Engagement + Expertise = Trust? Comparing Pathways to Credibility for Journalism and Healthcare

Abstract

Many journalists believe they must become more engaged with the public to improve trust in news. What remains unknown is how the public weighs the trustworthiness of engagement relative to the trustworthiness of a more traditional journalistic value: expertise. This study aims to address this gap by assessing public perceptions of engagement and expertise within journalism and comparing them with perceptions of expertise and engagement within another institution dealing with similarly high levels of distrust: healthcare. Professionals within both journalism and healthcare are attempting to mitigate their trust crises by increasing their engagement with the people they seek to serve, which means each profession is currently navigating an uncertain balancing act between engagement and people’s perceived expertise that this study seeks to explore. Using a US-based survey (N = 981) and employing structural equation modeling (SEM), we find that, when it comes to journalism, engagement does not significantly influence trust, while perceived expertise has a positive impact. In contrast, perceptions of healthcare specialists show both perceived expertise and engagement positively influencing trust, with engagement having a stronger effect. We conclude by exploring the implications of these findings for the relationship between journalists and the public.

1. Introduction

Journalists increasingly feel compelled to increase their engagement with the public as a means of improving the public’s trust in news. This industry-wide focus on engagement—loosely defined as demonstrable efforts by journalists to communicate with the public and develop improved relationships with them—has resulted in more newsroom roles dedicated to this area and a growing market for engagement-related tools and services (Nelson, 2021). A growing body of journalism studies research and industry-facing reports suggests that audience engagement and engaged journalism have become important aspects of news production within newsrooms across the globe (Green-Barber & McKinley, 2019; Lawrence et al., 2018). Consequently, innovative engagement strategies both online and off, including the use of platforms like Substack for newsletter subscriptions, the establishment of public newsrooms, and the hosting of real-time Q&A sessions or other live events, have transitioned from peripheral to mainstream modes of journalistic practice in a relatively short amount of time (for an overview, see Robinson, 2023).

However, engagement is just one of the factors that journalism practitioners, funders, and scholars typically focus on when exploring ways in which to increase trust in news. The other factor that is increasingly discussed—especially in the context of declining trust in institutions more broadly—is people’s perceptions of journalists’ expertise, or their specialized skills, professionalized knowledge, and/or authority that journalists and other professionals possess to aid their work (Carlson, 2017; Reich & Godler, 2016; Robinson, 2023). This emphasis on expertise is rooted in journalism’s historical reliance on a one-to-many broadcast model, where audience participation was minimal, confined to letters to the editor or mediated forms of interaction (Gans, 1979). This approach reinforced journalists’ professional authority by positioning them as the sole arbiters of newsworthiness and credibility, relying on detachment and objectivity to further entrench the authority of legacy institutions (Hallin, 1992; Carlson, 2017). In short, journalists have historically aspired to persuade the public that they are trustworthy by persuading the public that they are experts—or that they maintain what Carlson refers to “journalistic authority”—when it comes to news (2017).

Yet, in a digital media environment where the path to credibility appears to increasingly privilege a more relational approach to audiences, pursued through transparency and responsiveness rather than institutional affiliation (Carlson & Lewis, 2019; Vos & Craft, 2017; Waisbord, 2018), many within journalism are wondering if engagement should play a more central role when it comes to trust building. Engagement typically gets framed as an alternative to professional expertise (St. John, 2007), which traditionally advocates that journalists maintain a distance from the public in an effort to demonstrate their detached objectivity. However, others argue that journalists should more actively engage with the public to present themselves as peers who are worthy of their trust and support precisely because they understand the limits of their own knowledge and the public’s potential value when it comes to filling the gaps in the journalist’s knowledge (e.g., see discussion in Kligler-Vilenchik & Tenenboim, 2020; Lewis et al., 2014).

The tension between how journalists understand the value of their efforts to engage the public and their efforts to demonstrate their expertise to the public—as well as the extent to which the public actually perceives journalists as being engaged or an expert in the first place—raises questions with significant implications for how journalists approach news audiences and how those audiences ultimately respond. Are people more likely to trust journalists who present themselves as relative equals within the journalist–audience relationship? Or, alternatively, do people prefer that journalists present themselves as experts who should be trusted because their professional knowledge and norms have placed them above and outside the public sphere? Contrary to the prevailing view that expertise and engagement are distinct paths to trust-building, recent discussions have underscored the need for a fusion of both (Moon et al., 2023). As such, this paper seeks to understand the extent to which members of the public value engagement relative to expertise by comparing perceptions of journalism with another public-facing profession navigating a similar credibility crisis in a similar way: healthcare.

This study draws on survey data collected from 981 US adults in late 2022, representing a broad cross-section of attitudes toward journalism and healthcare—at least as manifested in the United States, though with applicability to similar developed Western countries. Employing structural equation modeling (SEM), we find that although a lack of trust exists in both healthcare and journalism, members of the public generally tend to feel that engagement with journalists does not significantly influence trust, even as the perceived expertise of journalists appears to have a positive impact. By contrast, public perceptions of healthcare specialists show that both expertise and engagement positively influence trust, with engagement having a stronger effect. We interpret these findings as underscoring the different types of engagement that people experience via healthcare as compared to the engagement people experience via journalism, namely, that people meet with doctors in a way they rarely, if ever, do with journalists, giving them a greater appreciation for engagement with healthcare professionals than whatever engagement they tend to encounter in journalism.

