Uncertain news: Trust and preventive practices in respiratory infectious diseases

Trust influences a range of human behaviors including health decision making. Over the past 60 years a significant industry has sprung up to influence public opinion and mobilize grassroots challenges against evidence-based threats to vested interests. Simultaneously, media reports of scientific fraud, misrepresentation, constantly changing "evidence" for health, and "hyped" predictions of disasters that were ultimately less significant amplify doubts about the reliability of scientific evidence and technology when hazards arise. This has contributed to the appearance of decay of trust in the veracity of scientific claims. Population responses during communicable disease epidemics illustrate these interacting processes that simultaneously create uncertainty and significant discomfort within communities. Research on the relative influences of formal versus informal information sources in driving protective behavior during recent influenza epidemics shows how both the uptake of everyday preventive practices such as hand hygiene, and specific health interventions, such as vaccination are affected by these processes. We review recent work on influenza-related personal preventive practices, with a particular focus on the shifting roles and utility of formal and informal sources in decision making among the public, and consider the implications within the context of prevailing levels of trust, uncertainty, and doubt surrounding health care recommendations.