We Need Them More Than They Need Us: Building Trust With Our Communities

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We aren’t rebuilding trust with communities; we’re building it. This shift in thinking requires a foundation that recognizes researchers' relationships with the communities around us.

Over the last couple of months, Academy Health has posted about the trust deficit between health services research and, by extension, health care and the public. The first post that caught my eye was titled, “What if there was never trust to rebuild? Rethinking health communication through a comparative lens.”

Obviously, the article’s title is meant to grab your attention, but context matters. As I read the article and understood the context of the working group this piece came from, the question, “What if there was never trust to rebuild?” hit differently. For communities that have experienced exclusion, discrimination, inaccessible care, dismissive encounters, and demands for trust with no accountability, there is no trust to “rebuild”. There’s just trust to build.

Furthermore, building trust requires a different set of thought processes than rebuilding. To build, we need to develop a solid foundation.

1. Trust requires a relationship

How do we build that foundation? I think the foundation starts with us researchers recognizing that we have relationships with our communities. Before you say, “but my work is on the bench and won’t matter to people for many years,” or “I do archival research that helps us better understand the past,” read the previous sentence again. We have relationships with our communities.

Universities were created to educate new generations and produce knowledge. Universities do not actually exist in bubbles disconnected from the rest of the world. We need our communities to send us their children to be educated, and we need those same communities to see value in the knowledge we create so they call on elected officials to allocate funds for our research. When we let those fundamentals slip because we forget those relationships, we lose. If our communities don’t buy into us, we can’t exist.

2. How to build trust in a relationship

Now that we have established that we in fact have relationships with our communities, we need to think about the components of trust. There are, of course, lots of resources and definitions available, but here are a few basic ideas and questions we can start asking ourselves:

1. Competence – Do you know what you claim to know?

2. Character – Will you do the right thing?

3. Consistency – Will you do what you said you would do?

4. Connection – Do you see and acknowledge the people impacted by your work?

Of course, some of these feel easier than others. For instance, we all have advanced degrees in our fields, which should mean we know what we need to know to make important contributions to knowledge. However, other questions are more complex.

Consider consistency. On the surface, I think we would all like to be the kind of people who follow through on the things we say we will do. But I can certainly think of times when I haven’t. Sometimes this only affects me (hello, not eating enough fruits and vegetables every day), but sometimes it affects my community partners (hello, not getting payments out in a timely fashion because of university bureaucracy). In the case of the payments, my character dictates that I do everything I can to make things right for my partners, ensure such delays don’t happen again, and be accountable to my connection with them as people impacted by those delays.

But when those kinds of things happen, trust with my partners gets damaged.

3. Earn Buy-In Before You Need It

Unfortunately, there is no easy solution for repairing damaged trust. And this is the hard part to hear. The only thing I know is to take the lumps, own up to your mistakes, be clear about what you can control, and keep investing in the relationships.

You can’t pick up and put down these relationships when it suits you. They require consistent attention and investment. You must earn the buy-in before you need it.

Your Turn: What Are You Doing to Earn Trust From Your Community Partners?

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