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Trust in Institutions and the COVID-19 Threat: A Cross-Sectional Study on the Public Perception of Official Recommendations and of Othering in Switzerland.

ABSTRACT: Objectives: To explore how perceived disease threat and trust in institutions relate to vaccination intent, perceived effectiveness of official recommendations, and to othering strategies. Methods: We conducted a cross-sectional survey of Swiss adults in July 2020. Outcome variables were vaccination intent, perceived effectiveness of official recommendations and othering strategies (labelling a given social group as responsible for the disease and distancing from it). Independent variables were perceived disease threat, trust in various institutions, perceived health-related measures, and sociodemographic variables. Linear and logistic regressions were performed. Results: The response rate was 20.2% (1518/7500). Perceived disease threat and trust in medical/scientific institutions were positively associated with vaccination intent and perceived effectiveness of official recommendations for coronavirus mitigation measures. Only disease threat was associated with a perception of effectiveness among othering strategies. Age and education levels were associated with vaccination intent. Conclusion: Reinforcing trust in medical/scientific institutions can help strengthen the perceived effectiveness of official recommendations and vaccination. It however does not prevent adherence to ineffective protecting measures such as othering strategies, where decreasing perceptions of epidemic threat appears to be more efficient.

SUBMITTER: Gilles I

PROVIDER: S-EPMC8790817 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:The central focus of this research is the fast and crucial impact of the COVID-19 pandemic on a crucial psychological, relational, and political construct: trust. We investigate how the consequences of the pandemic, in terms of healthcare, state intervention and impositions, and daily life and habits, have affected trust in public institutions in Italy, at the time when the contagion was rapidly spreading in the country (early March 2020). In this survey, addressed to 4260 Italian citizens, we analyzed and measured such impact, focusing on various aspects of trust. This attention to multiple dimensions of trust constitutes the key conceptual advantage of this research, since trust is a complex and layered construct, with its own internal dynamics. In particular, the analysis focuses on how citizens attribute trust to Public Authorities, in relation to the management of the health crisis: with regard to the measures and guidelines adopted, the purposes pursued, the motivations that determine them, their capacity for involvement, and their effectiveness for the containment of the virus itself. A pandemic creates a bilateral need for trust, both in Public Authorities (they have to rely on citizens' compliance and must try to promote and maintain their trust in order to be effective) and in citizens, since they need to feel that somebody can do something, can (has the power to) protect them, to act at the needed collective level. We are interested to explore how this need for trust affects the attributional process, regarding both attitudes and the corresponding decisions and actions. The most striking result of this survey is the very high level of institutional trust expressed by respondents: 75% of them trust Italian public authorities to be able to deal with the COVID-19 emergency. This is in sharp contrast with the relatively low levels of institutional trust characteristic of Italy, both historically and in recent surveys. Moreover, the survey allowed the discrimination of several potential predictors for trust, thus emphasizing factors that, during this crisis, are exhibiting an anomalous impact on trust.

Project description:The legality of euthanasia and assisted suicide (AS) and nature of regulations of these practices remain controversial and the subject of lively debate among experts and the general public. Our study investigates attitudes and behaviours towards AS among older adults in Switzerland where the practice of AS has a relatively long history and remains rather unregulated. We aim to explore how individuals' preferences regarding their end of life, as well as individuals' trust in institutions involved in the practice or control of AS are associated with attitudes and behaviours towards AS. We analyse nationally representative data of adults aged 55 and over from wave 6 (2015) of the Survey of Health, Ageing and Retirement in Europe (SHARE) in Switzerland (n = 2,145). While large majorities supported current legal arrangements around AS in Switzerland (81.7%) and stated that they could consider AS for themselves under certain circumstances (61.0%), only a minority either was a member of a right-to-die organisation already (4.9%) or stated they were likely to become a member of such an organisation (28.2%). Stated preferences for control over the end of life and for maintaining essential capabilities at the end of life showed a positive association with AS-related attitudes and behaviours, whereas preferences for feeling socially and spiritually connected, as well as for not being a burden displayed a negative association with our outcomes. Higher levels of trust in one's relative were positively associated with both support for the legality of AS and potential use of AS. A positive association was also found between trust in the Swiss legal system and support for the legality of AS. By contrast, trust in religious institutions displayed a negative association with all five AS-related attitudes and behaviours. Similarly, trust in healthcare insurance companies was negatively associated with potential use of AS. Taken together, older adults were generally supportive towards current practices regarding AS. This approval appears to be closely related to individuals' preferences and, at different extends, to trust in social and public institutions with regard to end-of-life issues, which is relatively high in Switzerland.

