Trust strategies in healthcare

A cross-disciplinary scoping review of quantitatively studied approaches to building, maintaining, and repairing trust

Bibliographic Data

ID23309581
AuthorsCole Etherington (0000-0002-7933-4593, Ottawa Hospital), Samantha B Meyer (0000-0002-2098-2828, University of Waterloo), Amira Brehaut (Ottawa Hospital), Jenny L Olson (0000-0003-2777-3794, Ottawa Hospital), Amelia Palumbo (0000-0003-0098-4540, Ottawa Hospital), Megan Bennett (Carleton University), Emily Gibson (0000-0002-5769-5398, Ottawa Hospital), Risa Shorr (0000-0003-0388-5812, Ottawa Hospital), Elisabeth Vesnaver (0000-0002-0499-8010, Children's Hospital of Eastern Ontario), Guillaume Fontaine (0000-0002-7806-814X, McGill University Health Centre), Justin Presseau (0000-0002-2132-0703, University of Ottawa, corresponding author)
Year2026
Volume406
Pages119623
Publication date2026-10-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSocial Science & Medicine (JOURNAL)
Journal identifiersISSN: 0277-9536 • E-ISSN: 1873-5347
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2026.119623
PMID42520622
OpenAlexW7171055742
LanguageEN
References cited73

Trust is foundational to the functioning of health systems and public health initiatives, yet it is increasingly strained by misinformation, politicization, and persistent structural inequities. Although multiple disciplines have examined how trust is built, maintained, and repaired, evidence remains fragmented and often lacks sufficient specification to support comparison or practical application. We conducted a scoping review to map empirically examined trust-related strategies across disciplines and to clarify how these strategies are articulated in actionable terms. We searched seven databases from inception to March 15, 2024, and included experimental, quasi-experimental, and observational studies assessing trust-related strategies. Screening and data extraction were completed in duplicate. Strategies were coded using the Action, Actor, Context, Target, Time (AACTT) framework and categorized by trust phase (building, maintaining, repairing). A reproducible, human-verified Python workflow supported data standardization and thematic clustering. Across 327 studies, we identified 1017 strategy instances (919 unique) spanning disciplines including psychology, sociology, political science, economics, technology, and healthcare. Strategies clustered into 14 themes, most commonly values-based approaches, structural assurances, transparency and disclosure, humanizing framings, and interpersonal communication. Strategies were predominantly enacted by individual actors within institutional contexts and primarily targeted individual trustors, with limited emphasis on structural or post-violation repair interventions. Overall, findings highlight the dominance of relational and informational strategies alongside structural safeguards, while underscoring gaps in institutional-level approaches. This review advances an interdisciplinary, action-oriented understanding of trust, offering a foundation for developing more explicit, evaluable, and contextually responsive trust-building strategies in health and social systems.

MEDLINE · Public health · Qualitative research · Electronic Health Records Systems · Patient Safety and Medication Errors · Trade Secret Protection Methods