Continuance intention and digital health resources from the perspective of elaboration likelihood model and DART model: a structural equation modeling analysis.

Background: Internet hospitals, online health communities, and other digital health APPs have brought many changes to people's lives. However, digital health resources are experiencing low continuance intention due to many factors, including information security, service quality, and personal characteristics of users. Methods: We used cross-sectional surveys and structural equation modeling analysis to explore factors influencing user willingness to continue using digital health resources. Results: Information quality (ß = 0.31, p < 0.05), service quality (ß = 0.19, p < 0.05), platform reputation (ß = 0.34, p < 0.05), and emotional support (ß = 0.23, p < 0.05) have significant positive effects on user value co-creation behavior. Additionally, user trust and perceived usefulness could mediate the association between user value co-creation behavior and continuance intention, with mediation effects of 0.143 and 0.125, respectively. User involvement can positively moderate the association between user value co-creation behavior and user trust (ß = 0.151, t = 2.480, p < 0.001). Also, user involvement can positively moderate the association between value co-creation behavior and perceived usefulness (ß = 0.103, t = 3.377, p < 0.001). Conclusion: The keys to solving the problem of low continuance intention are improving the quality and service level of digital health resources, and promoting users' value co-creation behavior. Meanwhile, enterprises should build a good reputation, create a positive communication atmosphere in the community, and enhance user participation and sense of belonging.

Implicit bias and experience influence overall but not relative trustworthiness judgment of other-race faces.

Impressions of trustworthiness are formed quickly from faces. To what extent are these impressions shared among observers of the same or different races? Although high consensus of trustworthiness evaluation has been consistently reported, recent studies suggested substantial individual differences. For instance, negative implicit racial bias and low contact experience towards individuals of the other race have been shown to be related to low trustworthiness judgments for other-race faces. This pre-registered study further examined the effects of implicit social bias and experience on trustworthiness judgments of other-race faces. A relatively large sample of White (N = 338) and Black (N = 299) participants completed three tasks: a trustworthiness rating task of faces, a race implicit association test, and a questionnaire of experience. Each participant rated trustworthiness of 100 White faces and 100 Black faces. We found that the overall trustworthiness ratings for other-race faces were influenced by both implicit bias and experience with individuals of the other-race. Nonetheless, when comparing to the own-race baseline ratings, high correlations were observed for the relative differences in trustworthiness ratings of other-race faces for participants with varied levels of implicit bias and experience. These results suggest differential impact of social concepts (e.g., implicit bias, experience) vs. instinct (e.g., decision of approach-vs-avoid) on trustworthiness impressions, as revealed by overall vs. relative ratings on other-race faces.

Retrospecting Digital Media Use, Negative Emotions, and Trust Gaps During the COVID-19 Pandemic in China: Cross-Sectional Web-Based Survey.

BACKGROUND: Retrospecting the trust gaps and their dynamics during the pandemic is crucial for understanding the root causes of postpandemic challenges and offers valuable insights into preparing for future public health emergencies. The COVID-19 pandemic eroded people's trust in strangers and acquaintances, while their trust in family members remained relatively stable. This resulted in 2 trust gaps, namely, the family members-strangers trust gap and the family members-acquaintances trust gap. Widening trust gaps impede social integration and undermine the effective management of public health crises. However, little is known about how digital media use shaped trust gaps during a pandemic. OBJECTIVE: This study aims to investigate the relationships between digital media use, negative emotions, the family members-strangers trust gap, and the family members-acquaintances trust gap during the COVID-19 pandemic in China. We test the mediating role of negative emotions between digital media use and 2 trust gaps and compare the indirect effect of digital media use on 2 trust gaps through negative emotions. METHODS: A cross-sectional web-based survey was conducted in China between January 31, 2020, and February 9, 2020. A total of 1568 adults participated in the survey. Questions related to digital media use, negative emotions, trust in family members, trust in acquaintances, and trust in strangers during the pandemic were asked. Regression analyses were performed to test the associations between the examined variables. We used a 95% bootstrap CI approach to estimate the mediation effects. RESULTS: Digital media use was positively associated with negative emotions (B=0.17, SE 0.03; P<.001), which in turn were positively associated with the family members-strangers trust gap (B=0.15, SE 0.03; P<.001). Likewise, digital media use was positively associated with negative emotions (B=0.17, SE 0.03; P<.001), while negative emotions were positively associated with the family members-acquaintances trust gap (B=0.08, SE 0.03; P=.01). Moreover, the indirect effect of digital media use on the family members-strangers trust gap (B=0.03, SE 0.01; 95% CI 0.01-0.04) was stronger than that on the family members-acquaintances trust gap (B=0.01, SE 0.01; 95% CI 0.003-0.027). CONCLUSIONS: The results demonstrate that negative emotions resulting from the frequent use of digital media are a key factor that accounts for the widening trust gaps. Considering the increasing reliance on digital media, the findings indicate that the appropriate use of digital media can prevent the overamplification of negative emotions and curb the enlargement of trust gaps. This may help restore social trust and prepare for future public health crises in the postpandemic era.

