ArticleBMC health services research2025
Pilot evaluation of the Health Organization and System Trustworthiness scale: reliability and validity testing.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Why do people trust (or mistrust) health organizations? A systematic review.International journal for equity in health · 2026Pooled it
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study evaluated the reliability, validity, and measurement invariance of the Healthcare Organization and System Trustworthiness (HOST) scale, a tool designed to assess perceived trustworthiness in healthcare systems. STUDY
designExploratory and confirmatory factor analyses (EFA/CFA) were conducted to examine the scale's structure, while measurement testing assessed its consistency across demographic groups. Agreement with the Medical Mistrust Index (MMI) was evaluated using a Bland-Altman plot, and concurrent validity was explored through associations with seven outcomes, including vaccine hesitancy, uptake, and trust in government. DATA COLLECTION/EXTRACTION
methodsData were collected from a national sample of 4,100 U.S. residents aged 18 years and older, with a diverse representation of race/ethnicity (25% Black, 24% Hispanic, 32% White) and LGBTQ identity (13% as cisgendered bisexual, 5% as cisgendered gay/lesbian, and 82% cisgendered straight).
findingsThe HOST scale demonstrated a unidimensional structure, high internal consistency (α = 0.80), and strong concurrent validity with the MMI (r = 0.52). Scalar invariance was established across gender, LGBTQ status and regular health care access. Weak invariance was observed across racial groups. Compared to the MMI, the HOST scale had stronger correlations with trust in vaccine-related actors (r = 0.71 vs. 0.14) and perceptions of government trustworthiness at the federal (r = -0.38 vs. -0.15), state (r = -0.40 vs. -0.09), and local levels (r = -0.42 vs. -0.11).
conclusionsThe HOST scale shows promise as a tool for assessing trustworthiness in healthcare systems, particularly in capturing perceptions of fairness, competence, and future expectations. While its strong predictive validity across diverse outcomes underscores its potential utility, further refinement and validation are necessary before broader application. Additional testing is recommended to explore its use in addressing health disparities and informing public health strategies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.