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

Authors: Isaiah J Sommers, Kathryn E Gunter, Kelly J McGrath, Cody M Wilkinson, Shari M Kuther, Monica E Peek, Marshall H Chin

The aim of this paper was to better understand strategies that CHWs use to build trust with participants of health screenings in frontier Idaho, USA. In-person, semi-structured interviews were conducted with CHWs and coordinators of food distribution sites (FDS) where CHWs hosted health screenings. The interview guides utilized were designed to assess facilitators and barriers to health screenings. Subsequent results identified trust and mistrust as dominant themes. Specifically, 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 also discussed their anticipation of confronting mistrust due to their association with the healthcare system and government, especially if CHWs were perceived as “outsiders”. These findings highlight why CHWs should be integral parts of trust building initiatives in rural areas. However, it is unclear whether trust in individual CHWs also extends to the broader healthcare system.