Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar;38(Suppl 1):18-24.
doi: 10.1007/s11606-022-07921-7. Epub 2023 Mar 2.

Trust Dynamics of Community Health Workers in Frontier Food Banks and Pantries: a Qualitative Study

Isaiah J Sommers  1 , Kathryn E Gunter  2 , Kelly J McGrath  3 , Cody M Wilkinson  3 , Shari M Kuther  3 , Monica E Peek  2 , Marshall H Chin  2
Affiliations

Trust Dynamics of Community Health Workers in Frontier Food Banks and Pantries: a Qualitative Study

Isaiah J Sommers et al. J Gen Intern Med. 2023 Mar.

Abstract

Background: Medical mistrust has had devastating consequences during the COVID-19 pandemic, particularly in rural communities. Community Health Workers (CHWs) have been shown to build trust, but there is little research on trust-building by CHWs in rural communities.

Objective: This study aims to understand the strategies that CHWs use to build trust with participants of health screenings in frontier Idaho.

Design: This is a qualitative study based on in-person, semi-structured interviews.

Participants: We interviewed CHWs (N=6) and coordinators of food distribution sites (FDSs; e.g., food banks and pantries) where CHWs hosted a health screening (N=15).

Approach: Interviews were conducted with CHWs and FDS coordinators during FDS-based health screenings. Interview guides were initially designed to assess facilitators and barriers to health screenings. Trust and mistrust emerged as dominant themes that determined nearly every aspect of the FDS-CHW collaboration, and thus became the focus of interviews.

Key results: CHWs encountered high levels of interpersonal trust, but low institutional and generalized trust, among the coordinators and clients of rural FDSs. When working to reach FDS clients, CHWs anticipated confronting mistrust due to their association with the healthcare system and government, especially if CHWs were perceived as "outsiders." Hosting health screenings at FDSs, which were trusted community organizations, was important for CHWs to begin building trust with FDS clients. CHWs also volunteered at FDS locations to build interpersonal trust before hosting health screenings. Interviewees agreed that trust building was a time- and resource-intensive process.

Conclusions: CHWs build interpersonal trust with high-risk rural residents, and should be integral parts of trust building initiatives in rural areas. FDSs are vital partners in reaching low-trust populations, and may provide an especially promising environment to reach some rural community members. It is unclear whether trust in individual CHWs also extends to the broader healthcare system.

Keywords: community health worker; food bank; food pantry; frontier; rural; trust.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they do not have a conflict of interest.

References

    1. Mueller JT, McConnell K, Burow PB, Pofahl K, Merdjanoff AA, Farrell J. Impacts of the COVID-19 pandemic on rural America. PNAS. 2021;118(1). 10.1073/pnas.2019378118. - PMC - PubMed
    1. Kim SH, Kim S. Particularized trust, institutional trust, and generalized trust: an examination of causal pathways. Int J Public Opin Res. 2021;33(4):840-855. 10.1093/ijpor/edab021.
    1. Jaiswal J. Whose responsibility is it to dismantle medical mistrust? Future directions for researchers and health care providers. Behav Med. 2019;45(2):188-196. 10.1080/08964289.2019.1630357. - PMC - PubMed
    1. Powell W, Richmond J, Mohottige D, Yen I, Joslyn A, Corbie-Smith G. Medical mistrust, racism, and delays in preventive health screening among African-American men. Behav Med. 2019;45(2):102-117. 10.1080/08964289.2019.1585327. - PMC - PubMed
    1. Hall MB, Vos P, Bess JJ, et al. Cervical cancer screening behaviors and perceptions of medical mistrust among Rural Black and White Women. J Health Care Poor Underserved. 2018;29(4):1368-1385. 10.1353/hpu.2018.0101. - PubMed

Publication types