Pre-existing Trust Research Articles

Digital Marketing Strategies and their Impact on Consumer Behavior

The advent of digital marketing has greatly altered customer behavior by altering the way in which companies communicate with their target audiences. The effects of different digital marketing methods on customer actions are discussed in this article. Content marketing, social media marketing, SEO, email marketing, and influencer marketing are some of the key tactics that are addressed. Research shows that these tactics increase customer involvement, familiarity with the brand, and ultimately, sales. The goal of content marketing is to increase customer trust and loyalty by providing them with high-quality, relevant material. In order to increase brand awareness and customer engagement, social media marketers use sites like Twitter, Instagram, and Facebook to build tailored and interactive campaigns. With search engine optimization (SEO), companies may increase their online presence and more effectively reach their target audience. One of the most effective ways to reach out to customers, build rapport, and increase sales is through email marketing. Influencer marketing leverages preexisting trust networks to sell items in a genuine way by teaming up with people who have large online followings. Not only do these tactics affect the whole buyer experience, from awareness to post-purchase assessment, but they also significantly affect consumers' views and preferences. The study highlights the need of comprehending customer behavior and psychology in order to customize digital marketing campaigns successfully. It also stresses how important it is for companies to keep up with new technology and trends if they want to be competitive. Businesses may improve marketing strategies, get insights into consumer preferences, and boost customer happiness by employing data analytics. The report finds that the most effective way to influence customer behavior and achieve corporate goals is through an integrated approach that combines numerous digital marketing methods.

Surveying Security Challenges in Cloud Computing: Current Landscape and Future Directions

Customers can access a shared computer resource pool on demand or on a pay-per-use basis using a cloud computing paradigm. Cloud computing has advantages for both users and cloud service providers (CSPs). Due to its benefits including cost effectiveness and versatility, it is one of the most alluring technological fields today. Given the lack of a central location, omniscience, and a preexisting trust connection, it allows the virtual organization to pool geographically dispersed resources to accomplish shared objectives. Despite the tremendous investment returns that cloud computing promises, customers are unsure about whether to use its services due to the security risks involved. This article is a survey that focuses more specifically on the various security vulnerabilities that have arisen because of how cloud computing systems deliver services. To deliver data secrecy, data integrity, and data availability, it makes several recommendations that should be implemented in further efforts.

Is this AI sexist? The effects of a biased AI’s anthropomorphic appearance and explainability on users’ bias perceptions and trust

Biases in artificial intelligence (AI), a pressing issue in human-AI interaction, can be exacerbated by AI systems’ opaqueness. This paper reports on our development of a user-centered explainable-AI approach to reducing such opaqueness, guided by the theoretical framework of anthropomorphism and the results of two 3 × 3 between-subjects experiments (n = 207 and n = 223). Specifically, those experiments investigated how, in a gender-biased hiring situation, three levels of AI human-likeness (low, medium, high) and three levels of richness of AI explanation (none, lean, rich) influenced users’ 1) perceptions of AI bias and 2) adoption of AI’s recommendations, as well as how such perceptions and adoption varied across participant characteristics such as gender and pre-existing trust in AI. We found that comprehensive explanations helped users to recognize AI bias and mitigate its influence, and that this effect was particularly pronounced among females in a scenario where females were being discriminated against. Follow-up interviews corroborated our quantitative findings. These results can usefully inform explainable AI interface design.

Is everything under control? An experimental study on how control over data influences trust in and support for major governmental data exchange projects

The steep rise in the exchange of (citizen) data through government-wide platforms has triggered a demand for better privacy safeguards. One approach to privacy is to give citizens control over the exchange of personal data, hoping to reinforce trust in and support for data-driven governance. However, it remains unclear whether more control fulfils its promise of more support and higher trust. Using an online survey experiment, we study how 1) textual information on control and 2) direct control (simulated through an exercise in which respondents choose data types that can be shared) affect citizen trust, support and policy concerns. Results suggest that a combination of information on and direct control result in relatively high levels of trust, support and policy concern. Moreover, we observe an interaction effect in which those respondents with low pre-existing trust in government report more positive attitudes when assigned to the full intervention (information on control + direct control) group. Our results imply that perceived control may be especially useful to mitigate negative attitudes of those who have low trust in government.

