Trust, Reciprocity, and the Role of Timebanks as Intermediaries: Design Implications for Addressing Healthcare Transportation Barriers

Millions of Americans forego medical care due to a lack of non-emergency transportation, particularly minorities, older adults, and those who have disabilities or chronic conditions. Our study investigates the potential for using timebanks—community-based voluntary services that encourage exchanges of services for “time dollars” rather than money—in interventions to address healthcare transportation barriers to seed design implications for a future affordable ridesharing platform. In partnership with a timebank and a federally qualified healthcare center (FQHC), 30 participants completed activity packets and 29 of them attended online workshop sessions. Our findings suggest that promoting trust between drivers and riders requires systems that prioritize safety and reliability; yet, there were discrepancies in the ability of the timebank and FQHC to moderate trust. We also found that timebank supports reciprocity, but healthcare transportation requires additional support to ensure balanced reciprocity. We explain these findings drawing from network closure and trust literature. Finally, we contribute design implications for systems that promote trust and facilitate relational over transactional interactions, which help to promote reciprocity and reflect participants’ values.