Dr. Renata Schiavo, Editor-In-Chief of the Journal of Communication in Healthcare, shares her research into trust and trustworthiness.
I’m so glad to have back to the show Dr. Renata Schiavo, a public health leader, Editor-In-Chief of the Journal of Communication in Healthcare. Dr. Schiavo talks about some of the most pressing concerns in health communication: lessons learned from the pandemic, and building back public trust.
Hi everybody, this is 10 Minutes to Better Patient Communication, ranked #20 in the Top 100 Podcasts in Social Sciences. Giving you inspiration and strategies to improve engagement, experience, and satisfaction since 2017. I’m Dr. Anne Marie Liebel, a researcher, consultant, and educator with expertise in communication and education. I’m here to dig into some of what we might take for granted about communication in our professional lives. If you want to strengthen the work you can do in your professional sphere, this is a place for you because communication touches everything. We’re here to learn, get inspired, and most importantly, make the difference we got into our jobs to make. If you value this show, the stories and inspiration and research, I’ve got good news: I can help your organization. Visit h-cpartners, or connect with me on linkedin.
Such a pleasure to have Dr. Schiavo return to the show. She was my guest back at the start of the pandemic. We have a lot to talk about, so I’m sharing this interview in two parts. We begin with Dr. Schiavo talking about some lessons learned about communication during the pandemic. Then we get into the topic of building and restoring public trust in health and science information. Here’s Dr. Schiavo:
Anne Marie: I’m live via Zoom with Dr. Renata Schiavo. Dr. Schiavo is coming back to the show. You might remember she is the editor in chief of the peer reviewed Journal of Communication in Healthcare Strategies, Media and Engagement in Global Health, published by Taylor and Francis. She’s also a senior lecturer in the Department of Sociomedical Sciences at Columbia University’s Mailman School of Public Health, and she’s Lead Faculty and Course Director of the Summer Professional Development Program, Health and Risk Communication in Pandemics and Beyond at the American University of Rome. Dr. Schiavo, welcome back to the show!
Dr. Schivao: Thank you for inviting me again, good to see you.
AM- I’m so glad to see you again, because you were in the show back at 2020, when we were just kind of at the beginning of the pandemic.
Dr. S: Yes.
AM: And I’ve gotta ask you, having you on the show in particular as a leader in health communication: what do you feel like is something you learned about health communication since we talked last? Since the pandemic came and almost went?
So I think that a lot of the key characteristics and key lessons that we have learned from other pandemics were also reinforced by the COVID -19 pandemic. Most importantly, the importance of preparedness. We know that we cannot improvise communication. And so concerted efforts need to be made in inter-pandemic phases to prepare for the response. To make sure that all of the resources, the people who need to participate in the response are lined up. And also the other thing, the importance of community and community engagement. It’s very difficult to go to communities only when we need something from them. And this is a theme that we also discussed in the previous interviews. But we need to involve them in the planning, implementation, evaluation, or communication intervention, or public health intervention, or response intervention in the case of the pandemic, so they can actually endorse, adopt, sustain those behavior and those modification we ask them to do in their lifestyle. And also the most important lessons from the COVID -19 pandemic is the importance of systems thinking, and looking at all of the solution across health and social systems, and removing barriers that people may have to adopt healthy behaviors. During the pandemic, for example, a very simple behavior was recommended to wash one hands. But this was something that a lot of people who live in the streets, the homeless population, or people who live in rural parts of the world that do not have access to water and to soap could not actually perform. So looking at system thinking, looking at removing the barriers to healthy behavior, was also a very other important lesson that emerged from the pandemic and reinforced a lot of my previous work on the topic.
– Thank you so much for that. I mean, what a powerful way to start off this conversation, too: preparedness; community engagement; systems thinking. Thank you so much for that amazing overview of some of the lessons learned about health communication from COVID. And now I’ve got the regular four questions that I ask of everybody. And I’m gonna ask them of you, Dr. Schiavo, what is an issue or a problem that you are trying to address right now related to health communication?