Project description:OBJECTIVES:We previously identified that general practitioners (GPs) in French-speaking regions of Europe had a variable uptake of common preventive recommendations. In this study, we describe GPs' reports of how they put different preventive recommendations into practice. DESIGN, SETTING AND PARTICIPANTS:Cross-sectional study conducted in 2015 in Switzerland and France. 3400 randomly selected GPs were asked to complete a postal (n=1100) or online (n=2300) questionnaire. GPs who exclusively practiced complementary and alternative medicine were not eligible for the study. 764 GPs (response rate: postal 47%, online 11%) returned the questionnaire (428 in Switzerland and 336 in France). MAIN OUTCOME MEASURES:We investigated how the GPs performed five preventive practices (screening for dyslipidaemia, colorectal and prostate cancer, identification of hazardous alcohol consumption and brief intervention), examining which age group they selected, the screening frequency, the test they used, whether they favoured shared decision for prostate cancer screening and their definition of hazardous alcohol use. RESULTS:A large variability was observed in the way in which GPs provide these practices. 41% reported screening yearly for cholesterol, starting and stopping at variable ages. 82% did not use any test to identify hazardous drinking. The most common responses for defining hazardous drinking were, for men, ?21?drinks/week (24%) and ?4?drinks/occasion for binge drinking (20%), and for women, ?14?drinks/week (28%) and ?3?drinks/occasion (21%). Screening for colorectal cancer, mainly with colonoscopy in Switzerland (86%) and stool-based tests in France (93%), was provided every 10 years in Switzerland (65%) and 2?years in France (91%) to patients between 50 years (87%) and 75 years (67%). Prostate cancer screening, usually with shared decision (82%), was provided yearly (62%) to patients between 50 years (74%) and 75-80 years (32%-34%). CONCLUSIONS:The large diversity in the way these practices are provided needs to be addressed, as it could be related to some misunderstandingof the current guidelines, to barriers for guideline uptake or, more likely, to the absence of agreement between the various recommendations.

Project description:BACKGROUND: Although the use of the Internet for health purposes has increased steadily in the last decade, only a few studies have explored the information provided by the websites of health institutions and no studies on the on-line activities of Italian hospitals have been performed to date. The aim of this study was to explore the characteristics of the contents and the user-orientation of Italian hospital websites. METHODS: The cross-sectional analysis considered all the Italian hospitals with a working website between December 2008 and February 2009. The websites were coded using an ad hoc Codebook, comprising eighty-nine items divided into five sections: technical characteristics, hospital information and facilities, medical services, interactive on-line services and external activities. We calculated a website evaluation score, on the basis of the items satisfied, to compare private (PrHs) and public hospitals, the latter divided into ones with their own website (PubHs-1) and ones with a section on the website of their Local Health Authority (PubHs-2). Lastly, a descriptive analysis of each item was carried out. RESULTS: Out of the 1265 hospitals in Italy, we found that 419 of the 652 public hospitals (64.3%) and 344 of the 613 PrHs (56.1%) had a working website (p = 0.01). The mean website evaluation score was 41.9 for PubHs-1, 21.2 for PubHs-2 and 30.8 for PrHs (p < 0.001).Only 5 hospitals out of 763 (< 1%) provided specific clinical performance indicators, such as the nosocomial infection rate or the surgical mortality rates. Regarding interactive on-line services, although nearly 80% of both public and private hospitals enabled users to communicate on-line, less than 18% allowed the reservation of medical services, and only 8 websites (1%) provided a health-care forum. CONCLUSIONS: A high percentage of hospitals did not provide an official website and the majority of the websites found had several limitations. Very few hospitals provided information to increase the credibility of the hospital and user confidence in the institution. This study suggests that Italian hospital websites are more a source of information on admissions and services than a means of communication between user and hospital.

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Trust in Institutions and the COVID-19 Threat: A Cross-Sectional Study on the Public Perception of Official Recommendations and of Othering in Switzerland.

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