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Primary Submission Category: Health systems

Community Trust in Health Care and Medical Research: Insights from Project ENTRUST Survey

Authors:  Michael Green, Jessica Sperling, Perusi Muhigaba, Nadine Barrett, Salimah El-Amin, Annie Tsui, Cindy Canty-Dumas, Stella Quenstedt, Dane Whicker, Keisha Bentley-Edwards,

Presenting Author: Michael Green*

Trust in health care organizations is essential for improving health equity. We aimed to describe community trust in a regional academic medical center, Duke Health. We designed an online cross-sectional survey that will be implemented every 5 years to identify perceptions of the trustworthiness of Duke Health care and research. Participants were adults who were 1) local community members, 2) patients, 3) employees, and/or 4) local community-based organizations. Measures included self-reported demographic characteristics (e.g. race, ethnicity, age, gender identity, sexual orientation). Outcomes included trust in Duke health care, medical research, community partnerships, and negative experiences or discrimination. The survey, launched in 2023, yielded 6,167 respondents. They were 94.9% patients, 34.5% community members, 27.3% employees, and 6.3% community-based organizations. On average, respondents reported that Duke Health is trustworthy as a health care system and as a research institution; however, bivariable analyses revealed significant mean differences in health care trust by respondent demographics, with higher trust observed among those who were older, White, Asian, non-Hispanic, female, financially stable, and insured. 33% reported negative experiences or discrimination. Interactions with health care personnel were the most prevalent factor influencing trust and distrust in health care and research. 21% ofl respondents felt that their healthcare provider was not listening to them. Community-based organization respondents without personal involvement in Duke Health partnerships had more positive perceptions of Duke Health than those with prior partnership experience. Our survey tool and process can serve as a model to assess trust and trustworthiness across large regional health care systems. A translation-to-action plan is underway to implement recommendations.