Gille Felix, Smith Sarah, Mays Nicholas
University of Zurich, Digital Society Initiative (DSI), Zürich, CH, Switzerland.
University of Zurich, Institute for Implementation Science in Health Care (IfIS), Zürich, CH, Switzerland.
Digit Health. 2022 Jul 17;8:20552076221111947. doi: 10.1177/20552076221111947. eCollection 2022 Jan-Dec.
Public trust in health systems is pivotal for their effective and efficient functioning. In particular, public trust is essential for personal data use, as demonstrated in debates in many countries, for example, about whether data from COVID-19 contact tracing apps should be pooled or remain on individuals' smartphones. Low levels of public trust pose a risk not only to health system legitimacy but can also harm population health.
Synthesising our previous qualitative and theoretical research in the English National Health Service which enabled us to conceptualise the nature of public trust in health systems, we present guiding principles designed to rebuild public trust, if lost, and to maintain high levels of public trust in personal data use within the health system, if not.
To build public trust, health system actors need to not rush trust building; engage with the public; keep the public safe; offer autonomy to the public; plan for diverse trust relationships; recognise that trust is shaped by both emotion and rational thought; represent the public interest; and work towards realising a net benefit for the health system and the public.
Beyond policymakers and government officials, the guiding principles address a wide range of actors within health systems so that they can work collectively to build public trust. The guiding principles can be used to inform policymaking in health and health care and to analyse the performance of different governments to see if those governments that operate in greater conformity with the guiding principles perform better.
公众对卫生系统的信任对于其有效且高效运行至关重要。特别是，公众信任对于个人数据的使用至关重要，正如许多国家的辩论所表明的那样，例如，关于来自新冠病毒接触者追踪应用程序的数据是否应该汇总或保留在个人智能手机上。公众信任水平低不仅会对卫生系统的合法性构成风险，还可能损害民众健康。
综合我们之前在英国国家医疗服务体系中进行的定性和理论研究，这些研究使我们能够对公众对卫生系统信任的本质进行概念化，我们提出了旨在重建公众信任（如果失去的话）以及在卫生系统内维持对个人数据使用的高度公众信任（如果尚未失去的话）的指导原则。
为了建立公众信任，卫生系统行为者需要不急于建立信任；与公众互动；保障公众安全；给予公众自主权；规划多样化的信任关系；认识到信任是由情感和理性思维共同塑造的；代表公众利益；并努力为卫生系统和公众实现净收益。
除了政策制定者和政府官员之外，这些指导原则还涉及卫生系统内的广泛行为者，以便他们能够共同努力建立公众信任。这些指导原则可用于为卫生和医疗保健政策制定提供信息，并分析不同政府的表现，以查看那些更符合指导原则运作的政府是否表现更好。