2. Literature Review

2.1. Journalism’s Credibility Crisis

Americans’ trust in journalism has reached an unprecedented low, with television news now ranking as the second-least trusted institution in the nation, surpassed only by Congress (Jones, 2022). According to Gallup and the Knight Foundation’s 2023 survey, half of the American public expressed skepticism about the intentions of national news organizations, with 50% of participants disagreeing with the statement that these organizations do not aim to mislead. Similarly, when asked about the concern for the well-being of their audience, 52% disagreed with the idea that national news media genuinely care about the best interests of their readers, viewers, and listeners. Only 23% of respondents believed journalists were acting in the public’s best interests (Knight Foundation, 2023).

This perhaps explains why an increasing number of people have started to advocate for a “do my own research” approach rather than relying solely on information provided by journalists, scientists, or other credentialed experts (Carrion, 2018; Ballantyne et al., 2022; Nelson & Lewis, 2023). For example, members of QAnon, a conspiracy group, label themselves as a “community of researchers uncovering hidden truths that journalists or other experts purportedly conceal from ordinary people” (Marwick & Partin, 2022). The digital era was accompanied by the promise of a more democratic media environment, which has resulted not only in people feeling empowered to uncover information for themselves but also in them becoming less trusting of those once regarded as experts who had skills and knowledge to obtain and provide information that the public depended upon, e.g., in the case of journalists, access to politicians and the ability to verify and report what they say (Reich & Godler, 2016). Moreover, unlike scientists—who have a specific area of expertise and produce scientific evidence perceived as corroborating accurate assessments and confirming expertise—the tools journalists rely on, such as audio and video content, are considered evidence that can easily be manipulated or taken out of context (Moon et al., 2023).

In light of these circumstances, it appears that journalism’s credibility crisis is not only the result of factors such as the spread of misinformation, the animosity with which politicians discuss the press, and the rise of anti-media populism across much of the globe, but is also the result of rising distrust in expertise more broadly. In the book The Crisis of Expertise, Eyal (2019) suggests that expertise is a performative discourse emerging from the negotiation of trust and risk, crucially shaping and being shaped by the socio-political mechanisms addressing techno-scientific controversies. Highlighting a significant mismatch between science and politics, where conflicts stem from differing assumptions about the status and legitimacy of expert knowledge, Eyal argues that expertise has become a contested concept, influencing social status and power dynamics. Within the spectrum of technocracy and participatory democracy and the choice between impersonal expert systems and individual professional judgment, he recommends shifting the focus from why people distrust experts to understanding why they might trust them, underscoring the importance of a supportive social and institutional context. Though the news industry considers itself the watchdog of government and institutions, and thus places itself at an objective distance, its reliance on those institutions—both as subject and source—may cast journalism in the same light. In a low-trust environment, this may adversely affect the perceived expertise and authority that journalists are seen to possess.

To address this issue, a growing number of journalism scholars, practitioners, and industry stakeholders are advocating for journalists to actively avoid a “a view from nowhere” approach (Schultz, 2021) toward their audience and instead foster more “authentic” and “engaged” conversations. The underlying logic of this argument is that, rather than attempting to persuade the public of what Carlson refers to as “journalistic authority” (2017) through one-sided lectures as the de facto reason why journalists should be trusted, journalists should instead earn public trust via engagement through a more explicitly reciprocal relationship with their audience (Lewis et al., 2014; Coddington et al., 2018). Indeed, Thomas (2019) notes that the term “paternalism” has become almost derogatory in discussions about how journalists approach their audiences, which seems rooted in this notion that journalists’ attempts to present themselves as experts risk alienating a public who increasingly associate the traditional means by which news professionals attempt journalistic authority with “elitism”. Instead, many now suggest that journalists should approach audience members as though they possess as much (if not more) knowledge as the journalists do, reversing the traditional dynamic. This shift underscores the importance of ordinary people’s perspectives, with journalists coming to understand that firsthand experiences of everyday events can bring forth insightful questions previously unconsidered by reporters (Schmidt et al., 2022).

2.2. The Rise of Engaged Journalism as an Alternative to Journalists as Experts

This dynamic has resulted in what has essentially become a tacit argument within journalism surrounding how journalists should approach the public, as well as what the public actually expects and wants from news. Those who advocate for journalists to maintain an objective, neutral, and detached approach to news reporting and interactions with news audiences have implicitly embraced the notion that expertise is still the most valuable trait when it comes to demonstrating credibility. Conversely, those who advocate for journalists to interact with the public as peers and to assume that knowledge has a significant, meaningful role to play in news production implicitly appear to believe that this more democratic, relational approach to the journalist–audience relationship is the best path forward to earning public trust. The idea is to involve the audience in various stages of news production, transforming journalists into community-builders for mutual benefit. Studies suggest that this approach fosters greater trust, connectedness, and community embeddedness. In essence, prioritizing engagement in news production aims to establish trust through the cultivation of community relationships, moving away from a solely expert-centric model. Embracing this collaborative and participatory shift reflects a broader movement towards rebuilding trust and laying a more robust foundation for progress (e.g., see Robinson, 2023).

