Defining, measuring and influencing trust in participatory health research partnerships

Introduction: Trust has been identified as integral to the participatory health research (PHR) process and its outcomes. However, trust is complex in that it is both dynamic and contextual, creating conceptual and operational gaps in knowledge about trust in PHR. This dissertation investigates the use of a novel approach sensitive to these complexities, called social network analysis (SNA). This dissertation answers the following overarching research questions: 1) How is trust identified and explored in the SNA and PHR literature? and 2) Can social network techniques be used to understand and support trust dynamics in PHR partnerships? If so, how?

Methods: This dissertation addresses the research questions across two sequential parts. Part 1 is a scoping review (Chapters 5 and 6) to address RQ#1 and Part 2 is a case study employing mixed methods using a sequential explanatory design (Chapters 7, 8 and 9) to address RQ#2.

Results: RQ#1: Strong alignment exists between SNA and PHR literature, conceptualising and operationalising trust across four overarching themes: 1) context specific, 2) relational, 3) complex and 4) incorporates features of social network analysis. RQ#2: SNA techniques can be used to understand and support trust dynamics in partnerships because they are: 1) context specific, aligning well with PHR, which allowed us to detect a subtle decrease in trust connections over time; 2) relational, revealing important relational and structural features of trust in the PPI Ignite Network; and 3) complex: trust needs to be explored multidimensionally, as distinct networks, over time.

Conclusion: This work offers novel insight for advancing our understanding and application of trust in PHR partnerships. It offers empirical support for using SNA to operationalise and measure the multiple dimensions of trust in a PHR partnership over time, but also as a tool to prompt critical and reflexive dialogue that is contextually situated.