DigiTrust: Building trust for digital health policies in the WHO European region

Abstract Background Public trust is fundamental to the success of digital health initiatives, underpinning citizen participation and the legitimacy of health systems. A previous qualitative study involving 57 digital health policymakers across Europe revealed that trust is frequently perceived as vague and abstract, making it difficult to translate into concrete policy measures. Policymakers raised the need for structured guidance to support the integration of trust-building principles into digital health policy. Addressing this gap is the aim of the present study. Methods Building on established conceptual frameworks on trust in health systems and health data sharing, we co-developed via online stakeholder consultations a self-assessment tool for policymakers involved in formulating digital health policies across the WHO European Region. Results The tool was co-developed and iteratively refined with 18 policymakers from across the Region, all directly engaged in the formulation of digital health policies. Stakeholders consulted highlighted its clarity, ease of use, and relevance to their routine policy work. The final tool is a concise, user-friendly document featuring guiding questions to support policymakers in assessing how trust is considered and integrated into their policies. Conclusions The tool offers policymakers a structured guide to trust-building in digital health policymaking. Its adaptability across governance contexts enhances its international relevance. By translating trust into actionable measures, the tool supports the formulation of digital health policies that actively build and sustain public trust. Key messages • Public trust is seen as essential to digital health, yet policymakers view it as an abstract concept and lack clear guidance on how to actively foster it through policy. • DigiTrust provides practical guidance to health policymakers, translating trust into actionable measures for integration into digital health policies.