Indeed, it seems that as the body of literature surrounding trust in news increases, the discourse centers on two broad, seemingly conflicting values: expertise and engagement (Moon et al., 2023). As journalistic professionalization has shifted, there has been a deliberate effort by some to maintain being neutral information providers over being active participants or advocates, embodying the watchdog role of holding those in power accountable (Bennett & Serrin, 2005; Hanitzsch & Vos, 2017). However, the public does not seem to believe that the press actually acts as a watchdog; rather, it is perceived as politically compromised (Flores et al., 2022). In addition, a notable vulnerability in news institutions as information intermediaries lies in their limited expertise concerning the subjects they cover, resulting in an ongoing challenge of how to organize and communicate reporters’ specialized knowledge (Reich & Godler, 2016). This challenge endures even if journalistic expertise remains consistent in a society marked by increasing complexity, thereby placing journalists in a state of relative knowledge inferiority. In contemplating the imperative to reconsider journalistic expertise, it is crucial to recognize that this proficiency has perpetually existed as a compromise (Reich & Godler, 2016), delicately balancing the knowledge constraints and ideals inherent in the practice of journalism.

This tension between how journalists weigh the value of expertise and engagement—as well as how the public responds—reflects a broader negotiation over journalistic authority, where expertise signifies a professional claim to knowledge and skills, while engagement challenges traditional notions of detachment by positioning journalists as collaborators rather than gatekeepers. Rather than being a static professional ideal, journalistic authority is continuously shaped by public discourse, which defines and redefines journalism’s role over time (Carlson, 2017; Zelizer, 1992). As Carlson (2017) explains, journalism “set[s] itself apart from other forms of information gathering and distribution while staking its normative claim as a central institution for the maintenance of democratic functioning” (p. 265). This authority is maintained and renegotiated through mechanisms such as boundary work (Gieryn, 1983; Schudson, 2001) and paradigm repair (Bennett et al., 1985), which allow journalism to delineate its professional jurisdiction and respond to challenges that threaten its legitimacy. As a result, journalistic authority remains fluid, shaped by public acceptance or rejection of specific narratives surrounding journalistic expertise and engagement (Vos & Craft, 2017).

This constructivist view of expertise aligns with the methodological approach of this study, which centers on public perceptions rather than an objective measurement of journalistic knowledge or skill. Since what constitutes journalistic authority is contingent on audience perceptions rather than fixed criteria, measuring how the public interprets expertise and engagement offers a valid means of assessing trust in news media (Hanitzsch et al., 2018; Newman, 2020). Expertise and engagement, in this sense, are not static qualities of journalists but social constructs negotiated through public discourse (Carlson & Lewis, 2019). The rise of participatory media has further destabilized traditional conceptions of journalistic expertise, challenging legacy institutions’ ability to claim authority based solely on professional training or institutional affiliation (Hermida, 2012). Instead, audiences increasingly evaluate journalistic credibility based on perceived responsiveness, transparency, and engagement—factors that blur distinctions between professional journalists and other information providers (Curry & Stroud, 2021; Waisbord, 2018).

Notably, unlike other professions with perceived expertise, such as scientists, journalists engage in a distinctive “bipolar interaction” between expert sources on one side and audiences on the other (Reich, 2012). While other professions also communicate with audiences, journalists are required to be constantly present in news consumers’ daily activities, which in turn shapes journalists’ professional inputs and outputs. Consequently, journalistic practices necessitate a significant mediation effort between the two poles of expert sources and audiences; this mediation process actively shapes the scope, limits, and language used in reporting. Thus, how journalists’ skill sets incorporate audience iteration in formats and contents has become more significant (and complicated) than ever before.

Given this context, as numerous news organizations grapple with the challenge of reclaiming relevance and reversing the trend of dwindling audiences (Carlson et al., 2021), fostering community connections emerges as a compelling strategy (Lawrence et al., 2018; Wenzel, 2020). Scholars increasingly advocate for journalists to rebuild trust by strengthening their bonds with communities (Knight Commission, 2019). Lewis et al. (2014) proposed that journalists online could develop a “reciprocal journalism” that “situates journalists as community-builders who, particularly in online spaces, might more readily catalyze patterns of reciprocal exchange … that, in turn, may contribute to the development of greater trust, connectedness, and social capital” (229). Such engagement aims to cultivate trust through the nurturing of community relationships. In fact, to reinvigorate trust that appears to be slipping away, news organizations are embracing various engaging approaches, including hosting conferences, reinventing their newsrooms, partnering with foundations, and leveraging social media, in addition to concerted approaches to holding listening sessions with disengaged community members (Robinson & Johnson, 2024). Journalists involved in these efforts are not only revitalizing their connection with audiences but also shaping a new professional discourse on the essence and impact of journalism (Robinson, 2023). This evolving landscape suggests that many in the field perceive “engagement” as a viable path forward for improving the current state of affairs.

