Background & Objective: Higher levels of institutional trust have been associated with increased health care utilization, greater adherence to treatment plans, better treatment outcomes, and improved overall health. Though numerous studies have documented the influence of institutional trust on important outcomes, there has been little attention to understanding approaches to improve patient institutional trust. This project sought to identify approaches to improve patient trust in health systems. Methods: The project used group concept mapping (GCM) to directly engage 18 insured individuals living within the Upper Darby community with at least one visit to a primary care provider within the last two years to elicit their perspectives on ways to improve patient trust. Participants first brainstormed in a group setting to develop a list of ideas about how systems could improve trust, then each participant sorted the idea into thematic domains and rated the statements based on both importance and feasibility. Results: Four primary domains for improving institutional trust emerged: privacy, patient-provider relationship, respect for patients, and health system guidelines. Overall, participants rated the “privacy” domain as the most feasible and important. The average overall cluster rankings varied based on age, where the aggregate importance ratings for individuals below the age of 40 rated were higher for the “respect for patients” cluster. Conclusion: We identify four domains that are important to our population for improving patient trust of health systems, with multiple actionable items within each domain. We suggest that efforts to improve trust of health systems will be most effective if designed to directly impact these domains. Next steps involve exploring the importance of these domains across other populations and developing interventions. / Public Health