Stronger than partisanship and motivated reasoning: news exposure and news frames predicting US state-level preventive behaviours against COVID-19

The COVID-19 pandemic has become a partisan issue rather than an independent public health issue in the US. This study examined the behavioural consequences of motivated reasoning and framing by investigating the impacts of COVID-19 news exposure and news frames, as apparent through a Latent Dirichlet topic modelling analysis of local news coverage, on state-level preventive behaviours as understood through a nationally representative survey. Findings suggested that the media effects on various preventive behaviours differed. The overall exposure rate to all COVID-19 news articles increased mask-wearing but did not significantly impact other preventive behaviours. Four news frames significantly increased avoiding contact or avoiding public or crowded places. However, news articles discussing anxiety and stay at home order triggered resistance and countereffects and led to risky behaviours. ‘Solid Republican’ state residents were less likely to avoid contact, avoid public or crowded places, and wear masks. However, partisan leanings did not interfere with the impact of differing local COVID-19 news frames on reported preventive behaviours. Plus, statements regarding pre-existing trust in Trump did not correlate with reported preventive behaviour. Attention to effect sizes revealed that news exposure and news frames could have a bigger impact on health behaviours than motivated reasoning.

Who rallies around the flag? Evidence from panel data during the Covid-19 pandemic

ABSTRACT Recent studies on political trust during the Covid-19 pandemic diagnosed a rally-around-the-flag effect leading to exceptionally high levels of trust in politics. While this finding has been established over various country contexts, our understanding of the precise dynamics behind the rally effect remains limited. In this paper, we argue that socio-demographic characteristics, in particular age differences, as well as pre-existing trust levels moderate the extent of the rally effect. Using individual-level panel data from the Netherlands, covering the time before and during the first Covid-19 wave, we show that the rally effect is particularly pronounced among older individuals, while it is absent among the young. Furthermore, we find a catch-up effect among the more distrusting parts of the population, such as populist supporters and low-income earners, who seem to largely drive the rally effect during the initial stage of the pandemic. This shows that the extent of the rally effect is conditional on socio-demographic characteristics, pointing towards the role of group risks and pre-crisis trust differentials in shaping people’s response to an existential threat.

Lessons learned from academic medical centers' response to the COVID-19 pandemic in partnership with the Navajo Nation.

IntroductionStructural forces that drive health inequalities are magnified in crises. This was especially true during the COVID-19 pandemic, and minority communities were particularly affected. The University of California San Francisco and Health, Equity, Action, Leadership Initiative jointly sent volunteer teams of nurses and doctors to work in the Navajo Nation during the COVID-19 pandemic. This presented an opportunity to explore how academic medical centers (AMCs) could effectively partner with vulnerable communities to provide support during healthcare crises. Therefore, the aims of this study were to describe volunteers’ perspectives of academic-community partnerships by exploring their personal, professional and societal insights and lessons learned based on their time in the Navajo Nation during COVID-19.MethodsWe recruited key informants using purposeful sampling of physicians and nurses who volunteered to go to the Navajo Nation during the spring 2020 COVID-19 surge, as well as hospital administrators and leaders involved in organizing the COVID-19 efforts. We used in-depth qualitative interviews to explore key informants’ experiences pre-departure, during their stay, and after their return, as well as perspectives of the partnership between an AMC and the Navajo Nation. We used thematic analysis to systematically identify, analyze and report patterns (themes) within the data.ResultsIn total, 37 clinicians and hospital administrators were interviewed including 14 physicians, 16 nurses, and 7 health system leaders. Overall, we found 4 main themes each with several subthemes that defined the partnership between the AMC and the Navajo Nation. Mission and values incorporated civic duty, community engagement, leadership commitment and employee dedication. Solidarity, trust and humility encompassed pre-existing trust, workforce sustainability, humility and erasure of ‘savior narratives.’ Coordination included logistical coordination, flexibility, selectivity of who and what traveled to the response and coordination around media response. Workforce preparation and support encompassed understanding of historical context and providing healthcare in limited settings, dangers of inadequate preparation and the need for emotional support.ConclusionThis study provides guidelines which AMCs might use to develop and improve partnerships they have or would like to develop with vulnerable communities. These guidelines may even be broadly applied to partnerships outside of a pandemic response. Importantly, such partnerships need to be built with trust and with an eye towards sustainability and long-term relationships as opposed to ‘medical missions’.