In this discussion of perceived expertise and engagement, journalism is not alone in contemplating the balance between emphasizing engagement and expertise to enhance public trust. The authority of healthcare workers and journalists has faced challenges during the COVID-19 pandemic, notably evident in the rise of vaccine hesitancy and individuals opting to “do their own research” on news and health information (Meppelink et al., 2019; Nelson & Lewis, 2023).

2.3. Healthcare as a Parallel to Journalism

Like journalism, healthcare is grappling with a similarly significant crisis in trust, a challenge that has become more pronounced and intensified since the onset of the coronavirus pandemic. Approximately one-third of Americans adhere to conservative populist views that often reject expert advice (Kennedy et al., 2022), and a substantial contingent hesitates to heed guidance from medical professionals. Trust in the Centers for Disease Control and Prevention (CDC) fell significantly during the pandemic, leading people to be less accepting of its health-related information (Schnirring, 2020). Moreover, the initial rise in news consumption surrounding the coronavirus has been followed by a notable and statistically significant increase in individuals actively avoiding news related to the pandemic (Kalogeropoulos et al., 2021). With more than 800,000 lives lost to COVID-19, the gravity of the situation is great. Recent research accentuates the pivotal significance of vaccination, revealing that individuals who remain unvaccinated face an 11-fold higher risk of succumbing to COVID-19 compared to their fully vaccinated counterparts. This dire reality underscores the profound consequences of a lack of trust, whether it pertains to medicine, journalism, or both.

Challenges of trust in healthcare are not new. Over the past few decades, the concept of trust has garnered heightened attention within the medical field, with researchers delving into the consequences of the lack of trust in healthcare and exploring potential interventions to enhance healthcare providers’ relationships with those they serve, thereby influencing the overall success of a patient’s treatment journey (Street et al., 2009; Naidu, 2009). This recognition is closely tied to various factors, such as an increased willingness to adhere to prescribed treatment regimens, attendance at follow-up visits, and an overall reduction in recovery time (Safran et al., 1999; Trachtenberg et al., 2005). Patients with elevated levels of trust in their physicians are not only more likely to proactively seek treatment in case of illness or injury, but they also are more likely to express higher levels of satisfaction with their doctors (Hall et al., 2002; Dugan et al., 2005).

Similar to journalism, healthcare specialists also have a long history of establishing professional norms through their specialist knowledge; physicians have tended to define empathy as a form of “detached” cognition and objective relationship with the patients (Halpern, 2007; Mcguire, 2017). Others, however, believe trust will only improve with more frequent and personal engagement. For example, healthcare could use patient-centered engagement, deepening one-on-one relationships with customized communication (i.e., based on knowledge about the patient), and being more approachable in order to fortify public trust in the medical field (Ward, 2018; Qudah & Luetsch, 2019).

A patient-centered approach has consistently been linked to better perceived quality of healthcare services (e.g., Rathert et al., 2015; Sofaer & Firminger, 2005). Such an approach emphasizes increased patient engagement, spending more time with patients, utilizing a conversational approach, and employing open-ended questions during patient interactions (Oates et al., 2000), including ones that incorporate customized communication strategies based on a patient’s unique characteristics (Thom et al., 2011). These elements, such as patient-centeredness and personalized care, are recognized as key components for cultivating trust within healthcare. In pursuit of a heightened “engaged” approach, novel practices are now being attempted and implemented. For instance, co-generating medical records through collaborative contributions using new technology like SOAP notes (or OurNotes) (Frenzel, 2010) aims to make patients feel more at ease with doctors, fostering an approachable relationship rather than a perception of authoritative expertise.

This shift toward engagement over detached expertise in healthcare mirrors broader discussions about how professional authority is constructed and negotiated across institutions. The discursive construction of authority extends beyond journalism and finds a parallel in the field of healthcare. Scholarship in Science and Technology Studies (STS) has demonstrated that public trust in science, including medical sciences, is not solely rooted in practitioners’ technical expertise but is instead socially and culturally constructed (Irwin & Wynne, 1996). Just as journalism must negotiate its authority through public discourse, the medical field relies on societal acceptance of its expertise, which is continually reshaped by historical context, media representations, and political dynamics. This parallel underscores the importance of examining how institutions legitimize themselves not through objective measures of expertise but through public trust and negotiated legitimacy. In summary, there has been a parallel move among journalism and healthcare professionals toward a more “engaged turn” as each institution grapples with its own crisis of expertise.

