Trust Through Others' Eyes: An Experiment on How Vicarious Health Care Experiences Shape System Trust

Area of Science:

• Health Services Research
• Social Psychology
• Health Communication

Background:

• Declining trust in the US health care system impacts patient engagement and outcomes.
• Vicarious experiences (stories from networks) influence health care trust, especially within racial/ethnic communities.
• Research is needed on how narrative valence and narrator race affect trust, considering respondent race and provider trust.

Purpose of the Study:

• To examine how vicarious health care experiences influence trust in the US health care system.
• To investigate the moderating roles of narrator race and respondent race on this influence.
• To assess how baseline trust in one's own provider affects susceptibility to vicarious experiences.

Main Methods:

• Online survey experiment with 1,042 US adults, demographically representative.
• Participants were randomly assigned to vignettes with varying emotional valence (positive/negative) and narrator race (in-group/out-group).
• Sample was evenly divided between non-Hispanic White and non-Hispanic Black participants.

Main Results:

• Vicarious experiences significantly affected health care system trust, with differential effects by race.
• Non-Hispanic White participants were influenced by out-group narratives, while non-Hispanic Black participants were influenced by in-group narratives.
• Strong patient-provider relationships buffered individuals from negative systemic narratives, while low provider trust increased susceptibility.

Conclusions:

• Collective narratives play a crucial role in shaping systemic health care trust.
• Health systems should monitor community narratives and proactively address negative experiences.
• Investing in patient-provider relationships can enhance trust resilience, particularly for marginalized communities.