Performance based Risk driven Trust (PRTrust): On modeling of secured service sharing in peer-to-peer federated cloud

Peer-to-peer (P2P) federated cloud system has emerged as a promising service delivery model wherein multiple cloud service providers (CSPs) collaborate and share resources and services among themselves to fulfill the spikes in demand from their cloud service consumers (CSCs). It facilitates CSPs to accomplish the committed service level agreements (SLAs) to their CSCs. However, the lack of preexisting trust relationships and unawareness about the cloud infrastructure and service delivery performance among CSPs in a distributed environment poses a risk to the quality of service (QoS) being delivered. We address this challenge by proposing a trust model, PRTrust, for a peer-to-peer federated cloud system that capitalizes the triangular relationship of performance, risk, and trust for the participating CSPs. The main contributions of this work are: (1) providing a logical design and architecture for trust and performance management in a peer-to-peer federated cloud system; (2) providing a two-tier weighted performance evaluation mechanism for CSPs; (3) providing a risk evaluation mechanism for CSPs based on their current performance level; (4) providing an improvised mechanism to evaluate and manage personalized reputation-based trust for the participating CSPs; (5) providing a CSP selection mechanism from a trusted list of CSPs, using the evaluated performance-based risk, for sharing the resources and services in a peer-to-peer federated cloud system. The proposed PRTrust model has shown better threat resilient behavior in dealing with malicious peer CSPs when compared with the reference EigenTrust model.

International perspectives on procedural justice: Trust and respect matter even when body-worn cameras are present.

We assessed the impact of body-worn cameras (BWCs) in two countries on perceptions of everyday encounters with police, independent of officer respectfulness and participants' preexisting trust in police. We expected BWC presence, officer respectfulness, and preexisting trust in police to all significantly improve individuals' perceptions of a police encounter. We also expected interactions indicating that BWC presence and preexisting trust in police reduce the effect of officer respectfulness on perceptions of the encounter. In each of three experimental studies, we measured participants' preexisting trust in police, and then presented participants with a vignette describing an encounter with a police officer in which officer respectfulness (respectful, disrespectful) and the presence/disclosure of a BWC (absent, present and disclosed by officer, present but undisclosed by officer) were independently manipulated. In Studies 1 (N = 422, Mage = 29 years, 73% women, 68% Australian) and 2 (N = 210, Mage = 19 years, 64% women, 59% Hispanic) in Australia and the United States, respectively, participants assumed the role of the driver in a traffic stop as they read the vignette. In study 3 (N = 504, Mage = 29 years, 72% women, 34% English), participants in Australia assumed the role of a citizen interacting with a police officer enforcing COVID-related restrictions. Participants then recorded their perceptions of procedural justice of and satisfaction with the encounter, legitimacy of the police, and willingness to co-operate with police. Across three studies and two countries, we found no support for the notion that BWC presence influenced people's perceptions of police-citizen interactions independent of officer respectfulness and preexisting trust. The effect of BWC presence, established in prior research, might operate via its effect on officer respectfulness. These findings underscore the importance of preexisting trust in police and respectful behavior by police officers, even in BWC-recorded encounters. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Facilitating use of climate information for adaptation actions in small coastal communities

Municipalities are key agents in the transition to sustainability, and yet we have poorly developed theories and practices for how to facilitate the use of climate information by local governments in adapting to climate change. Existing research suggests that climate information is more likely to lead to adaptation actions when it is coproduced by researchers and policy makers because doing so increases the likelihood that the content of information is credible, salient, and legitimate. In this study, we explored how the coproduction process facilitated or hindered use of information from two climate adaptation projects in coastal New Hampshire. Based on 17 interviews and document review, we found that, contrary to expectations, highly engaged coproduction of knowledge may not be necessary due, in part, to preexisting trust among New Hampshire coastal municipalities, technical service providers, and researchers. However, we found in small towns with limited capacity, even the best climate knowledge is unlikely to be used without ongoing context-specific implementation assistance. Our research provides both practical recommendations for those actively advancing climate adaptation, as well as contributions to the undertheorized third phase of transdisciplinary research in which knowledge is translated to action.

Exploring trust in religious leaders and institutions as a mechanism for improving retention in child malnutrition interventions in the Philippines: a retrospective cohort study

ObjectivesIn the context of persistent child malnutrition in the Philippines, the objective of this study was to examine how different dimensions of trust affected programme retention and physiological outcomes when...