Surprisingly little research—with the recent exception of Moon et al. (2023)—has sought to draw comparisons between the professions of journalism and healthcare in order to more fully investigate how expertise and engagement, either separately or in combination, may be associated with greater trust in these institutions on the part of consumers. This is especially important because, even as engagement has become a major focus of professional discourse in journalism in recent years (Nelson, 2021; Robinson, 2023), journalists do not have nearly as much face-to-face contact with members of the public, nor as obvious a personal relationship with “patients”, as doctors do in their day-to-day roles. And yet, both sets of professions are navigating relatively similar challenges to their expert judgment and authority, ones that gesture to larger challenges for public faith in institutions. Thus, examining the public’s perception of the values of engagement and expertise in these two professional contexts offers a crucial step toward understanding the public’s increasing wariness towards institutions, both broadly and specifically concerning the approaches used within each profession. Under the theoretical framework of competing notions of professional expertise vs. an engaging, audience-centered approach, the following research questions are proposed (see Figure 1 for the conceptual model):

RQ1: How does the public perceive the value of expertise when it comes to trust in journalism and healthcare?

RQ2: How does the public perceive the value of engagement when it comes to trust in journalism and healthcare?

RQ3: How does the interaction between expertise and engagement influence public trust in journalism and healthcare?

3. Data and Method

This study estimated all the models using fixed-effects regression methods under structural equation modeling (SEM), an advanced quantitative procedure adopted by an increasing number of social science researchers (Kline, 2023). Based on the variables devised (expertise, engagement, and trust), we categorized results and developed SEM (see Table 1 and Table 2) based on the survey design described below.

3.1. Research Object and Scale Design

A survey questionnaire on the public perception of journalists as professionals was developed based on the Pew Research Center’s questionnaire exploring Americans’ views of the news media (Pew Research Center, 2011). The survey included questions about subjects’ trust in media and news consumption habits, the press’s performance, and attitudes toward journalism organizations and individual journalists. In this study, following a constructionist perspective of journalistic authority (Carlson, 2017), we measured perceived expertise—the extent to which the public views journalists as competent professionals based on normative expectations and socially constructed understandings of journalistic authority. Rather than assessing journalists’ actual skills or specialized knowledge, we focused on how the public evaluates their role in providing accurate information, upholding ethical standards, and contributing to democratic society. A clustered sampling strategy was utilized.

For engagement variables, we added questions that described how close the public feels to journalism and expectations of the press as a good neighbor, as we assumed that the distance between the public and the press would be a key theme of the study. These variables, along with the characteristics of engagement and expertise qualities in both the journalism and healthcare professionals, are shown in Table 1 and Table 2. A 5-point Likert scale was used in the questionnaire, with response options of very much agree, agree, uncertain, disagree, and very much disagree, recorded as 5, 4, 3, 2, and 1, respectively. After the questionnaire was completed, two experts were invited to provide suggestions for modification. After the pretest, the questionnaire items were further improved.

3.2. Data Collection and Sample Characteristics

Data were collected through an online survey conducted between November 2022 and February 2023. Subjects were randomly selected from Cloud Research, a US-based web-based platform for surveys. From the original sample size (N = 981), after excluding the samples that did not pass the attention check, the final sample size was N = 955. The participants were all 18 and older and represented a cross-section of age (aged 40 and under: 32.3%, 41–60: 35.5%, older than 60: 32.3%) and political leaning (very conservative: 12.9%, conservative: 12.9%, somewhat conservative: 16.1%, neither conservative nor liberal: 16.1%, somewhat liberal: 12.9%, liberal: 16.1%, very liberal: 12.9%), which approximates standardized quotas used by survey research firms to match U.S. demographics (Nelson & Lewis, 2022).

Table 1. Measurement indicators of variables: journalism.

Variable Name	Items
Expertise	News organizations/journalists provide the best information I need
	News organizations protect democracy
	News organizations are highly professional
	News organizations stand up for society
Engagement	Journalists look or sound like me
	Journalists seem friendly and warm
	I can easily contact journalists/news organizations
	I like or feel close to journalists/news organizations
	News organizations care about the people they report on
Trust	The information given by the journalists is credible
	I trust the news content I am reading
	I have confidence in news media

Table 1. Measurement indicators of variables: journalism.

Variable Name	Items
Expertise	News organizations/journalists provide the best information I need
	News organizations protect democracy
	News organizations are highly professional
	News organizations stand up for society
Engagement	Journalists look or sound like me
	Journalists seem friendly and warm
	I can easily contact journalists/news organizations
	I like or feel close to journalists/news organizations
	News organizations care about the people they report on
Trust	The information given by the journalists is credible
	I trust the news content I am reading
	I have confidence in news media

Table 2. Measurement indicators of variables: healthcare.

Variable Name	Items
Expertise	S/he gave me more information than I can find on Google (or another online information source)
	I will visit healthcare services to obtain an accurate diagnosis by healthcare specialists, even when I know what medication I need (or when I am able to care for my condition myself)
	The healthcare specialists provide more accurate information than I can obtain online
Engagement	The healthcare specialists seem friendly and warm
	I could easily contact a healthcare specialist (accessibility)
	I like or feel close to the healthcare specialists
	The healthcare specialist (nurse/doctor) paid attention to what I wanted
Trust	The information given by the nurse/doctor was credible
	I could trust the healthcare specialist I met
	The health service I received was worth the time I spent/price I paid

Table 2. Measurement indicators of variables: healthcare.