When Trustworthiness Meets Face: Facial Design for Social Robots.

As a technical application in artificial intelligence, a social robot is one of the branches of robotic studies that emphasizes socially communicating and interacting with human beings. Although both robot and behavior research have realized the significance of social robot design for its market success and related emotional benefit to users, the specific design of the eye and mouth shape of a social robot in eliciting trustworthiness has received only limited attention. In order to address this research gap, our study conducted a 2 (eye shape) × 3 (mouth shape) full factorial between-subject experiment. A total of 211 participants were recruited and randomly assigned to the six scenarios in the study. After exposure to the stimuli, perceived trustworthiness and robot attitude were measured accordingly. The results showed that round eyes (vs. narrow eyes) and an upturned-shape mouth or neutral mouth (vs. downturned-shape mouth) for social robots could significantly improve people's trustworthiness and attitude towards social robots. The effect of eye and mouth shape on robot attitude are all mediated by the perceived trustworthiness. Trustworthy human facial features could be applied to the robot's face, eliciting a similar trustworthiness perception and attitude. In addition to empirical contributions to HRI, this finding could shed light on the design practice for a trustworthy-looking social robot.

COVID-19 vaccine mistrust, health literacy, conspiracy theories, and racial discrimination among a representative ethnically diverse sample in Canada: The vulnerability of Arab, Asian, Black, and Indigenous peoples.

Despite increased risk of severe acute respiratory syndrome coronavirus 2 infections and higher rates of COVID-19-related complications, racialized and Indigenous communities in Canada have lower immunization uptake compared to White individuals. However, there is woeful lack of data on predictors of COVID-19 vaccine mistrust (VM) that accounts for diverse social and cultural contexts within specific racialized and Indigenous communities. Therefore, we sought to characterize COVID-19 VM among Arab, Asian, Black, and Indigenous communities in Canada. An online survey was administered to a nationally representative, ethnically diverse panel of participants in October 2023. Arabic, Asian, Indigenous, and Black respondents were enriched in the sampling panel. Data were collected on demographics, COVID-19 VM, experience of racial discrimination, health literacy, and conspiracy beliefs. We used descriptive and regression analyses to determine the extent and predictors of COVID-19 VM among racialized and Indigenous individuals. All racialized respondents had higher VM score compared to White participants. Among 4220 respondents, we observed highest VM among Black individuals (12.18; ±4.24), followed by Arabic (12.12; ±4.60), Indigenous (11.84; ±5.18), Asian (10.61; ±4.28), and White (9.58; ±5.00) participants. In the hierarchical linear regression analyses, Black participants, women, everyday racial discrimination, and major experience of discrimination were positively associated with COVID-19 VM. Effects of racial discrimination were mediated by addition of conspiracy beliefs to the model. Racialized and Indigenous communities experience varying levels of COVID-19 VM and carry specific predictors and mediators to development of VM. This underscores the intricate interaction between race, gender, discrimination, and VM that need to be considered in future vaccination campaigns.

Inconsistent advice by ChatGPT influences decision making in various areas.

The ChatGPT technology is increasingly becoming a part of our daily lives and is starting to be utilized in various decision-making contexts. The current study builds upon prior research, demonstrating that people's moral decision-making is influenced by ChatGPT across three perspectives, as evidenced by two studies (total n = 1925). The findings suggested that ChatGPT advice impacted decision-making similarly to expert advice, although not all decisions were susceptible to influence, particularly those based on negative emotions. Additionally, ChatGPT advice affected decisions beyond moral judgments, but no effect was observed when the advice recommended immediate low rewards. Moreover, individuals with a higher tendency for personal fear of invalidity were more likely to be influenced by both expert and AI advice, but this was not related to trust in AI.

Longitudinal associations between intergroup contact and intergroup trust among adolescents in ethnic regions of China.

