How Building Trust Can Save Lives
A health campaign to address Ebola worked by building trust and accountability.
Posted September 15, 2020 | Reviewed by Abigail Fagan
Just a few years ago, Ebola was tearing through communities in West Africa. A massive health campaign to warn people of the dangers of this disease and provide tools for slowing its spread was imperative. But in Liberia, decades of corruption and abuse left people wary of their government, suspicious of its intentions and unwilling to trust anything it said.
Research from MIT’s GOV/LAB sheds light on how the government of Liberia was still able to mount an effective public health campaign to protect the health of its people. The secret to its success was a focus on building trust and accountability.
Trust in Persuasion
Social psychologists have long recognized the role of trust in persuasion. The same message seems more persuasive when it comes from someone we feel we can trust than when it comes from someone we don’t trust.
Way back in the 1950s when research on persuasion was first developing, Carl Hovland and Walter Weiss tested the importance of trust. For example, they gave people an article about atomic-powered submarines but sometimes they said it came from American physicist Robert Oppenheimer, and sometimes they said it came from the official newspaper of the Communist Party of the Soviet Union.
By and large, people trusted Oppenheimer more than the Soviet paper, and even though it was exactly the same article, they were more persuaded by it when it was attributed to Oppenheimer.
The same patterns pop up again and again—it helps to be seen as a trustworthy communicator. Sure, there are times when people look past who is making the argument and focus more on the content of that argument, but having a trusted reputation generally gives you an edge.
And people can infer trustworthiness from all sorts of signals. For example, people seem more trustworthy if they have a history of being honest or if they’re willing to say things to go against their own interests. And people seem untrustworthy if they appear to have ulterior motives or are making a concerted effort to manipulate your views.
Letting Locals Guide the Way
To combat the Ebola epidemic, the Liberian government’s first move was to send its own staff to knock on doors and deliver public awareness messages. This turned out to be a catastrophic failure—the government workers were met with disbelief and even violence. Trust in the government was so abysmal that rumors started spreading that the government was just dispatching people to infest community wells with poison. They thought the government had invented the Ebola crisis just as a way to rake in aid money.
So the government tried to correct course by recruiting local intermediaries who could talk to members of their own community about Ebola and how to protect themselves. One benefit of using locals to spread the message is that they’re familiar members of the community. Even still, these intermediaries were often met with suspicion since they were still ultimately working for the government.
But the local intermediaries were still able to engender more trust by assuring people that they were spreading the message because they cared about their community. They made it clear that they weren’t getting paid—they weren’t the government.
And the real benefit of having locals deliver the information was that because they lived nearby, they could be held accountable! People could see that these volunteers were not benefitting lavishly from the government. As one volunteer put it, “If I’m going up there to the big people in government to sell you, would I still be wearing slippers? If I benefit in money, you would see my life would change.”
And even more seriously, by being embedded in the local community, these communicators opened themselves up to retribution if they turned out to be lying. In fact, they would often make this point explicitly, giving people their phone numbers and telling them where they lived so they could be held accountable if need be.
Testing the Campaign’s Success
So did the trust campaign work? The research team surveyed a representative sample of more than 1,000 people living in Liberia’s capital city. Since the local volunteers were able to reach people more or less at random, we can compare residents who had and had not been approached by the local intermediaries to see if the campaign had an influence.
First, not only did the campaign increase people’s trust in the national ministry of health, but it also increased trust in the Liberian government overall. And as a result, compared to people who were never approached by the campaign, people who had talked to local intermediaries ended up knowing more about Ebola, they were more likely to use hand sanitizer daily, they were more supportive of restrictions to help control the spread of Ebola, and they were even more likely to actually comply with a ban on social gatherings.
Building Trust to Save Lives
In a time and place where people were understandably suspicious of their government, a massive communication campaign was still able to make a dent in an urgent health crisis by building trust through community members who communicated honest intentions and held themselves accountable for protecting their neighbors’ health.
Tsai, L. L., Morse, B. S., & Blair, R. A. (2020). Building credibility and cooperation in low-trust settings: Persuasion and source accountability in Liberia suring the 2014–2015 Ebola Crisis. Comparative Political Studies, 53, 1582-1618.