Variable Name	Items
Expertise	S/he gave me more information than I can find on Google (or another online information source)
	I will visit healthcare services to obtain an accurate diagnosis by healthcare specialists, even when I know what medication I need (or when I am able to care for my condition myself)
	The healthcare specialists provide more accurate information than I can obtain online
Engagement	The healthcare specialists seem friendly and warm
	I could easily contact a healthcare specialist (accessibility)
	I like or feel close to the healthcare specialists
	The healthcare specialist (nurse/doctor) paid attention to what I wanted
Trust	The information given by the nurse/doctor was credible
	I could trust the healthcare specialist I met
	The health service I received was worth the time I spent/price I paid

4. Reliability and Validity Analysis

4.1. Journalism

To test reliability, Cronbach’s alpha coefficients were calculated for the scales used in the model. The Cronbach’s alpha coefficients for expertise, engagement, and trust were 0.897, 0.825, and 0.896, respectively, showing high reliability. Furthermore, the Average Variance Extracted (AVE) showed values above 0.5, except for engagement. However, the values of standardized regression weights were above 0.5, supporting convergent validity (Anderson & Gerbing, 1988). Furthermore, the values of construct reliability (CR) were higher than 0.6, indicating convergent validity.

Table 3. Reliability and validity: journalism.

Variable	Cronbach’s Alpha	CR	AVE
Expertise	0.897	0.850	0.586
Engagement	0.825	0.744	0.430
Trust	0.896	0.855	0.663

presents a summary of the reliability and validity measures.

A bivariate correlation analysis of each measurement item tested the discriminant validity. The results showed that there was no correlation above 0.8. To test the possibility of multicollinearity, a multiple regression analysis was conducted. The Variation Inflation Factor (VIF) showed that the VIF was 2.47 for both expertise and engagement, which did not exceed 10. As the VIF above 10 generally indicates multicollinearity, no signs of multicollinearity were detected.

Table 4. Correlation between constructs: journalism.

Indicators	Expertise	Engagement	Trust
Expertise	1
Engagement	0.772 ***	1
Trust	0.863 ***	0.748 ***	1

*** p < 0.001.

outlines the correlation between constructs.

4.2. Healthcare

For the healthcare sector, Cronbach’s alpha coefficients for engagement and trust were above 0.6, indicating acceptable reliability (Nunnally & Bernstein, 1994). The Average Variance Extracted (AVE) also showed values above 0.5, indicating convergent validity, except for expertise. However, for all three constructs, construct reliability (CR) showed values higher than 0.6, indicating convergent validity (Lam, 2012).

Table 5. Reliability and validity: healthcare.

Construct	Cronbach’s Alpha	CR	AVE
Expertise	0.601	0.645	0.390
Engagement	0.712	0.816	0.530
Trust	0.813	0.875	0.700

provides an overview of the reliability and validity measures.

A bivariate correlation analysis of each measurement item showed that there is no correlation above 0.8. Further multiple regression analysis to test the Variation Inflation Factor (VIF) showed that the VIF is 1.57 for both expertise and engagement and does not exceed 10 (the threshold for multicollinearity). Thus, there were no issues related to multicollinearity. Interconstruct correlations are presented in

Table 6. Correlation between constructs: healthcare.

Indicators	Expertise	Engagement	Trust
Expertise	1
Engagement	0.602 ***	1
Trust	0.623 ***	0.761 ***	1

*** p < 0.001.

.

5. Findings

Having encountered no issues pertaining to multicollinearity and having successfully undergone validity and reliability evaluations via a multi-regression analysis of the measurement model, we proceeded to assess the research questions using the proposed structural equation model.

5.1. Journalism

To test relationships among the variables, we conducted structural equation modeling (SEM) using AMOS version 28. As SEM measures constructs with observable variables allowing measurement errors, the current study adopted SEM to test the research questions. First, RQ1 was tested through the proposed model. The model showed adequate fit: RMR = 0.042, GFI = 0.961, AGFI = 0.937, CFI = 0.980, NFI = 0.975, IFI = 0.980, and RMSEA = 0.064. The results (see

Table 7. Results: journalism.

Path	Estimate		S.E.	C.R.
	B	β
Expertise → Trust	0.888	0.936	0.078	11.446 ***
Engagement → Trust	0.046	0.032	0.114	0.405 (n.s.)

*** p < 0.001, n.s. = Not Significant.

) suggested that while expertise has significant and positive influence on trust (β = 0.936, p < 0.001), engagement does not affect trust (β = 0.032, p = 0.686).

5.2. Healthcare

Likewise, the proposed model for healthcare was tested through structural equation modeling using AMOS version 28. As expected, the proposed model showed acceptable fit: RMR = 0.031, GFI = 0.969, AGFI = 0.947, CFI = 0.972, NFI = 0.965, IFI = 0.972, and RMSEA = 0.061. All standardized regression coefficients were statistically significant (see

Table 8. Results: healthcare.

