Development and psychometric validation of a multidimensional institutional trustworthiness scale

An academic medical center's trustworthiness is a necessary precondition of patient and community trust. Current operationalizations of trustworthiness fail to capture the construct's complexity at the institutional level. We propose a novel multidimensional scale to assess perceived trustworthiness of academic medical centers.

We propose and psychometrically evaluate a 20-item Multidimensional Institutional Trustworthiness Scale (MITS). Invitations to complete an online survey in REDCap were sent to 175 leaders, investigators, staff and community partners affiliated with an academic medical center. Item-total correlations were calculated and construct validity assessed using confirmatory factor analysis.

Items in the hypothesized four factors demonstrated high factor loadings (>0.7) and explained substantial item variance (>50%), providing strong empirical support for the proposed scale and affirming its conceptual structure and measurement integrity. Tests of scale reliability showed high Cronbach's alphas (>0.9) for all four factors, suggesting that all subscales produce consistent and dependable scores.

This study provides support for the construct validity and scale reliability of a novel institutional trustworthiness scale, based on perspectives from community and academic affiliates of an academic medical center. We discuss the importance of measuring institutional trustworthiness using multiple dimensions to inform future interventions aiming to improve institutional trustworthiness.