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

Nos actions sont nécessairement influencées par notre appartenance à un certain nombre de milieux formels, organisés selon des règles bien connues. Ce sont elles qui rendent possibles les entreprises collectives, aussi diverses soient-elles, et qui entretiennent notre impression de permanence des sciences, de la politique, de la technique, du commerce, de la religion ou des arts : nos règles communes organisent notre vivre ensemble. Toutes nos organisations, pourtant, se trouvent plongées dans des circonstances où leur structure formelle, telle que perçue et répétée par leurs acteurs, est prise en défaut : ils parlent alors de crise, et c'est premièrement à une investigation des limites de la pertinence de cette dimension formelle du phénomène organisationnel qu'invite cette thèse. Nous avons rencontré à cette fin des gestionnaires de différentes organisations dont l'expérience concrète en situation de crise, recueillie et analysée en suivant les procédures d'une recherche qualitative selon la théorie enracinée de Strauss et Corbin (1990), nous a permis de préciser les circonstances, vécues comme intenses, conduisant les membres des organisations à déroger à la convention formelle, lorsqu'ils la perçoivent comme inadéquate. Le phénomène organisant ne semble alors plus dépendre que de la confiance entre ces individus réunis en situation, occupés à lui donner un sens pour y agir ensemble. Nous répondons ainsi à une problématique managériale faisant le constat de l'importance de la confiance entre les gestionnaires de crise des différentes organisations impliquées dans sa réponse, rassemblés pour agir ensemble. Nous en clarifions les raisons, et nous intégrons ce processus de retour à la confiance comme dernier rempart du phénomène organisant, au processus plus général de l'expérience de la crise par les gestionnaires. Outre les recommandations pratiques aux gestionnaires susceptibles de faire face à des situations de crise relativement à l'utilité de la règle formelle, cette recherche contribue à une meilleure connaissance théorique de la relation interpersonnelle de confiance, ici envisagée entre les gestionnaires de différentes organisations, en décrivant un processus de confiance influencé par leur expérience de l'intensité du contexte de la relation.

Η καθημερινή χρήση ηλεκτρονικών υπηρεσιών έχει αυξηθεί σημαντικά. Για την διεκπεραίωση τέτοιου είδους συναλλαγών δεν υπάρχει άλλη επιλογή από το να παρέχουμε πλήθος προσωπικών πληροφοριών για σκοπούς εξουσιοδότησης (authorization), διεκπεραίωση χρηματικών συναλλαγών ή απλά επειδή το απαιτούν οι όροι χρήσης της υπηρεσίας από το πάροχο. Η έλευση τεχνολογιών όπως τα Big Data, τα διάχυτα περιβάλλοντα(pervasive environments) και τα πανταχού παρόντα συστήματα(ubiquitous systems), ευνοούν ακόμα πιο πολύ την διασπορά όλων αυτών των προσωπικών πληροφοριών. Ως αποτέλεσμα, αποδυναμώνεται η ιδιωτικότητα (privacy) του ατόμου-χρήστη και επομένως δημιουργούνται κίνδυνοι κατάχρησης αυτής της πληροφορίας. Η εργασία αυτή εστιάζει στην μελέτη Privacy by Design τεχνικών προστασίας της ιδιωτικότητας που ενσωματώνονται σε τεχνολογίες ταυτοποίησης. Ένας αποδοτικός και διαδεδομένος τρόπος προστασίας της ιδιωτικότητας επιτυγχάνεται με την χρήση συστημάτων ανωνύμων credentials. Η επικρατούσα τεχνολογία στην κατηγορία των ανώνυμων credentials είναι το σύστημα Identity Mixer(idemix) το οποίο αναπτύχθηκε από την IBM Research με σκοπό την παροχή ισχυρών μηχανισμών αυθεντικοποίησης (authentication) και προστασίας της ιδιωτικότητας ταυτόχρονα. Επιλέξαμε την τεχνολογία Idemix για να παρουσιάσουμε ένα σενάριο χρήσης της τεχνολογίας για υλοποίηση εφαρμογών που σέβονται την ιδιωτικότητα του χρήστη. Τέλος, παρουσιάζεται η αξιολόγηση ευχρηστίας της διεπιφάνειας χρήστη, για ένα υποθετικό σενάριο online αγοράς όπου ενσωματώνονται αρχές προστασίας της ιδιωτικότητας / At this thesis we study Privacy by Design techniques used in identification technologies. We focus on implementing an easy way to issue and embed the use of anonymous credentials in applications, by using the existent protocols for anonymous credential systems and libraries. While there are already protocols describing anonymous credential systems there is lack of applications using these systems. In our use case we use Idemix open source library, which provide strong authentication mechanisms in a privacy preserving way. Our java based application, provide user control over his data without affecting systems functionality and usability.

