Engage for Equity: The Role of Trust and Synergy in Community-Based Participatory Research

Abstract

Community-based participatory research (CBPR) partnerships exist as complex, dynamic relationships that incorporate shared decision that supports trust development between communities and academics. Within CBPR, the interest in understanding the concept of trust has grown with the realization that, without trust, CBPR relationships fracture. A barrier to monitoring the trust health of a partnership is the lack of a shared operationalization of the concept, its antecedents, and measurement tools. To address these barriers, a six-category trust typology was created as a developmental theory of trust progress. To advance the theory, this article reports on the quantitative structural elements of the trust typology, identifies variability in trust correlates, and creates an empirical foundation for the trust types. Using Engage for Equity data, trust covariates included measures of synergy, CBPR principles, participation, and influence. Structural equation models were used to assess associations between trust types and the latent constructs measured by the items in each measure. The findings demonstrate that the six trust types generally operate on a continuum. Specifically, it does appear that trust deficit, role-based trust, functional trust, proxy trust, and reflective trust are on a single continuum from low to high. Scale scores for reflective trust and proxy trust were consistently and statistically significantly higher than those for functional trust, role-based, neutral, and trust deficit. These results support the construct validity of the trust typology as representing “higher levels” of trust phases. Due to the dynamic nature of partnerships, regular monitoring of partnership trust types can serve as a proxy for partnership functioning.

Engage for Equity: Development of Community-Based Participatory Research Tools

“…With each tool and relying on community knowledge systems as a basis for their work, teams were supported through successive rounds of reflection and action cycles, in line with the Freirian concept of “praxis.” The driver of disrupting power hierarchies is also central to empowerment, both in seeking shared power for community members within partnerships and in disrupting social and health inequities (Cook et al, 2019; Muhammad et al, 2015; Wallerstein, Muhammad, et al, 2019). The tools provided opportunities for praxis (i.e., ongoing reflection with eventual actions) on power and other issues which support sustained participation, commitment, and trust, necessary for partners as they move forward (see Lucero et al, 2020). The River of Life allowed teams to consider past efforts that influence their present work together.…”

Engage for Equity: A Long-Term Study of Community-Based Participatory Research and Community-Engaged Research Practices and Outcomes

“…To facilitate collective reflection/action processes, we adapted or developed four tools: two qualitative (River of Life (Belone et al, 2016), and developed through dynamic processes of respect and mutual participation (Lucero, 2013; see Lucero et al, 2020). These tools and collective reflection/ action processes were made available to all partnerships through the website, for both the non-workshop partnerships, as well as those that attended the workshop (see examples of tools in https://engageforequity.org and (Parker et al, 2020).…”

“…Analyses of team interviews are uncovering the importance of facilitation, the facilitation positionality in relation to the projects (i.e., shared race/ethnicity), and the value of the CBPR model as an overarching implementation framework for strengthening collective reflection (Sánchez et al, 2020;see Table 3 for exemplar quotes). During the workshops, facilitators held daily collective reflections on our own learnings, further identifying that we saw teams recommitting to power-sharing and trust development (Lucero et al, 2020) as a result of workshop participatory processes.…”

“…Externally, we have observed power dynamics in many spaces: in a multisite case study analysis (Wallerstein, Muhammad, et al, 2019); in survey analyses ; in workshops, even among committed CEnR partners; and among our think tank, such as recognizing academics benefit from NIH funding more than community partners. Our analysis of pathways identifies "collective empowerment" as a middle-range theory of change (comprising collective reflection, influence, shared values, and community fit), similar to theories of synergy and trust (Jagosh et al, 2015;Khodyakov et al, 2011;Lucero et al, 2020), yet we still need to better understand the journeys of disrupting power hierarchies and power-sharing through community members perceiving their influence and fit of work to community, as well as how to activate and sustain reflection/action cycles. We recommend continued work to help explain the theoretical mechanisms of CBPR and CEnR to achieve improved health and health equity.…”

Commentary on Community-Based Participatory Research and Community Engaged Research in Health for Journal of Participatory Research Methods

“…We have seen the use and adaptation of the CBPR conceptual model being disseminated internationally, with a recent chapter showing examples from Australia, Sweden, Nicaragua, and the United States (Wallerstein et al, 2021). Analyses are showing validation and extension of metrics and measures, as well as continuing identification of practices that contribute to outcomes (Lucero et al, 2020). Other studies by other research groups, nationally and internationally, are in process to add to our collective knowledge of participatory models, measures, metrics, and promising practices which contribute to impacts and outcomes.…”