Social trust and health seeking behaviours: A longitudinal study of a community-based active tuberculosis case finding program in the Philippines

Introduction

The conducive role of social trust and psychosocial resources for health promotion is well-established (Carpiano, 2006; Islam et al., 2006; Murayama et al., 2012), with a range of studies showing trust and social support to be key drivers of health seeking behaviours, treatment adherence and health outcomes (Law et al., 2019; Nieminen et al., 2013; Ramage-Morin & Bougie, 2017; van Hoorn et al., 2016; Yang et al., 2017; Zarychta, 2015). While there is some evidence for heterogeneity in the effect of social trust in facilitating cooperative behaviours between gender groups (Irwin et al., 2015), two mechanisms that explain these associations were consistently observed in these studies: firstly, providers of support, such as family, friends, community members or healthcare providers, were able to help individuals navigate through uncertain and difficult circumstances throughout the treatment process, such as by providing health information, encouragement or physical assistance. Next, when individuals felt better supported, they were able to cultivate better attitudes toward their disease and its associated treatment, leading to increased motivation to take the necessary actions for their health and well-being.

Earlier research on health seeking behaviour had primarily been based on models that conceptualized health as a product of individual behaviours, and behaviours as modifiable characteristics. These ideas have since shifted, and there is increasing recognition that the forces shaping health seeking behaviour do not lie within the individual alone, but are instead intertwined with the relationships and societal structures that surround the individual (MacKian et al., 2004). Researchers have identified a range of factors that may affect health-seeking behaviours, including cultural and sociodemographic factors, economic factors, physical accessibility, and perceived quality of services and confidence in the health provider (Shaikh & Hatcher, 2004). In order to form a comprehensive understanding individual decision-making regarding health, health seeking cannot be conceptualized as a spontaneous event, but rather “the result of an evolving mix of social, personal, cultural and experiential factors” (MacKian et al., 2004, p. 144).