New tool helps gauge trust in government, aims to help inform better public health policies

People are less likely to adopt new health policies if they don't have faith in their government, and a new tool from University of Waterloo researchers aims to fix that.

The tool—designed by a team based in Waterloo's School of Public Health Sciences—aids lawmakers in how trustworthy they may appear to the public and could help improve the uptake of public health policies by informing their design and communication.

The study, "Development and validation of the Trust in Government measure (TGM)," was published in the journal BMC Public Health and co-authored by Kathleen E. Burns, Patrick Brown, Michael Calnan, Paul R. Ward, Jerrica Little, Gustavo S. Betini, Christopher M. Perlman, Helena Godinho Nascimento and Meyer.

Policymakers can use the tool to measure citizens' trust in government and inform the design and communication of public health initiatives in ways that build confidence across members of diverse communities.

"I've always been interested in understanding why people do or do not engage in health services," said Dr. Samantha Meyer, a researcher in Waterloo's School of Public Health Sciences, which is the first interdisciplinary department in Canada dedicated to health promotion, preparing the next generation of leaders to respond to the complex adaptive systems that affect health and health care.

"Prior to COVID-19, we had started a project looking at trust in health care and how it shaped health behaviors. When we began collecting data during the COVID-19 pandemic, we found that the determining factors to action weren't associated with trust in health care, but trust in government," Mayer added.

Public trust in the government is critical to adopting new health policies amid a reported decline in confidence in countries tracked by the Organization for Economic Co-operation and Development (OECD). The OECD found that only 51% of citizens in OECD countries trusted their national government.

The researchers worked with market researcher Leger in 2022 to administer an online survey to test the validity of the trust in government measure. Close to 900 Canadians completed the survey in both English and French, and the researchers found that this tool could be used to gauge trust in government as a barometer of public support for health initiatives.

For example, low trust in government was linked to a belief in conspiracy theories and vaccine hesitancy during the COVID-19 pandemic.

A key feature of the study was that it oversampled participants from historically disadvantaged groups to determine what type of variation there is between different communities to understand, design and communicate public health initiatives in ways that build trust across multiple and diverse communities.

"I think it will hopefully give us at least a better quantification of how trust varies across population groups and to understand why to a certain extent," Meyer said.

She added that the tool, which can be accessed by contacting Meyer, was developed and validated by interviewing and surveying participants representing LGBT2SQ+, Black, Indigenous, low-income, youth and newcomer communities. However, the team has plans to validate their tool for use within individual priority populations.

"This tool is not just meant to determine how we foster Canadians' trust in government; it's about making sure that our government is acting and communicating in a manner that demonstrates its trustworthiness. It's a two-way street," Meyer stressed.