Division of Learning and Knowledge Systems, Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI.
Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI.
Health Serv Res. 2018 Apr;53(2):824-845. doi: 10.1111/1475-6773.12654. Epub 2017 Jan 18.
To measure public trust in a health information sharing in a broadly defined health system (system trust), inclusive of health care, public health, and research; to identify individual characteristics that predict system trust; and to consider these findings in the context of national health initiatives (e.g., learning health systems and precision medicine) that will expand the scope of data sharing.
Survey data (n = 1,011) were collected in February 2014.
We constructed a composite index of four dimensions of system trust-competency, fidelity, integrity, and trustworthiness. The index was used in linear regression evaluating demographic and psychosocial predictors of system trust.
Data were collected by GfK Custom using a nationally representative sample and analyzed in Stata 13.0.
Our findings suggest the public's trust may not meet the needs of health systems as they enter an era of expanded data sharing. We found that a majority of the U.S. public does not trust the organizations that have health information and share it (i.e., the health system) in one or more dimensions. Together, demographic and psychosocial factors accounted for ~18 percent of the observed variability in system trust. Future research should consider additional predictors of system trust such as knowledge, attitudes, and beliefs to inform policies and practices for health data sharing.
衡量公众对广泛定义的卫生系统（系统信任）中健康信息共享的信任程度，包括医疗保健、公共卫生和研究；确定预测系统信任的个体特征；并在将扩大数据共享范围的国家卫生倡议（例如学习型卫生系统和精准医学）背景下考虑这些发现。
调查数据（n=1011）于 2014 年 2 月收集。
我们构建了系统信任的四个维度（能力、保真度、完整性和可信度）的综合指数。该指数用于线性回归，评估人口统计学和社会心理预测因素对系统信任的影响。
GfK Custom 使用全国代表性样本进行数据收集，并在 Stata 13.0 中进行分析。
我们的研究结果表明，随着卫生系统进入扩大数据共享的时代，公众的信任可能无法满足卫生系统的需求。我们发现，大多数美国公众在一个或多个维度上不信任拥有健康信息并共享信息的组织（即卫生系统）。人口统计学和社会心理因素共同解释了系统信任观察到的可变性的约 18%。未来的研究应考虑系统信任的其他预测因素，例如知识、态度和信念，以为卫生数据共享的政策和实践提供信息。
