Community Trust Must Be Earned: Building Authentic Relationships Is the Key

After Mercy Hospital closed, the Public Health Management Corporation Public Health Campus on Cedar (Cedar) opened on its site. According to our survey 3 years later, only 17.6% of households in the catchment area used Cedar's services. A history of hospital closures and the former hospital's reputation contributed to deep community mistrust in local health care institutions.

This study examined community awareness of Cedar, willingness to try its services, and trust as a predictive factor.

Using a community-based participatory research approach, the evaluation team, a community advisory board, and an evaluation committee developed a representative household survey. Chi-sqare & logistic regression were used to predict who was most likely to be aware of and most willing to use Cedar campus.

Almost 60% of respondents were unaware that Cedar is now operating on the former hospital site and 58.8% reported willingness to use its services. The outcome of a step wise regression model revealed that the strongest adjusted odds ratio (AOR) in predicting awareness of Cedar were living in the neighborhood more than 2 years (AOR = 2.89, P = .014), followed by African-American race, having 3+ daily servings of fruits and vegetables, and two factors relating to trust (experience with the campus and thinking provider skills were important for building trust; P ≤ .05 each). Significant predictors of willingness to try Cedar included having asthma, (AOR = 3.0, P = .001) and not having a heart condition (AOR = 4.27, P = .002), followed by 3+ daily servings of fruits and vegetables and perceiving transparency was important to building trust (P ≤ .05).

Community mistrust continues to limit Cedar's reach. Trust building efforts that center on transparency, provider quality, and awareness can increase utilization and a campaign targeting residents with specific chronic conditions can ensure health equity.