Intergroup trust is a crucial psychological foundation for promoting ethnic unity and maintaining social stability. This study explored the dynamic relationship between intergroup contact and trust among adolescents in ethnic regions of China and sought to uncover the mechanisms behind this relationship. Through a two-wave longitudinal survey of 679 adolescents, employing the Intergroup Contact Experience Scale, the Intergroup Trust Scale, and the UCLA Loneliness Scale, the study yielded several findings: (1) Over the year, a significant increase in intergroup contact was observed among the adolescents. Notably, junior high students demonstrated a marked rise in intergroup trust, whereas no significant change was discernible in high school students. (2) Cross-lagged analysis indicated that early intergroup contact significantly predicted subsequent intergroup trust and loneliness. Initial loneliness also forecasted future intergroup trust, yet early intergroup trust did not predict later intergroup contact or loneliness. (3) Loneliness served as a partial mediator in the longitudinal link between intergroup contact and trust among these adolescents. These findings reinforce the premise that in China's ethnic regions, intergroup contact is a precursor to intergroup trust, both directly enhancing trust among adolescents and indirectly by reducing loneliness.

Perceived social fairness and trust in government serially mediate the effect of governance quality on subjective well-being.

Governance quality refers to how well the processes and institutions of public governance function and is widely recognized as having an important influence on human well-being. We developed and tested a theoretical model that elucidates the relationship between governance quality and the subjective well-being of residents in China by revealing the serial mediation effects of perceived social fairness and trust in government. Using data from the nationally representative Chinese Social Survey conducted in 2021 (n = 5019), we performed structural equation modeling to empirically examine our hypotheses. The results indicated that governance quality exerted a significant positive fully indirect impact on subjective well-being through perceived social fairness, trust in government, and their serial mediation effects. This study contributes to the literature by providing valuable insights into the determinants of subjective well-being and highlighting the serial mediating roles of perceived social fairness and trust in government in the relationship between governance quality and subjective well-being. The findings also provide practical insights for policymakers, as they indicate that promoting perceived social fairness and fostering trust in government are essential to translate governance quality into subjective well-being.

The awareness of public about the Emergency Medical Services in the Eastern region of Saudi Arabia.

Emergency Medical Services (EMS) are crucial for immediate medical assistance during life-threatening situations. However, insufficient public awareness about EMS services can impede their effectiveness. This study aimed to assess EMS knowledge and trust among the population of Eastern Saudi Arabia while identifying factors contributing to low awareness. A cross-sectional study was conducted in Eastern Saudi Arabia from September 2022 to September 2023. The study included participants aged 18 to 60 from diverse backgrounds. Using a convenience sampling approach, data was collected using a validated questionnaire covering demographics, hypothetical scenarios, EMS knowledge, and trust in EMS. We conducted the Chi-square tests and logistic regression using Jamovi software, with significance levels set at p < 0.05. Our study yielded 435 participants; 55% were males. Gender-based analysis showed significant differences in responses regarding first aid provision and EMS services (P < 0.001). Expectations for EMS response times also varied by gender (P = 0.01). Knowledge-based analysis revealed that age and education significantly influenced EMS knowledge (P < 0.001). Respondents with EMS knowledge were more likely to know how to provide first aid, understand the importance of emergency number 112, and trust EMS (P < 0.001). Trust-based analysis showed age and education-related differences in EMS trust (P < 0.001). Respondents with EMS knowledge and awareness of emergency numbers displayed higher trust in EMS (P < 0.001). This study underscores the need for enhanced public awareness of EMS services in Eastern Saudi Arabia. Age, education, and gender emerged as critical factors affecting EMS knowledge and trust. Bridging this awareness gap necessitates tailored educational campaigns and continuous monitoring. Policymakers should prioritise EMS awareness within broader healthcare strategies, contributing to improved public health outcomes and community well-being.

Barriers to medical consultation and strategies for enhancing the prevention and reporting of child abuse: A cross-sectional survey of caregivers of paediatric patients at a tertiary care center in Karachi, Pakistan.

Objective: To assess the knowledge of caregivers in a tertiary care setting about child abuse, their perception of potential barriers in the way of seeking medical advice for the victims, and to identify proposed solutions to ensure prevention and reporting of child abuse. METHODS: The cross-sectional study was conducted from June to December 2022 at the paediatric ward of the Aga Khan University Hospital, Karachi, and comprised caregivers who were attendants of inpatients. Data was collected using a predesigned anonymous questionnaire consisting of demographic information and 27 items that were scored on a 6-point Likert scale. Data was analysed using SPSS 20. RESULTS: Of the 144 caregivers, 96(66.6%) were females and 48(33.3%) were males. Overall, 86(59.7%) were aged <35 years, 132(91.7%) were married, and 120(83.3%) were the admitted child's parent. The majority of caregivers 110(76.4%) perceived themselves to possess a high level of knowledge about child abuse. Barriers identified included a lack of trust in police and medicolegal departments 136(94.4%), fear of repercussion from the suspect 120(83.3%) and lack of confidentiality of the victims' identity 116(80.6%). The proposed solutions included spreading awareness among teachers 136(94.4%) and caregivers 131(91.0%) about timely reporting and consultation, and developing proper mechanisms to follow-up on victims 133(92.4%). There were significant associations between some demographic characteristics of the respondents and their self-perceived knowledge and perceptions (p<0.05). Conclusion: There was found a need to enhance public trust, ensure confidentiality, and fostering awareness through targeted strategies for a safer and more facilitative environment for children.

