Ryan Molly J, Giles-Vernick Tamara, Graham Janice E
Pediatrics (Infectious Diseases), Dalhousie University, Halifax, Nova Scotia, Canada.
Unité d'Epidémiologie des Maladies Emergentes, Institut Pasteur, Paris, France.
BMJ Glob Health. 2019 Feb 13;4(1):e001272. doi: 10.1136/bmjgh-2018-001272. eCollection 2019.
Trust is an essential component of successful cooperative endeavours. The global health response to the 2014-2016 West Africa Ebola outbreak confronted historically tenuous regional relationships of trust. Challenging sociopolitical contexts and initially inappropriate communication strategies impeded trustworthy relationships between communities and responders during the epidemic. Social scientists affiliated with the Ebola 100-Institut Pasteur project interviewed approximately 160 local, national and international responders holding a wide variety of roles during the epidemic. Focusing on responder's experiences of communities' trust during the epidemic, this qualitative study identifies and explores social techniques for effective emergency response. The response required individuals with diverse knowledges and experiences. Responders' included on-the-ground social mobilisers, health workers and clinicians, government officials, ambulance drivers, contact tracers and many more. We find that trust was fostered through open, transparent and reflexive communication that was adaptive and accountable to community-led response efforts and to real-time priorities. We expand on these findings to identify 'technologies of trust' that can be used to promote actively legitimate trustworthy relationships. Responders engaged the social technologies of openness (a willingness and genuine effort to incorporate multiple perspectives), reflexivity (flexibly responsive to context and ongoing dialogue) and accountability (taking responsibility for local contexts and consequences) to facilitate relations of trust. Technologies of trust contribute to the development of a framework of practical techniques to improve the acceptance and effectiveness of future emergency response strategies.
信任是成功合作努力的重要组成部分。全球对2014 - 2016年西非埃博拉疫情的应对面临着历史上脆弱的区域信任关系。具有挑战性的社会政治背景以及最初不恰当的沟通策略阻碍了疫情期间社区与应对者之间建立可信赖的关系。与埃博拉100 - 巴斯德研究所项目相关的社会科学家采访了大约160名在疫情期间担任各种角色的当地、国家和国际应对者。这项定性研究聚焦于应对者在疫情期间社区信任的经历，识别并探索有效的应急响应社会技巧。应对疫情需要具备不同知识和经验的人员。应对者包括实地社会动员者、卫生工作者和临床医生、政府官员、救护车司机、接触者追踪员等等。我们发现，通过开放、透明和反思性的沟通可以促进信任，这种沟通具有适应性，并对社区主导的应对努力和实时优先事项负责。我们进一步阐述这些发现，以确定可用于积极促进合法信任关系的“信任技术”。应对者运用了开放（愿意并真诚努力纳入多种观点）、反思（灵活应对情境和持续对话）和问责（对当地情况和后果负责）等社会技术来促进信任关系。信任技术有助于构建一个实用技术框架，以提高未来应急响应策略的接受度和有效性。
