefGoogle Scholar

  • Siegrist, M., Cvetkovich, G. T. (2001). Better negative than positive? Evidence of a bias for negative information about possible health dangers. Risk Analysis, 21, 211–218. First citation in articleCrossrefGoogle Scholar

  • Siegrist, M., Cvetkovich, G. T., Roth, C. (2000). Salient value similarity, social trust, and risk/benefit perception. Risk Analysis, 20, 353–362. First citation in articleCrossrefGoogle Scholar

  • Siegrist, M., Earle, T. C., Gutscher, H. (2003). Test of a trust and confidence model in the applied context of electromagnetic field (EMF) risks. Risk Analysis, 23, 705–716. doi: 10.1111/1539-6924.00349 First citation in articleCrossrefGoogle Scholar

  • Siegrist, M., Earle, T. C., Gutscher, H. (2007). Trust in cooperative risk management: Uncertainty and scepticism in the public mind. London, UK: Earthscan. First citation in articleGoogle Scholar

  • Skowronski, J. J., Carlston, D. E. (1989). Negativity and extremity biases in impression formation: A review of explanations. Psychological Bulletin, 105, 131–142. First citation in articleCrossrefGoogle Scholar

  • Slovic, P. (1993). Perceived risk, trust, and democracy. Risk Analysis, 13, 675–682. First citation in articleCrossrefGoogle Scholar

  • Slovic, P. (1999). Trust, emotion, sex, politics, and science: Surveying the risk-assessment battlefield. Risk Analysis, 19, 689–701. (Reprinted from Environment, ethics, and behavior, pp. 277-313, 1997). First citation in articleCrossrefGoogle Scholar

  • Twyman, M., Harvey, N., Harries, C. (2008). Trust in motives, trust in competence: Separate factors determining the effectiveness of risk communication. Judgment and Decision Making, 3, 111–120. First citation in articleGoogle Scholar

  • van der Weerd, W., Timmermans, D. R. M., Beaujean, D., Oudhoff, J., van Steenbergen, J. E. (2011). Monitoring the level of government trust, risk perception and intention of the general public to adopt protective measures during the influenza A (H1N1) pandemic in the Netherlands. Bmc Public Health, 11, 575. doi: 10.1186/1471-2458-11-575 First citation in articleCrossrefGoogle Scholar

  • Walter, D., Bohmer, M. M., Heiden, M. A. D., Reiter, S., Krause, G., Wichmann, O. (2011). Monitoring pandemic influenza A (H1N1) vaccination coverage in Germany 2009/10-Results from thirteen consecutive cross-sectional surveys. Vaccine, 29, 4008–4012. doi: 10.1016/J.Vaccine.2011.03.069 First citation in articleCrossrefGoogle Scholar

  • Walter, D., Bohmer, M. M., Reiter, S., Krause, G., Wichmann, O. (2012). Risk perception and information-seeking behaviour during the 2009/10 influenza A (H1N1)pdm09 pandemic in Germany. Eurosurveillance, 17, 9–16. First citation in articleCrossrefGoogle Scholar

  • White, M. P., Eiser, J. R. (2005). Information specificity and hazard risk potential as moderators of trust asymmetry. Risk Analysis, 25, 1187–1198. First citation in articleCrossrefGoogle Scholar

  • White, M. P., Eiser, J. R. (2006). Marginal trust in risk managers: Building and losing trust following decisions under uncertainty. Risk Analysis, 26, 1187–1203. doi: 10.1111/J.1539-6924.2006.00807.X First citation in articleCrossrefGoogle Scholar

  • White, M. P., Johnson, B. B. (2010). The Intuitive Detection Theorist (IDT) model of trust in hazard managers. Risk Analysis, 30, 1196–1209. First citation in articleCrossrefGoogle Scholar

  • Wichmann, O., Stocker, P., Poggensee, G., Altmann, D., Walter, D., Hellenbrand, W., Eckmanns, T. (2010). Pandemic influenza A (H1N1) 2009 breakthrough infections and estimates of vaccine effectiveness in Germany 2009–2010. Eurosurveillance, 15, 2–5. First citation in articleCrossrefGoogle Scholar

  • Zingg, A., Siegrist, M. (2012). Measuring people’s knowledge about vaccination: Developing a one-dimensional scale. Vaccine, 30, 3771–3777. First citation in articleCrossrefGoogle Scholar