Examining the influence of technological self-efficacy, perceived trust, security, and electronic word of mouth on ICT usage in the education sector.

The context of education has changed due to revolutionary developments in the information communication technology (ICT) industry in the post-COVID era. Innovative learning methods were introduced in the education sector to promote quality education. The students find it more convenient to use ICT tools to integrate their knowledge-seeking. China has recently paid more attention to developing and adopting electronic infrastructure. The study assesses the effect of technology self-efficacy (TSE) on ICT acceptance and implementation in China's education sector. It also analyzed the role of perceived trust, perceived security, and electronic word of mouth (eWOM) in integrating digital information sharing and interaction tools. Data is collected from 382 business students at Chinese universities. The results revealed that perceived trust mediates the relationship between TSE and the actual use of ICT tools, intention to use ICT tools for information, and intention to use ICT tools for interaction. Further, perceived security and eWOM significantly moderate the relationship between TSE and perceived trust. The findings indicate that it is essential to offer assistance and instruction to students in the educational sector so they can use ICT technology more frequently. It is also crucial for organizations to establish a supportive culture and provide the necessary technological resources to facilitate the use of ICT.

Trust and quality of life: A study in organizations for individuals with intellectual disability.

BACKGROUND: Based on social exchange within organizations for individuals with intellectual disability, we explore trust between supervisors and team members and its association with organizational performance oriented to the quality of life of service users. AIMS: We examine the mediating role of teams' trust in supervisors in the relationship between supervisors' trust in teams and performance focused on improving the quality of life of service users. We expect teams to reciprocate supervisors' trust by reporting greater levels of trust in supervisors and better performance. METHOD AND PROCEDURES: We tested this trust-mediated model with a sample of 139 supervisors (reporting trust in their teams), 1101 team members (reporting trust in their supervisors), and 1468 family members (reporting performance focused on quality of life). OUTCOMES AND RESULTS: Our findings confirmed a cross-level mediation process. Supervisors' trust in their teams leads to teams' trust in their supervisors. This trust at the team level in turn is positively associated with organizational performance oriented to improving the quality of life of individuals with intellectual disability, reported by family members. CONCLUSIONS AND IMPLICATIONS: Our study builds on and extends an established stream of research on trust theory by considering trust and its association with performance focused on quality of life.

Callousness, exploitativeness, and tracking of cooperation incentives in the human default network.

Human cognitive capacities that enable flexible cooperation may have evolved in parallel with the expansion of frontoparietal cortical networks, particularly the default network. Conversely, human antisocial behavior and trait antagonism are broadly associated with reduced activity, impaired connectivity, and altered structure of the default network. Yet, behaviors like interpersonal manipulation and exploitation may require intact or even superior social cognition. Using a reinforcement learning model of decision-making on a modified trust game, we examined how individuals adjusted their cooperation rate based on a counterpart's cooperation and social reputation. We observed that learning signals in the default network updated the predicted utility of cooperation or defection and scaled with reciprocal cooperation. These signals were weaker in callous (vs. compassionate) individuals but stronger in those who were more exploitative (vs. honest and humble). Further, they accounted for associations between exploitativeness, callousness, and reciprocal cooperation. Separately, behavioral sensitivity to prior reputation was reduced in callous but not exploitative individuals and selectively scaled with responses of the medial temporal subsystem of the default network. Overall, callousness was characterized by blunted behavioral and default network sensitivity to cooperation incentives. Exploitativeness predicted heightened sensitivity to others' cooperation but not social reputation. We speculate that both compassion and exploitativeness may reflect cognitive adaptations to social living, enabled by expansion of the default network in anthropogenesis.

Medical Distrust Among Kidney Transplant Candidates.

