Grant: Project Grant

Trust is essential for safe, effective, and equitable healthcare. It shapes whether people seek care, follow advice, and stay engaged in their health. The pandemic showed how easily trust can be shaken: uncertainty and polarization reduced confidence in health services, especially among communities already facing systemic barriers. With alternate sources of health information-often not evidence-informed-gaining influence, rebuilding and sustaining trust in healthcare and public health is critical to support informed decision-making and achieve equitable health outcomes. Although trust is widely recognized as vital, there is little clarity on which strategies are best to build, rebuild, and maintain it, particularly in ways that reflect how historical injustices, structural inequities, and lived experiences shape mistrust. Lessons about trust exist across many fields-from community engagement to leadership and psychology-but have not been brought together to guide healthcare and public health. This project will combine knowledge from research, lived experience, and professional practice to create the first comprehensive, evidence-informed guide to building, rebuilding, and sustaining trust. Through focus groups, interviews, surveys, and consensus-building activities, we will identify strategies currently used, examine what shapes their success, and assess their acceptability. We will pay particular attention to the experiences and priorities of communities historically facing stigma or systemic barriers. All stages will use a trauma-informed approach, fostering safety, trustworthiness, choice, collaboration, and empowerment. The result will be a co-developed set of practical strategies that healthcare and public health organizations can use to strengthen trust. By improving trust, health services can better support all people in receiving high-quality, respectful care and making informed decisions about their health.