Trust, Blockchain-based Technologies, Public Sector, and the Social Good

Many public institutions, government bodies, municipalities are experimenting with blockchain based systems, decentralized ledgers, smart contracts to deliver new innovative services to citizens, or improve the speed, efficiency, accuracy of existing ones. This short policy analysis looks at the potential mismatch between usually high-trust public institutions, and trust-minimizing technological infrastructures. We warn that, in general, we should avoid replacing a high-trust environment with a trust-minimizing technology. Pre-existing trust is very valuable, and no new technology should endanger trust which is extremely hard to build but very easy to destroy. Of course, not all institutions enjoy the trust of the citizenry. In low-trust environments the implementation of trust minimizing technologies need to consider the relative benefits and harms of the different approaches to dealing with low-trust environments. One can decide to implement a technology that is able to operate in such low-trust settings. The alternative to this is to try to implement technologies and policies that foster the emergence of trust. What is the preferable way forward: replacing distrusted public entities with trust-minimizing technologies, or improving their trustworthiness? Should we implement a trust-minimizing architecture, or a trust-maximizing one? Our institutions may be imperfect, and often produce arbitrary outcomes; sometimes they are downright oppressive. But at least there are clear lines of social, public, institutional, political and economic accountability and oversight. Such mechanisms of trust are yet to mature with regard to blockchain technologies. Unless these technologies can be brought into the fold, they remain largely unaccountable, thus fundamentally untrustworthy. And even if they are, we still don’t know which is preferable: a polycentric system of power of checks and balances, which involves democratic oversight, or an ideally decentralized and disintermediated one, where power concentration is prevented? This should be a warning to well-intentioned public servants, institutions and private actors who are looking at implementing blockchain systems in order to better their domain or be seen as innovative, or simply because they fear missing out on a technology development sold to them as a revolution. It may be worth their while not to rush. It is OK to be slow and cautious. Disruptive digital innovation that targets trust should be treated with extreme caution.

Korean Counseling Students’ Perceptions of Dual Relationships in Group Counseling Coursework

The purpose of this study was to explore Korean counseling students’ perceptions of dual relationships experienced in group counseling as part of their coursework. A total of 14 students were interviewed, and the interviews were analyzed using the Consensual Qualitative Research (CQR) method. Results indicated that both negative and positive impacts of dual relationships were experienced. First, participants reported several negative impacts of dual relationships experienced in in-class group counseling, such as feeling pressured to do well due to their professor’s authority and power, making efforts to present oneself positively, negative interactions between group dynamics and relationships outside the counseling group, and discomfort showing oneself in the counseling group. Second, participants addressed the positive impacts of dual relationships in in-class group counseling, including preexisting trust relationships that facilitated group dynamics and an increased level of comfort in relationships formed outside the counseling group. Implications are presented.

Meeting Changing Customer Requirements in Food and Agriculture Through Application of Blockchain Technology

This document summarizes research supporting the implementation of blockchain technology in the food and agriculture industry in Ontario. First, our research indicates that blockchain technology based solutions are an existing and proven set of technologies, where it has already been proven that the source of food items can be identified in seconds where previous processes required days and weeks of effort. Second, we also describe how blockchain based supply chain provenance information has many more benefits than its current use for food safety and product recalls. Consumers are willing to pay premium prices for food based on reliable supply chain information that matches the consumers expectations and values. Costs related to blockchain technology based solution development and implementation will be relatively small in comparison to revenues generated through increased market share by organizations providing useful information to consumers, and other stakeholders in the food supply chain. Third, we recommend that costs for development of blockchain based solutions should also be distributed across stakeholders, and apportioned by the relevant industry associations. Implementation of smart contracts can be used to guarantee a pre-arranged distribution of revenues and costs across stakeholders across the food supply chain. A consortium approach will reduce individual organization related risks, and will ensure that complete end to end supply chains participate in blockchain based technology solutions. Our research indicates that adoption of blockchain technology in agriculture will be achieve critical mass earlier when the industry applies a consortium approach, in a regulatory environment that is supported by government. Finally, this report also makes recommendations relevant to the integration of blockchain technology with per item labelling, one of the core competencies and strengths of the project partner, Accu-Label Inc. Instead of each organization attempting to navigate their own path through the different choices in technologies, we recommend a consortium approach where a blockchain technology based solution is selected and implemented through existing industry associations. Industry associations by design address the needs of their members, and therefore have a built-in relationship of trust with their members. This preexisting trust between industry associations and their members will enable pre-arranged distribution of costs and revenues related to implementation of blockchain technology between different stakeholders. Industry associations can pilot simpler low cost blockchain based solutions to reduce the risks developing more complex and expensive solutions. Blockchain based smart contracts provide an additional layer of assurance by pre-defining conditions of revenue/cost distribution, and automating the process. Summary of Recommendations: 1. Pilot different blockchain technologies to determine the best fit for the industry and organization. 2. Determine information that is of value to stakeholders in the supply chain, such as end consumers, and that they are willing to pay for. 3. Distribute the costs of blockchain technology development across different stakeholders in a consortium approach through industry associations. 4. Ensure that a robust mechanism exists to bridge information flows with physical food product flows.

