The science of trust: future directions, research gaps, and implications for health and risk communication.

'Trust is among the most important factors in human life, as it pervades' all domains of society [1] and related decision-making processes. This includes people's trust in science, and in clinical and public health solutions. Unequivocally, community and patient trust are foundational to the adoption and maintenance of health-related behaviors, social norms, and policies. Yet, trust has to be earned and developed over time and through multiple interactions. Trust is about dialogue and human connection. It's about listening and knowing that one interaction will not be enough to build trust. It is also influenced by a variety of social, economic, cultural, and political factors, past experiences, and the history of specific communities and patient groups. It should be at the core of the health and social systems with which people interact. More recently, trust in evidence-based information has also been affected by misinformation, not only on social media but also in a variety of community, institutional, and patient settings. Ultimately, we are in the midst of a global trust crisis that precedes the COVID-19 pandemic and is often rooted in the health, racial, and social inequities many groups experience [2].

Assessing the Electronic Evidence System Needs of Canadian Public Health Professionals: Cross-sectional Study.

BACKGROUND: True evidence-informed decision-making in public health relies on incorporating evidence from a number of sources in addition to traditional scientific evidence. Lack of access to these types of data as well as ease of use and interpretability of scientific evidence contribute to limited uptake of evidence-informed decision-making in practice. An electronic evidence system that includes multiple sources of evidence and potentially novel computational processing approaches or artificial intelligence holds promise as a solution to overcoming barriers to evidence-informed decision-making in public health. OBJECTIVE: This study aims to understand the needs and preferences for an electronic evidence system among public health professionals in Canada. METHODS: An invitation to participate in an anonymous web-based survey was distributed via listservs of 2 Canadian public health organizations in February 2019. Eligible participants were English- or French-speaking individuals currently working in public health. The survey contained both multiple-choice and open-ended questions about the needs and preferences relevant to an electronic evidence system. Quantitative responses were analyzed to explore differences by public health role. Inductive and deductive analysis methods were used to code and interpret the qualitative data. Ethics review was not required by the host institution. RESULTS: Respondents (N=371) were heterogeneous, spanning organizations, positions, and areas of practice within public health. Nearly all (364/371, 98.1%) respondents indicated that an electronic evidence system would support their work. Respondents had high preferences for local contextual data, research and intervention evidence, and information about human and financial resources. Qualitative analyses identified several concerns, needs, and suggestions for the development of such a system. Concerns ranged from the personal use of such a system to the ability of their organization to use such a system. Recognized needs spanned the different sources of evidence, including local context, research and intervention evidence, and resources and tools. Additional suggestions were identified to improve system usability. CONCLUSIONS: Canadian public health professionals have positive perceptions toward an electronic evidence system that would bring together evidence from the local context, scientific research, and resources. Elements were also identified to increase the usability of an electronic evidence system.

Black Lives Matter in health promotion: moving from unspoken to outspoken.

Racism is a public health crisis. Black communities (including Africans, the African diaspora and people of African descent) experience worse health outcomes as demonstrated by almost any measure of health and wellbeing-e.g. life expectancy; disease prevalence; maternal mortality rates. While health promotion has its foundation in promoting equity and social justice, it is clear that however well-intended, we are not affecting meaningful change for Black communities quickly enough. Through this article, we outline the intersection of social determinants of health and anti-Black racism. We describe how in the first 8 months of 2020 Black communities around the globe have been disproportionately affected by COVID-19, while also having to respond to new instances of police brutality. We assert that the time has come for health promotion to stop neutralizing the specific needs of Black communities into unspoken 'good intentions'. Instead, we offer some concrete ways for the field to become outspoken, intentional and honest in acknowledging what it will take to radically shift how we promote health and wellbeing for Black people.