{"id":21819,"date":"2021-03-01T09:07:34","date_gmt":"2021-03-01T14:07:34","guid":{"rendered":"https:\/\/participatorymedicine.org\/epatients\/?p=21819"},"modified":"2023-02-20T11:06:48","modified_gmt":"2023-02-20T16:06:48","slug":"trust-is-complicated-person-first-safe-living-in-a-pandemic-part-3","status":"publish","type":"post","link":"https:\/\/participatorymedicine.org\/epatients\/2021\/03\/trust-is-complicated-person-first-safe-living-in-a-pandemic-part-3.html","title":{"rendered":"Trust is Complicated: Person-First Safe Living in a Pandemic Part 3"},"content":{"rendered":"

Trust in COVID19 times depends on context: circumstances, historical identity, tolerance for risk, comfort with uncertainty, attitude about individual rights and social responsibility, critical thinking & more. Introducing a trust label.\u00a0 Podcast episode here<\/a>
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Proem (Preface)<\/h2>\n

As we spending much of our time trying to absorb and filter some of the dirty water spewing from the cacophony of COVID-19 stuff, we keep asking, who wrote this?\u00a0 Who said that<\/em>? When? Is it still true?\u00a0 So what? But what about xxx?<\/em>\u00a0 It\u2019s exhausting. Who to trust? What to trust?<\/em> After draining, maddening calls with family and friends who clearly trust something different than us, we feel the cloudy mechanisms of trust, conscious or unconscious. Some people trust Dr. Fauci, others Mr. Trump.\u00a0 Some follow the CDC, others QAnon. What does trust even mean? What is trustworthiness?<\/p>\n

\"\"In this piece, we will examine trust.\u00a0 We don\u2019t have the chutzpah, the energy, or the resources to give Seals of Approval for trust. At best we can promote a bit of self-awareness about trust. Picture a family sitting around the breakfast table with a young person waving their tablet and exclaiming, \u2018look what I found about mask-wearing!\u2019 Imagine an adult responding, \u2018Who wrote that? When was it written? Who paid for it? Did it cite any references? Does it make sense to you?\u2019 We advocate for self-awareness<\/strong> of our own trust faith, filters, and responses.<\/p>\n

Our overriding lesson learned: Trust Is Complicated.<\/strong><\/p>\n

<\/a>Person-first<\/h2>\n

\"\"Let\u2019s approach trust using our person-first<\/strong> theme -starting with regular people and meeting them where they are.\u00a0 Person-first<\/strong> includes knowing your audience and end-users and understanding their questions, their circumstances, their preferences, and conditions. People will find information where they usually find information \u2013 talking heads, websites and searches, cronies, professionals.\u00a0 They may or may not question what they read, hear, watch. Many will share what they learn and become someone with an apparent 15-minute advantage (knowing just a bit more).<\/p>\n

<\/a>The context of trust<\/h2>\n

For some trust reveals itself most when they lose it – think about losing trust in a family member, friend, politician, celebrity, or movement or when someone important to you loses trust in you \u2013 devastating, a punch in the gut. The inertia is trust until it isn\u2019t. For others, the inertia is mistrust. Trust must be built in a headwind. Show me your trustworthiness.\u00a0 So, trust ferments in a context, a relationship. Let\u2019s try to understand the personal ingredients that flavor the creation of trust. In Covid19-world, personal trust ingredients include understanding an individual\u2019s circumstances, experience, and historical identity, their tolerance for risk, their comfort with uncertainty, their attitude toward individual rights and social responsibilities, and their capacity and willingness to think critically. We\u2019ll examine each ingredient next.<\/p>\n

<\/a>Circumstances, experience, historical identity<\/h3>\n

Ponder 911. Many people trust that when they call 911, someone will come quickly to help them, whatever the help they need. But if you live in a community where 911 doesn\u2019t come or the help isn\u2019t helpful or is downright lethal, you won\u2019t rust 911. 911 has a long racist history.<\/a> Many people raise The Tuskegee Syphilis Study<\/a> as an influence on trusting the medical system. Different circumstances, different experiences, a different history. Trust is complicated.<\/strong><\/p>\n

<\/a>Risk Tolerance<\/h3>\n

\"\"Here\u2019s a Covid-19 Risk Tolerance Scale published by the APNA, the Association for Premier Nanny Agencies<\/a>, ranging from Very Strict to Very Open. Some people, very strict, want to stay in their bubble with people living in the same house and avoid all outside contact.\u00a0 Some, Fairly Strict, may leave home for work and socialize with a mask, physically distant. Still others, Very Open, socialize without masks or physical distance. Self-awareness of your risk tolerance helps to understand the trust of others. Understanding others\u2019 risk tolerance helps to understand of their trust. Trust is complicated.<\/strong><\/p>\n