How consumers respond to social norms: an evidence from pay-what-you-want (PWYW) pricing

PurposeThis paper aims to investigate consumer behaviour in response to social norms under pay-what-you-want (PWYW) pricing. Specifically, it explores the critical role of social norms such as norm priming and consumer prior trust in the retailer on consumers’ perceived price fairness, trust, willingness to pay, purchase intentions and intentions to spread negative word of mouth about the retailer.Design/methodology/approachData on dependent measures were collected through the scenario-based online experimental approach and assessed using MANOVA analysis.FindingsResults confirm the significance of norms by indicating the critical role of norm belief on consumer responses. Also, increasing the salience of norms by priming them usually intensifies negative behaviour, and pre-existing trust in the retailer serves as an imperfect cushion against consumer negative reactions to norm violation, but this effect is observed to be decreasing with increase in prior trust.Research limitations/implicationsFurther research should consider the contextual (time, place, media) influences and assumptions to increase the generalizability of the findings.Originality/valueTo the best of the authors’ knowledge, this is the first paper to explicitly examine the effects of social-norm compliance by sellers on consumer behaviour in the context of PWYW pricing.

TrustyFeer: A Subjective Logic Trust Model for Smart City Peer‐to‐Peer Federated Clouds

Cloud computing plays a major role in smart cities development by facilitating the delivery of various services in an efficient and effective manner. In a Peer‐to‐Peer (P2P) federated clouds ecosystem, multiple Cloud Service Providers (CSPs) collaborate and share services among them when experiencing a shortage in certain resources. Hence, incoming service requests to this specific resource can be delegated to other members. Nevertheless, the lack of preexisting trust relationship among CSPs in this distributed environment can affect the quality of service (QoS). Therefore, a trust management system is required to assist trustworthy peers in seeking reliable communication partners. We address this challenge by proposing TrustyFeer, a trust management system that allows peers to evaluate the trustworthiness of other peers based on subjective logic opinions, formulated using peers’ reputations and Service Level Agreements (SLAs). To demonstrate the utility of TrustyFeer, we evaluate the performance of our method against two long‐standing trust management systems. The simulation results show that TrustyFeer is more robust in decreasing the percentage of services that do not conform to SLAs and increasing the success rate of exchanged services by good CSPs conforming to SLAs. This should provide a trustworthy federated clouds ecosystem for a better, more sustainable future.

Goals of Care or Goals of Trust? How Family Members Perceive Goals for Dying Nursing Home Residents.

Dementia affects more than 5 million Americans, and is a leading cause of death. Family members of nursing home (NH) residents with advanced dementia report difficulty making decisions about care toward the end of life. As part of a randomized trial testing an intervention to improve decision making, this qualitative study aimed to understand how family decision makers experienced goal-based decision making in advance of the death of their relative. This qualitative study was conducted as part of the goals of care clinical trial. Study participants (n = 16) were family decision makers in North Carolina whose relative with advanced dementia died after participating in the goals of care intervention. Semi-structured interviews were analyzed using a qualitative description approach. Family members' experience of decision making and death differed based on the presence or absence of trusting relationships with NH staff. Family members who reported trust described a positive end-of-life experience and less need for prescribed goals of care discussions. In the absence of trust, family members reported that goals of care discussions were ignored by staff or created confusion. Among family members of persons who recently died from dementia in NHs, expressions of trust in staff were strongly related to perceptions of decision making about goals of care. Although goals of care discussions may potentially promote communication to earn trust, the presence of pre-existing trust ultimately influenced the decision making and end-of-life experiences of residents and families.

