Unpacking Trust in Participatory Health Research Partnerships – A Qualitative Study in Ireland

Context: Advancements to evaluating the impact of participatory health research (PHR) have been made through comprehensive models like the community-based participatory research (CBPR) conceptual model, a useful framework for exploring how context and partnership processes can influence health research design and interventions. However, challenges in operationalizing aspects of the model limit our understanding and evaluation of the PHR process. Trust is often discussed as a vital component of the CBPR model, supporting the development of key partnership outcomes, such as partnership synergy. However, trust continues to be limited to a binary view (present/absent), which is problematic given its dynamic and temporal nature.

Objective: To understand the evolution of trust in an Irish PHR partnership –‘the public and patient involvement (PPI) research network.’

Study Design: A qualitative study design. 15 semi-structured interviews discussing the evolution of trust in the Network over one year; 2021(T1) and 2022(T2). We used reflexive thematic analysis to iteratively develop, analyze and interpret our mediated reflection of the data.

Setting: The PPI Ignite Network.

Population Studied: Individuals from academic, health services and community organizations, categorized as Local or National partners or Site Leads as per their roles and responsibilities in the Network.

Instrument: An interview guide developed around 4 social network maps from an earlier phase of the study, visually representing trust connections between Network members at T1 and T2.

Results: Participants described the evolution of trust as a function of 3 contextual factors: 1) the set-up and organization of the Network, 2) how people work together, and 3) reflection on the process and outcomes. Descriptions of these themes varied by partnership type, describing National Partners and Site Leads as having more opportunity to demonstrate trust (↑ resources), compared to Local Partners. Visibility and opportunity to be visible, seemed to play an important role in the evolution of trust over time, underscoring an equity issue. From these findings, we propose important questions for reflection be considered for future PHR partnerships.

Conclusions: As opportunity and visibility to build and maintain trust over time may not be equally available to all partners, it is important to find ways to invest in and commit to equitable relationships that are key to the success and longevity of PHR partnerships.