Perceptions and determinants of partnership trust in the context of Community-Based Participatory Research

Trust is difficult to conceptualize and define because of its diverse applications in different disciplines. Historic mistrust between vulnerable communities and researchers based on past adverse experiences can negatively affect the ability to collaborate and conduct effective research with such populations. Community Based-Participatory Research (CBPR) is a collaborative approach to research that can reduce historic mistrust and health disparities among minority populations. Although how trust development occurs in CBPR partnerships has been explored, there is a need to determine how to move from one stage to the next in fostering and maintaining that trust. The present study contributes to this discussion by addressing the lack of a shared operational definition of partnership trust and of how to measure it in the CBPR literature. We modified Dietz and Den Hartog’s (2006) Multi-dimensional Measure of Trust Model to investigate contextual factors that influence perceptions and development of trust in collaborative partnerships pursuing the reduction of health disparities. We conducted focus groups and key informant interviews with English and Spanish speaking stakeholders of a culturally relevant health promotion organization in the southeastern United States. Stakeholders reported experiencing different types of partnership trust depending on their role, and the length and nature of involvement with the organization. We identified determinants of partnership trust among stakeholders, including organizational, socio-economic, and cultural determinants. Most study participants agreed that trust with Hispanic communities is built slowly, with personal face-to-face contact and follow-up, and that engaging stakeholders throughout the process of working together in an intentional way is vital to building and maintaining trust. Findings of this study will inform the development of a culturally and linguistically relevant quantitative instrument to measure partnership trust in the context of CBPR

How Partnership Trust can Facilitate and Result from CBPR: An Assessment of Situational, Organizational, and Institutional Related Factors

This study used secondary qualitative data analysis to determine the extent to which selected constructs of Community-Based Participatory Research (CBPR) promoted and supported the development of partnership trust among organizational and community stakeholders of a community-based health organization (CBHO). The Centers for Disease Control (CDC) identifies partnership trust as an integral factor that contributes to the optimal performance of public health research networks in their attempts to develop relationships with the communities and partners with whom they work. The present study was preceded by two studies which were informed by a modified version of Dietz and Den Hartog’s Multidimensional Measure of Trust Model (MMTM). The first study explored perceptions of partnership trust among the organization’s stakeholders and informed the development of a bilingual survey instrument (English and Spanish) to measure partnership trust as an outcome of CBPR (CBPR-PTS). The second study evaluated meaning and translation factors and issues related to the CBPRPTS, using cross-cultural cognitive interviewing (CCCI). In the present study we used directed content analysis to evaluate the face validity of the constructs of the “situational, organizational, and institutional constraints” dimension of the MMTM, by analyzing the extent to which the CCCI qualitative data reflected the intended meaning and explanations related to partnership trust development. In addition, we analyzed the extent to which the identified CBPR-related constructs contributed to the development of a trustor-trustee relationship. Findings from this study show that stakeholders’ perception of the CBHO’s trustworthiness may have been influenced by selected CBPR processes and methods including, (a) facilitating the building of communities’ research capacities through collaborative research efforts; (b) sustainability efforts such as empowering community leaders; and (c) facilitating effective communication practices like listening to, learning from, and promoting the participation of the trustors. In addition, that the CBPR-related constructs integrated in the “situational, organizational, and institutional constraints” dimension hold acceptable levels of face validity and are appropriate for use in exploring the role of CBPR in promoting partnership trust. Knowledge gained from our CBPR-PTS development research process has the potential to advance the development of tools to evaluate relevant outcomes of CBPR among underrepresented populations

Reducing Maternal and Child Health Disparities among Latino Immigrants in South Carolina Through a Tailored, Culturally Appropriate and Participant-Driven Initiative

Newly arrived Latino immigrants in South Carolina (SC), especially Latina mothers, experience many health related barriers including a general lack of health services information. The PASOs program, which means “steps” in Spanish, uses education, outreach, partnerships and advocacy to empower Latino families to utilize available health care services throughout SC. PASOs is a community-based program conducted by college trained bilingual/bicultural facilitators with the support from community health care workers (promotores de salud). Participants (n=523) were expectant mothers with an average age of 27 (SD=6) years, mostly from Mexico (69%), with an average of 9 (SD=4) years of education and 7 (SD=5) years living in the US. Repeated measures analyses from pre-test to post-test indicated significant knowledge improvement (p<0.005) regarding the importance of prenatal care, signs of preterm delivery, benefits of breastfeeding, and the importance of folic acid intake during periconception. By the end of the course, the majority of the Latinas (93%; p<0.0001) were able to name a birth control method they planned to use following their current pregnancy. Results of this study emphasize the benefits associated with the implementation of a culturally-appropriate program with newly arrived Latino immigrants, including an increase on preconception, pregnancy, and post-pregnancy knowledge

A Contribution to Measure Partnership Trust in Community-Based Participatory Research and Interventions With Latinx Communities in the United States

Given the growing diversity in the United States, responsiveness to the needs of diverse communities is paramount. Latinx communities in the United States often state mistrust in outside institutions because of adverse experiences. Community-based participatory research (CBPR) is considered a trust-building process and is one approach to understand disparities. However, the conceptualization and evaluation of trust as a CBPR outcome are understudied. This article summarizes a community-engaged research process conducted for the cultural and linguistic refinement of a partnership trust survey tool to assess partnership trust as an outcome of CBPR (CBPR-PTS), by using Perinatal Awareness for Successful Outcomes (PASOs) as a case study and cross-cultural cognitive interviewing (CCCI) methodology. The participants were 21 diverse stakeholders of PASOs, a community-based health organization that serves the Latinx population in South Carolina. A modified version of the multidimensional measure of trust model informed instrument development. The team analyzed the CCCI data using compiling informal analysis to identify which survey items’ wordings must be changed or adapted based on the participants’ accounts. Sixteen of 28 questions subjected to CCCI required modifications due to translation errors, culturally specific errors, or general cognitive problems. The new survey instrument has 19 scales and 195 items categorized into nine dimensions of the modified multidimensional measure of trust model. CCCI was a useful tool to address the cross-cultural understanding issues of the CBPR-PTS. Measurement instruments should be able to capture the socioeconomic, cultural, and geographic/environmental variability of community stakeholders to help understand the diversity of the comprehension and views of the communities involved in disparities’ reduction efforts