BACKGROUND: Medical distrust may hinder kidney transplantation (KT) access. Among KT candidates evaluated for waitlisting, we identified factors associated with high distrust levels and quantified their association with waitlisting. METHODS: Among 812 candidates (2018-2023), we assessed distrust using the Revised Health Care System Distrust Scale across composite, competence, and values subscales. We used linear regression to quantify the associations between candidate and neighborhood-level factors and distrust scores. We used Cox models to quantify the associations between distrust scores and waitlisting. RESULTS: At KT evaluation, candidates who were aged 35-49 years (difference = 1.97, 95% CI: 0.78-3.16), female (difference = 1.10, 95% CI: 0.23-1.97), and Black (difference = 1.47, 95% CI: 0.47-2.47) were more likely to report higher composite distrust score. For subscales, candidates aged 35-49 were more likely to have higher competence distrust score (difference = 1.14, 95% CI: 0.59-1.68) and values distrust score (difference = 0.83, 95% CI: 0.05-1.61). Race/ethnicity (Black, difference = 1.42, 95% CI: 0.76-2.07; Hispanic, difference = 1.52, 95% CI: 0.35-2.69) was only associated with higher values distrust scores. Female candidates reporting higher rescaled values distrust scores (each one point) had a lower chance of waitlisting (aHR = 0.78, 95% CI: 0.63-0.98), whereas this association was not observed among males. Similarly, among non-White candidates, each 1-point increase in both rescaled composite (aHR = 0.87, 95% CI: 0.77-0.99) and values (aHR = 0.82, 95% CI: 0.68-0.99) distrust scores was associated with a lower chance of waitlisting, while there was no association among White candidates. CONCLUSION: Female, younger, and non-White candidates reported higher distrust scores. Values distrust may contribute to the long-standing racial/ethnic and gender disparities in access to KT. Implementing tailored strategies to reduce distrust in transplant care may improve KT access for groups that experience persistent disparities.

Bridging Research, Accurate Information and Dialogue (BRAID): A Novel Strategy to Build Community Trust.

BACKGROUND: Efforts to promote COVID-19 vaccination uncovered the effects of longstanding structural racism and perpetuated the erosion of community trust in science and public health institutions. Rebuilding trust is a priority to overcome barriers to vaccine uptake. Bridging Research, Accurate Information and Dialogue (BRAID) is a model that combines several evidence-based approaches to nurture trusting relationships with community experts, leading to the dissemination of accurate, timely, and acceptable COVID-19 vaccine messages. OBJECTIVE: To describe an innovative community-engaged participatory research model with the potential to build trust and spread accurate health information through social networks. METHODS: BRAID provided safe spaces for a series of facilitated conversation circles involving trusted community experts and invited clinicians and scientists. Community experts were encouraged to share their experiences, raise concerns, and ask pandemic-related questions in an informal setting. Community experts were empowered to codesign and coproduce accurate health messages acceptable to their communities. To gain insight into the process of building trust, dialogues involving 22 community experts were transcribed and coded, and post survey data from 21 participants were analyzed. CONCLUSIONS: BRAID is a manualized community engagement model that aims to build the trust needed to improve COVID-19 vaccine uptake in historically marginalized communities. Through BRAID, participants developed increased trust in health systems and research. By empowering community experts to share information through their established social networks, BRAID has the potential to amplify the reach and impact of communications regarding health topics that are controversial and divisive, such as COVID-19 vaccination.

Social intelligence in health professions educationists: how it helps to deal with challenges at the workplace? a mixed-method study.

Objectives: To identify the social intelligence of medical educationists, and the coping strategies used to deal with workplace challenges. METHODS: The mixed-method study with an explanatory sequential design was conducted from March 15 to July 30, 2021, after approval from the ethics review committee of Riphah International University, Rawalpindi, Pakistan, and comprised medical educationists working in medical and dental colleges and institutions across the country. Data was collected using Tromso social intelligence scale in the quantitative phase. The socially intelligent educationists were identified, and were interviewed. Qualitative data was subjected to thematic analysis to identify predominant themes explaining the coping strategies used. RESULTS: In the quantitative phase, there were 80 participants; 51(63.7%) females and 29(36.3%) males, with 24(30%) having >10 years of professional experience. Of them, 11(13.8%) scored low, 54(67.5%) moderate and 15(18.8%) high on the social intelligence scale. In the qualitative phase, there were 13 subjects; 9(69.2%) females and 4(30.8%) males. There were 4 themes identified as coping strategies; inspire respect and trust, bringing readiness before a change, a collaborative and inclusive approach and use of soft skills. CONCLUSIONS: Variation was seen in the levels of social intelligence among medical educationists working in academic institutions. Those with high levels of social intelligence used their non-cognitive soft skills to manage workplace challenges.