Trust in biomedical research is essential, multidimensional, and shaped by individual experiences, culture, and communication. Participants’ trust relies on researchers’ commitment to ethical practices. As public trust in science declines due to misinformation and disinformation campaigns, biomedical researchers (BmRs) must ensure trust and cultivate trustworthiness. This study explores BmR’s perspectives on trust and trustworthiness.

We employed a qualitative, phenomenological approach to explore the experiences of BmRs. Through purposive sampling via the Indiana Clinical and Translational Sciences Institute, we invited BmRs to participate in semi-structured interviews. We employed rapid qualitative analysis (RQA) to identify key themes from interviews with BmRs. This action-oriented approach enables a research team to efficiently summarize experiences and perspectives, using structured templates and matrixes for systematic analysis and interpretation.

Fourteen BmRs were interviewed. Volunteer demographics were collected for race/ethnicity, gender, faculty rank, and investigator experience level. The following domains were identified: individual trust and trustworthiness, institutional trustworthiness, and trust and equity as a crucial part of structural and social drivers of health.

We recognize that BmRs are dedicated to health equity and addressing disparities. However, in addition to committing to “best practices,” BmRs should prioritize actions that foster genuine trust from the communities they serve. More development opportunities are needed for reflection of what it means to be trusted by research volunteers and communities. Furthermore, intentions alone aren’t sufficient; earned trust and trustworthiness are vital.

Continued global environmental degradation generates risks to human health, for example, through air pollution, disease, and food insecurity. This study focuses on these three types of health impact and explores what drives these risks. The risks can arise from diverse causes including political, economic, social, technological, legal/regulatory, and environmental factors. We assembled diverse experts to work together to produce ‘system maps’ for how risks arise, identifying monitoring ‘watchpoints’ to help track risks and interventions that can help prevent them materialising. We critically appraise this pilot methodology, in order to improve our capacity to understand and act to protect human health.

Systemic risks arise through a process of contagion across political, economic, social, technological, legal/regulatory, and environmental systems. The highly complex nature of these risks prevents probabilistic assessment as is carried out for more conventional risks. This study critically explores a new approach based on participatory systems mapping with experts from diverse backgrounds helping to appraise these risks and identify data and monitoring ‘watchpoints’ to track their progress. We focus on three case studies: air quality, biosecurity, and food security. We assembled 36 experts selected in a stratified way to maximise cognitive diversity, plus 14 members of the interdisciplinary project team. Across 7 workshops, we identified 39 ‘risk cascades’, defined as pathways by which systemic risk can have negative impacts on human health, and we identified 681 watchpoints and interventions. We identify a broad range of interventions to reduce risk, exploring systems approaches to help prioritise these interventions; for example, understanding co-benefits in terms of reducing multiple different types of risk, as well as trade-offs. In this paper, we take a reflective approach, critically discussing constraints and refinements to our pilot methodology, in order to enhance capacity to appraise and act on systemic risks.

How can we act on the risks from air pollution, disease, and food insecurity? Insights from a new systemic risk assessment methodology.