– So I think that the most important issue of our times, and also an issue I’m sort of obsessed about, is building and restoring trust in health and science information, in health and science information that is evidence-based. The pandemic, because we were just speaking about it, made it evident that a lot of people didn’t trust the health and science information that was being disseminated and that would have helped protect themselves. And so while this is something that emerged very clearly during the pandemic, it’s an issue that we have been dealing with for so many decades. Vaccination hesitancy is linked, both to misinformation and issues of trust. And also if we think about outside of health, if we think about the stigma that sometimes is attached with, you know, basically different groups of population. And the stigma attached to diseases in the mental health field, these are also fueled by mistrust, by misinformation, by issues that actually we have been dealing with decades. The pandemic exacerbated it, but they were already there.
Thank you for that. And I mean, trust has been such an issue that we’ve heard about, and I mean, when pandemic was happening, when it was raging, everyone was talking about trust. And it’s certainly still very much an issue. How are you dealing with the issue of trust?
In many different ways. So, first of all, in 2021, we started–the Journal of Communication in Health Care–the Science of Trust Initiative. So this seeks to create a platform for exploring issues of trust and mistrust across different disciplines, across different fields, with particular reference to community and population health and more than the interpersonal realm. And so through the Science of Trust initiative, we have worked on a variety of basically activities from roundtable discussion to special issues to article collections that I invite you and your listeners to explore, because they provided a bulk of evidence around this issue. I’m also being a big advocate through my capacity-building and training work and other work about the idea of measuring trust. Trust is a very important factors in human behavior, and it’s seldom measured at the beginning of intervention, or across research issues. So I actually worked on developing a model for measuring trust, and actually making sure that we think trust together with communities, so that they can tell us what are some of the solutions that we need to actually make sure to build or restore trust.
Leaving room for–I like the idea of the model–for leaving room for the the fact that different communities may construct trust differently. You’re not saying “here’s what trust is,” and now everyone’s going to conform to this one definition on this one measure. Like, no! There’s different ways, there’s different signals, there’s different aspects to trust that may come to the fore in different communities. And I love the fact that you’re thinking about it in that way. What have you learned? Do you have any initial learnings yet from the work that you’re doing, from the special issues that you’re doing from these collaborations?
So I think that some of the things that we learned that, again, being connected with communities is very important and this should precede any encounter that we may organize when we want to work with them in collaboration for something. Or when we want to propose a project or a grant opportunity. We need to have solid relationships with community. The other thing that pretty much came across is to recognize the history of the community, and the history also in terms of experience with health and social systems. Have they been exposed to bias? Have they been exposed to misinformation? Do they trust the institution based on previous experiences? So all of these different factors and many others influence trust. And in fact, when we look at the model that we developed, primarily just like you were saying, as a framework to help the people, practitioners, researchers to think about some factors that may influence trust. But I’m a firm believer that we need community-driven solution to actually address trust and mistrust issues in any given community. The community are really the expert on what they need, and how actually they can come to a way that they perceive us as trustworthy. So it starts with trustworthiness. With being trustworthy all the time, and actually making sure that our interaction, our way of thinking is based on strong or basically competence and this feeling of trustworthiness. Also, we need to be aware of the many factors that influence basically trust from the social, political, structural, and environmental determinants of health, to the information and communication system. Whether people trust it, whether it’s evidence-based or not, and then going and looking at trust across different drivers and dimensions. But all of these drivers and dimension as well as the factors needs to be discussed with local communities because the community can have a true engagement about factors that influence their ability to trust or not information. Just as for everything else we do in public health and care in medicine. So going to the source, going to the expert, the community member, the patient, the leaders, the organization working with them.
– Thanks for that. And it’s difficult to even wrap our heads around trust because it has so many dimensions. There are so many influential factors.
Thanks again to Dr. Renata Schiavo for visiting and for her insights. Don’t miss part 2 of my interview when she explains what her research has found about the dimensions of trust, and the drivers of trust. Enjoying this show? If your team needs help tackling big issues in health communication, I’d love to support you. Visit healthcommunicationpartners.com to learn more about working with me. This has been 10 Minutes to Better Patient Communication.