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Development and validation of the Trust in Multidimensional Healthcare Systems Scale (TIMHSS).
Samantha B Meyer1, Patrick Brown2, Michael Calnan3
1School of Public Health Sciences, University of Waterloo, 200 University Ave West, Waterloo, ON, N2L 3G1, Canada. samantha.meyer@uwaterloo.ca.
International Journal for Equity in Health
|May 9, 2024
Summary
A new multidimensional measure of trust in healthcare, the TIMHSS, was developed to assess trust in doctors, policies, and the system. This scale aids in identifying disparities and evaluating interventions to rebuild healthcare trust.
Area of Science:
- Health Services Research
- Health Policy
- Psychometrics
Background:
- The COVID-19 pandemic highlighted the need for robust measures of trust in healthcare systems.
- Existing trust measures have conceptual and methodological limitations.
- There is a renewed focus on understanding and addressing lower trust in equity-deserving populations.
Purpose of the Study:
- To develop a multidimensional measure of trust in healthcare.
- To create a tool responsive to limitations of existing measures.
- To facilitate identification of systemic factors affecting trust and inform interventions.
Main Methods:
- A comprehensive review of existing trust measures was conducted.
- Qualitative interviews with oversampling for equity-deserving populations were performed.
- Factor analyses and validation testing used two waves of survey data (N=1434).
Main Results:
- The Trust in Multidimensional Healthcare Systems Scale (TIMHSS) was developed.
- TIMHSS is a 38-item, three-factor measure assessing trust in doctors, policies, and the system.
- Measurement invariance tests indicate TIMHSS is suitable for diverse populations.
Conclusions:
- The TIMHSS is a global measure for population-level and subpopulation-level trust assessment.
- It can inform interventions aimed at rebuilding healthcare trust.
- TIMHSS can support research on trust's association with therapeutic outcomes.
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