Who is a credible source of preventive advice? An experimental questionnaire study of general public attitudes towards role expansion in health and social care

Objectives: To investigate comparative source credibility for three types of health and social care professionals when giving preventive health and safety advice relating to ‘traditional’ or ‘expanded’ prevention roles. Design: An experimental between subjects questionnaire study presenting nine combinations of professional (General Practitioner(GP); Health Visitor; Firefighter) and prevention topic (stopping smoking; preventing cot death or fire safety). Combinations were either congruent with a traditional role (e.g. Health Visitor and cot death), or an expanded role (e.g. Firefighter and stopping smoking). Methods: Adults were recruited from public locations in a large metropolitan region in Northern England. Participants were randomised to complete a validated 18-item source credibility questionnaire for one combination of professional and topic. Ratings overall and for the three dimension subscales were compared for traditional and expanded role combinations using Mann-Whitney tests. Results: 369 participants completed the questionnaire (49.3% women, 64% White British, age range 16-83). Ratings were generally high across professions and scenarios. Participants rated professionals as significantly more credible overall (U=12199, p=.002, d=0.32) and competent (U=8994, p<.001, d=0.70) where scenarios related to their traditional roles than expanded roles yet equally as caring (U=14905, p=.816, d=0.02) and trustworthy (U=14083, p=.277, d=0.11). Conclusions: This initial evidence may suggest that the competence dimension of source credibility is specific to professional identity; large effects on individual subscales may have a small effect on source credibility overall. Public sector professionals may be perceived as caring and trustworthy deliverers of advice on a wide range of topics not traditionally associated with their job role, but less competent. Public communications about the role expansion agenda may support policy implementation; further research on different combinations in a larger sample is needed