<\/a>Comfort with uncertainty<\/h3>\n

We continue to meet our audience and end-users where they are when we understand their comfort with uncertainty. Most people (professional and non-professional) feel more comfortable with certainty than uncertainty.\u00a0 Certainty is a continuum. Certain<\/u>: The earth is round. I will be safer if I look both ways before I cross a busy street. A bit less certain<\/u>: I will still have a job tomorrow. Ibuprofen will reduce my fever. Much less certain<\/u>: I will win the Lotto. I will never contract COVID-19. In our Covid-19 world, certainty seems harder to pin down. Things appear to change every day. We\u2019re repairing the airplane while we\u2019re flying it.<\/em> Part of comfort with uncertainty is that some people think in black and white (it\u2019s correct or not) and some think in shades of grey (it depends). Perhaps people who think in grey are more comfortable with uncertainty?\u00a0 Knowing where people live on the continuum of comfort with uncertainty helps us understand their trust context. Trust is complicated.<\/strong><\/p>\n

<\/a>Individual rights and social responsibility<\/h3>\n

Another continuum relevant to profoundly understanding the context of trust can be represented by individual rights and social responsibility<\/a>. Those who prize individuals’ liberties to pursue life without others’ interference have a different trust context than those that prize duties or obligations for community cooperation, respect, and participation. It\u2019s my right not to wear a mask<\/em> versus wear a mask to protect each other. <\/em>\u00a0How much will the person that values individual rights over all else trust strict evidence-informed mask-wearing and physical distancing? How will a person that values cooperation and community over all else trust a voice on the other end of the continuum? Trust is complicated.<\/strong><\/p>\n

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<\/a>Critical thinking<\/h3>\n

Critical thinking, at its root, is curiously, persistently questioning everything. Does this make sense? So what? How does it apply to this situation? <\/em>\u00a0Who benefits?<\/em> Critical thinking, like music, is a skill using many muscles that ne\"\"<\/strong>ed practice and exercise. As a patient-caregiver activist, I\u2019m a person who appears to question everything. Yet I\u2019m happy to leave most decisions about my multiple sclerosis to those I trust (my wife, my primary care doc, and neurologist).\u00a0 But without trust, I question everything. My wife, on the other hand, seems to question everything. It\u2019s less about trust and more about comfort. Here\u2019s two models to help with critical thinking: Who, What, Where, When, How<\/em> and I.N.Q.U.I.R.Y<\/strong><\/p>\n

Trust is complicated.<\/strong><\/p>\n

<\/a>Trustworthy versus factual<\/h3>\n

Once we meet people where they are and understand their risk tolerance, comfort with uncertainty, attitude toward individual rights and social responsibility, and willingness and capacity to think critically, then we bump up against the dilemma of trustworthy and factual. They\u2019re different. A simple definition of factual is verifiable \u2013 <\/em>data that is verifiable \u2013 getting the same results repeatedly. Yet COVID-19 facts \u2013 really almost all facts – seldom stand alone. Interpretation and commentary are constant companions to facts. What do facts mean to me, to my community? That\u2019s where trust comes in. Interpretation and commentary. Trust is complicated.<\/strong><\/p>\n

<\/a>Trust label<\/h2>\n

\"\"Likely, you still ask, this context stuff is all well and good, makes sense, but who and what should I trust as I make decisions for safe living in a pandemic? Point me in the right direction. Remember that we started with We don\u2019t have the chutzpah, the energy, or the resources to give Seals of Approval for trust.<\/em> \u00a0Instead, we became drawn to the nutrition label model. Most people don\u2019t use nutrition labels, but those that do use the nutrition label to make food selection decisions. Most people who use nutrition labels trust them. Why? For those people concerned about their diet, the nutrition offers some factual<\/u> information about the food package contents. It makes no claim to healthiness or taste. A person needs to want to know about the contents and interpret the calories, sugar, fat, fiber for themselves. See the label here for macaroni and cheese. You can see serving size, calories, nutrients and fiber, and percent of the daily value. Perhaps, a trust label could offer some facts about answering resources that the end-user can interpret for themselves.<\/p>\n

\"\"In this table you can see some of the questions we sought to answer with a trust label and some fields that could be easily attached to the answering resource. Perhaps you\u2019re thinking that a trust label seems underwhelming, too simple. Well, the creation of the nutrition label was a big ask. The nutrition label history<\/a> runs from a White House Conference on Food, Nutrition, and Health in 1969 to the passing of the Nutrition Labeling and Education Act in 1990, 21 years. The evolution of values and standards continued through the 1990s, 30 years. Trust is complicated.<\/strong><\/p>\n

<\/a>Now what?\u00a0 Next steps.<\/h2>\n

So, we have taken some baby steps: standing up a library, a repository, a website<\/a> with person-facing resources containing a trust label so people can more easily seek and share answers to their questions about safe living in a pandemic. Join us. Help us enter answering resources using this Google Form<\/a>. We built a website safeliving.tech<\/a> to house our materials. Talk to us here info@safeliving.tech<\/a>. Our next step will be summarizing our work for regular people, clinicians, and knowledge management professionals and hosting some virtual spaces to chat about this work. Trust is complicated.<\/strong> Safe living is complicated.<\/strong><\/p>\n

Resources about trust in safe living info<\/h2>\n