Path	Estimate		S.E.	C.R.
	B	β
Expertise → Trust	0.105	0.134	0.047	2.251 *
Engagement → Trust	0.692	0.876	0.052	13.350 ***

* p < 0.05, *** p < 0.001.

). Specifically, the results showed that both expertise (β = 0.134, p < 0.05) and engagement (β = 0.876, p < 0.001) have a positive impact on trust and that the influence of engagement is bigger than expertise.

6. Moderation Analysis

6.1. Journalism

To investigate the interplay of expertise and engagement in shaping trust within the journalism sector, we conducted a moderation analysis (Hayes, 2017; Model 1; bootstrapped with 5000 draws). The outcomes showed a significant and negative moderating influence of engagement on the relationship between expertise and trust (b = −0.041, t = −2.64, p = 0.008). To illuminate the nuances of this moderating effect, we conducted a simple slope analysis. As depicted in Figure 2, the slope showed a pronounced steepness at lower levels of engagement, indicating that the influence of expertise on trust is stronger when engagement is low, as opposed to situations where engagement is high. In other words, as engagement levels rise, the impact of expertise on trust experiences a diminishing effect.

6.2. Healthcare

Similarly, we extended our moderation analysis to the healthcare sector. The findings were replicated, indicating a significant and negative moderating impact of engagement on the influence of expertise on trust (b = −0.188, t = −9.31, p < 0.0001). A simple slope analysis (see Figure 3) illustrated that at lower levels of engagement, the influence of expertise on trust is more pronounced compared to high levels of engagement. Stated differently, as levels of engagement increase, the impact of expertise on trust decreases.

7. Discussion

The proposed SEM offers insights into the relative impact of perceived expertise and engagement within two professions, modeling the connections between public trust and public perceptions of professional quality. The findings highlight that while both engagement and perceived expertise are valued in healthcare, the positive relationship between engagement and trust may be influenced by individuals’ frequent in-person interactions with healthcare providers. In contrast, in journalism, only perceived expertise has a significant and positive influence on trust, while perceived engagement does not exhibit the same effect.

These findings complicate ongoing discussions of the role that perceived expertise and engagement play when it comes to people’s trust in healthcare and journalism— professions that face an increasingly severe credibility crisis. Although the discourse surrounding engagement within journalism emphasizes the notion that a relational approach to the public will increase public trust in journalism, our findings suggest that feeling a sense of closeness or relatability to journalists does not necessarily translate into higher trust in news. Unlike in healthcare, where interpersonal engagement is inherently part of professional interactions, journalism’s role as an information provider may position engagement differently in the trust equation. While calls for journalists to emulate certain aspects of healthcare professionals—such as fostering more direct interactions with the public—may enhance perceptions of engagement, the findings indicate that increasing perceived engagement alone may not be sufficient to rebuild trust in news. Instead, the relationship between engagement, expertise, and trust in journalism requires further exploration, particularly in terms of how public perceptions of journalistic authority are constructed and negotiated, particularly when it comes to public perceptions of expertise.

Despite news organizations actively trying to engage with their audiences, as part of the broad “audience turn” in journalism (Costera Meijer, 2020), there remains a hesitance in personal engagement as a sign of trust. It may stem from the historically limited interaction between people and news professionals, as the journalism industry has traditionally relied on creating imagined, parasocial relationships with its audience rather than meaningful personal engagement. The lack of interactions between most individuals and journalists could lead to unfamiliarity, thereby impeding the development of trust-based relationships between the public and journalists. In contrast, as people have had more chances to feel a personal connection and experience to build rapport with their own healthcare providers, it is not surprising that people’s perception of meaningful engagement strongly affects their sense of trust in that relationship. As such, this emphasis on engagement highlights a “labor of trust” that appears more like community organizing or in-person contact for journalists (Zahay et al., 2021).

Unlike healthcare professionals, whose interactions with the public are often deeply personal and recurring, journalists in large-scale news organizations operate in an environment that prioritizes efficiency, branding, and audience reach over direct engagement (Belair-Gagnon, 2015; Robinson, 2023). This structural constraint means that trust-building strategies cannot rely on the same interpersonal relationship-building seen in healthcare. Instead, digital newsrooms must find alternative ways to cultivate perceived expertise and credibility. Research suggests that transparency initiatives, such as open-source journalism, behind-the-scenes reporting, and interactive fact-checking, can help bridge this gap by offering audiences greater insight into the journalistic process (Graves & Konieczna, 2015; Karlsson, 2011). These efforts make journalistic expertise more visible, even in environments where direct engagement is impractical.

Comparing two different professions not only underscores the significance of nuanced exploration in comprehending trust dynamics but also provides a glimpse into the constructed nature of two distinct expertise fields—journalists and doctors. People genuinely value both engagement and expertise, indicating that journalists are right to believe that increased engagement will lead to more trust. Journalists being present in the community they cover and talking to their sources may sound like common-sense strategies. However, considering that the journalism industry has been built on creating unidirectional relationships with the audience—particularly on the national level, where large news organizations think of audience relationships in terms of ratings or readership numbers rather than personal connections with their viewers—such gestures can have a significant impact on the level of public trust in these organizations (Napoli, 2011); as such, news organizations tend to focus more on building their brand rather than increasing the visibility of their reporters.