The purpose of this study was to explore whether academic disidentification (i.e., the relation between ASC and GPA), differed based on students’ gender and reported level of parental racial-ethnic socialization and teacher trust. This study was exploratory in nature, as few researchers have examined the relation between parental racial-ethnic socialization and academic outcomes or the relation between teacher trust and academic outcomes. Secondary goals of this study included and examination of (1) the relation between racial socialization and academic outcomes, (2) the relation between teacher trust and academic outcomes, (3) the relation between parenting constructs (i.e., racial socialization and parental warmth) and teacher trust, and (4) the role of parental warmth as a variable that potentially buffers negative child outcomes or enhances positive child outcomes. Participants included 319 African American students (120 males, 199 females) recruited from a large, southwestern, predominantly white university. Results indicated the presence of academic disidentification as unique to upperclassmen males (i.e., the relation between ASC and GPA was significant for females and underclassmen males, but not upperclassmen males). Parental messages of promotion of mistrust were found to significantly moderate the relation between ASC and GPA. Further, in examining the influence of the combination of teacher trust x sex on the relation between ASC and GPA, a significant three-way interaction was present. Teacher trust was also found to be a significant predictor of GPA, with gender significantly moderating this relation. Gender differences were present for teacher trust, but there were not differences between underclassmen and upperclassmen. Racial socialization variables were not found to significantly predict GPA. However, two types of racial socialization (promotion of mistrust and egalitarianism) and parental warmth were found to be significant predictors of teacher trust. Theoretical and practical implications of these findings are discussed. / text

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Mistrust in law enforcement is a current problem that America is facing. This study examined how officer gender and race influences perceptions of trust, “masculine” and “feminine” attributes, and level of guilt in a scenario depicting potential police brutality. A hundred American adult participants read one of four possible vignettes describing a shooting between a police officer and a n African American male victim. The conditions varied along the two key dimensions of police race and police gender. Thus the study consisted of a 2 (Police Race: Black or White) by 2 (Police Gender: Male or Female) between- participants factorial design. Participants were then asked to rate the degree of officer blame, officer “masculinity” and “femininity”, as well perceptions of trust in the officer. White, male officers are expected to be blamed significantly more than female and African American officers. Trust in female officers is also expected to be significantly higher than in male officers. Male officers are likely to be considered more “masculine” and less “feminine” than female officers.

Prior research has reported that individual differences influence both placebo and nocebo responses. The present study examined how individual personality, as well as trust, influence placebo/nocebo belief and symptom reporting after receiving an inert capsule that for some was described as an active “cognitively-enhancing” trial medication. Individuals (N = 104) were randomly assigned to one of three conditions: condition A participants were told they’d received the medication, condition B participants were told they’d received a placebo, and condition C participants were told, via random assignment, each would receive either the medication or placebo (after the experiment this condition listed the group – medication or placebo - each believed s/he was in). The study was completed in the UNT Student Health and Wellness Center to provide context in a medical setting. Of the 104 participants, 46 (44.2%) were either placed by experimental design or self-report in the medication group. Participants with a belief in medication ingestion, regardless of condition (i.e., A or C), reported significantly more symptoms (M = 16.65, SD = 3.178), than participants who believed they had ingested a placebo (M = 14.21, SD = 2.58), t (102) = 4.32, p = .001. Aspects of Neuroticism and Extroversion, as well as trust were correlated with symptom reporting and/or placebo/nocebo responses. It appears that that personality is part of a combination including trust, context and expectations. It is recommended that future research on personality and placebo effects consider the role of individual factors, context and communication of expectations.