Trust includes “Both relational trust—earned through shared experiences and backgrounds—and transactional trust—earned through interactions and give-and-take—are necessary in collaborative efforts. Trust may need to be rebuilt or regularly renewed.”³⁷

“I think it goes back to trust. Sitting at the table knowing that we trust each other. We put a grant out. And all our grantees came in with their grants. And we sent them back and said, ‘No, you were told to collaborate.’ And I think it was very scary for them to share their information, knowing that they were all competing for the same money. But [we knew] that this was going to do better in our community if we could align and come together. It comes down to trusting somebody that you’re not going to just take my information and run with it and go get the grant on your own, that we are going to be working together, come the end of the day. And I think it only takes a couple times to see that it works. And then people just get in the mode of that’s how we need to work, but it comes down to trust. Do I trust you? Are you going to do what you said you’re going to do?”

– Social Services Representative, CA

Key Takeaways

Trust is a key building block in aligning.
The convening function of ACHs can help to build trust across diverse people, groups, and boundaries.
Trust is not an end result, but rather a process outcome that should be continually monitored, strengthened, and repaired when necessary.

Survey Findings

97% of respondents agreed that most ACH participants (staff, partners, etc.) are trustworthy (n=471).
96% of respondents agreed that most ACH participants (staff, partners, etc.) are reliable (n=467).
92% of respondents feel that what they, their tribe, or their organization brings to the ACH is appreciated and respected by other participants / their colleagues (n=437).

“There’s been a lot of conversation about: how do we have communication, and how do we disagree? And we have our national conflict resolution guidelines, and you know how to have difficult conversations. We have all of that in place because that goes back to the thoughtful desire to create something that feels very inclusive. That goes back to the power. That goes back to having everyone feel like they do have a role to play and can be a contributor in a process.”

– Health Care Representative, CA

Perceptions of Trust

As evidenced by survey results, MSC participants had generally high levels of trust overall. However, we found that people who had an annual household income of less than $24,999 had lower levels of trust.

The Influence of Trust

Trust influences much of what happens in an MSC. Our research showed that trust most strongly influenced perceptions of MSC effectiveness, data practices, and shared purpose.

“My perception is that [the ACH] was extremely transparent. A lot of information was on the website in advance. There’s always opportunities for input, community response, meetings. They are very much wanting to find out: what do people actually want, what do people need? And then making sure that the decisions that were made were available for review, that there was a clear explanation of things that were done now.”

– Health Care Representative, WA

From the Data

97% of respondents agreed that most MSC participants (staff, partners, etc.) are trustworthy (n=471).
96% of respondents agreed that most MSC participants (staff, partners, etc.) are reliable (n=467).
92% of respondents feel that what they, their tribe, or their organization brings to the MSC is appreciated and respected by other participants / their colleagues (n=437).
If you’re interested in learning more about how we measured trust, check out our Measurement Toolbox.

Related Resources

Powering Change Curriculum: Building Healthy, Equitable Communities Together, a Population Health Innovation Lab (PHIL) and California Accountable Community for Health Initiative (CACHI) curriculum for multisector collaboratives (2021)

View all references for the Data Walk.