Challenges of Implementing a Communication-and-Resolution Program Where Multiple Organizations Must Cooperate.

To implement a communication-and-resolution program (CRP) in a setting in which liability insurers and health care facilities must collaborate to resolve incidents involving a facility and separately insured clinicians. Six hospitals and clinics and a liability insurer in Washington State. Sites designed and implemented CRPs and contributed information about cases and operational challenges over 20months. Data were qualitatively analyzed. Data from interviews with personnel responsible for CRP implementation were triangulated with data on program cases collected by sites and notes recorded during meetings with sites and among project team members. Sites experienced small victories in resolving particular cases and streamlining some working relationships, but they were unable to successfully implement a collaborative CRP. Barriers included the insurer's distance from the point of care, passive rather than active support from top leaders, coordinating across departments and organizations, workload, nonparticipation by some physicians, and overcoming distrust. Operating CRPs where multiple organizations must collaborate can be highly challenging. Success likely requires several preconditions, including preexisting trust among organizations, active leadership engagement, physicians' commitment to participate, mechanisms for quickly transmitting information to insurers, tolerance for missteps, and clear protocols for joint investigations and resolutions.

Understanding micro-processes of community building and mutual learning on Twitter: a ‘small data’ approach

This article contributes to an emerging field of ‘small data’ research on Twitter by presenting a case study of how teachers and students at a sixth-form college in the north of England used this social media platform to help construct a ‘community of practice’ that enabled micro-processes of recognition and mutual learning. Conducted as part of a broader action research project that focused on the ‘digital story circle’ as a site of, and for, narrative exchange and knowledge production, this study takes the form of a detailed analysis of a departmental Twitter account, combining basic quantitative metrics, close reading of selected Twitter data and qualitative interviews with teachers and students. Working with (and sometimes against) Twitter's platform architecture, teachers and students constructed, through distinct patterns of use, a shared space for dialogue that facilitated community building within the department. On the whole, they were able to overcome justified anxieties about professionalism and privacy; this was achieved by building on high levels of pre-existing trust among staff and by performing that mutual trust online through personal modes of communication. Through micro-processes of recognition and a breaking down of conventional hierarchies that affirmed students' agency as knowledge producers, the departmental Twitter account enabled mutual learning beyond curriculum and classroom. The significance of such micro-processes could only have been uncovered through the detailed scrutiny that a ‘small data’ approach to Twitter, in supplement to some obvious virtues of Big Data approaches, is particularly well placed to provide.

Trust, confidentiality, and the acceptability of sharing HIV-related patient data: lessons learned from a mixed methods study about Health Information Exchanges

BackgroundConcerns about the confidentiality of personal health information have been identified as a potential obstacle to implementation of Health Information Exchanges (HIEs). Considering the stigma and confidentiality issues historically associated with human immunodeficiency virus (HIV) disease, we examine how trust—in technology, processes, and people—influenced the acceptability of data sharing among stakeholders prior to implementation of six HIEs intended to improve HIV care in parts of the United States. Our analyses identify the kinds of concerns expressed by stakeholders about electronic data sharing and focus on the factors that ultimately facilitated acceptability of the new exchanges.MethodsWe conducted 549 surveys with patients and 66 semi-structured interviews with providers and other stakeholders prior to implementation of the HIEs to assess concerns about confidentiality in the electronic sharing of patient data. The patient quantitative data were analyzed using SAS 9.2 to yield sample descriptive statistics. The analysis of the qualitative interviews with providers and other stakeholders followed an open-coding process, and convergent and divergent perspectives emerging from those data were examined within and across the HIEs.ResultsWe found widespread acceptability for electronic sharing of HIV-related patient data through HIEs. This acceptability appeared to be driven by growing comfort with information technologies, confidence in the security protocols utilized to protect data, trust in the providers and institutions who use the technologies, belief in the benefits to the patients, and awareness that electronic exchange represents an enhancement of data sharing already taking place by other means. HIE acceptability depended both on preexisting trust among patients, providers, and institutions and on building consensus and trust in the HIEs as part of preparation for implementation. The process of HIE development also resulted in forging shared vision among institutions.ConclusionsPatients and providers are willing to accept the electronic sharing of HIV patient data to improve care for a disease historically seen as highly stigmatized. Acceptability depends on the effort expended to understand and address potential concerns related to data sharing and confidentiality, and on the trust established among stakeholders in terms of the nature of the systems and how they will be used.