This suggests that while journalists are correct in believing that increased engagement can build trust, this alone is not enough. If journalists seek to engage the public in a manner akin to how doctors interact with patients, they must also demonstrate expertise comparable to that of doctors. This means reporting news that is unbiased and accurate, and highlighting their training—whether from journalism school or on-the-job experience—as the foundation for effective reporting. However, just as the public’s engagement does not extend to aiding in the actual practice of medicine, a similar boundary should exist in journalism. The public’s role in engaging with journalists should inform but not directly contribute to the practice of journalism itself.

This phenomenon is further compounded by the fact that news consumers often develop generalized perceptions of journalists based on national coverage, which may not accurately reflect the work of local reporters (Belair-Gagnon et al., 2019). As a result, efforts to build trust should account for these structural challenges by incorporating targeted interventions, such as partnerships between national and local newsrooms, increased coverage of local communities by national outlets, and efforts to decentralize newsroom operations (Lewis et al., 2014; Wenzel, 2020). Scholars who study engaged journalism have long observed that engagement often appears more gratifying to both members of the public and the press when these interactions unfold within small communities, ideally during in-person gatherings (Robinson, 2023; Wenzel, 2020). However, this sort of engagement tends to be the most challenging for journalists to pursue and maintain, which means it is possible that the lack of a connection between engagement and trust when it comes to journalism might reflect a lack of imagination surrounding what this sort of engagement can and should entail as opposed to a lack of perceived value in engagement in the first place. We encourage journalism scholars to (1) pursue more research examining the efficacy of these sorts of localized, in-person engagement efforts, (2) to consider incorporating training in public engagement into their journalism courses, and (3) to pursue partnerships with news organizations that might help them train their journalists to better foster conditions for these sorts of meaningful interactions without compromising the reporting process.

It is also noteworthy that moderation analysis reveals a significant finding: when engagement is low, expertise has a more substantial impact on trust compared to situations where engagement is high. In simpler terms, when people feel less engaged, the expertise of a source becomes more critical in earning their trust. Conversely, in situations where people are highly engaged, factors such as expertise, accuracy, and watchdog responsibilities may not be as influential. In such cases, individuals might trust a source simply because it feels familiar, similar to trusting a neighbor or someone they know well. More specifically, within the spectrum of engagement and expertise, it is suggested that the nature of engagement and expertise is as important as the balance between the two. People require criteria to evaluate institutional actors; in the absence of such criteria, they will turn to alternative measures. Importantly, this does not necessarily mean that engagement can replace expertise, or vice versa, but rather that the significance of one increases as the presence of the other decreases.

7.1. Limitations

In light of these findings, several limitations should be considered. First is the relatively low Average Variance Extracted (AVE) for the expertise construct within the healthcare sector, and the engagement construct within journalism prompts consideration. While the AVE serves as a metric for construct reliability and convergent validity, the lower values in these instances might reflect the nuanced nature of these domains or the intricacies involved in capturing these constructs through the selected indicators. Additionally, the pronounced correlation identified between expertise and trust within journalism introduces concerns regarding discriminant validity, which can affect the stability and interpretability of regression results. Our research design employed a cross-sectional approach, thereby constraining our ability to establish causal relationships or capture dynamic changes over time within each industry. Considering that our data are from a survey collected after the year of the end of COVID-19 pandemic, this particular time may have altered the answers the public provided.

7.2. Conclusions

This article is inspired by and builds upon previous studies critically examining public skepticism toward journalism and healthcare (Moon et al., 2023). While prior research on audience engagement in journalism often views such engagement uncritically or as inherently beneficial for rebuilding trust in the news industry, the actual impact of these efforts on trust and the extent to which they are perceived as trustworthy remains unexplored. By comparing public perceptions of expertise and engagement’s influence on trust in journalism with their dynamics in other institutions, we identify underlying assumptions in each profession, leading to theoretical and practical implications. Journalism scholars and practitioners increasingly consider audience engagement as a potential trust-building strategy (Robinson, 2023; Kalsnes & Krumsvik, 2019; Belair-Gagnon et al., 2019).

Yet, it appears people are limited when it comes to their “imagined engagement” with journalism, simply because people by and large do not engage with journalists in a way that is as deep, personal, and meaningful as with other kinds of knowledge professionals, such as doctors. Consequently, if journalists truly want to practice engagement in a way that builds trust with the public, they may need to find ways to emulate healthcare professionals who appear to have better luck building trust with the public via this sort of one-on-one engagement. To be sure, this is no easy task, especially at a moment when so many news organizations are seeing shrinking staff and diminishing revenue. But considering how low trust in news continues to be and how important trust in news is as a prerequisite for support for news, this sort of investment in meaningful, one-on-on engagement is perhaps worth the investment of scant resources.