Trust: The currency of community development work in public health

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The value of community-centred approaches has become increasingly well recognised within public health. As a provider of award-winning weight management programmes, we’ve been working in communities across the UK for more than 15 years, and understand the importance and impact of these approaches for the country’s public health. 

A core component of a community-centred approach that designs and delivers effective and engaging health interventions is trust. However, whilst essential to the long-term success of health interventions in the real world, building trust in the community is not a quick or simple process.  

We start by trying to understand community life and habits, building trust, and working collaboratively to create meaningful, culturally relevant ways to support people in their day-to-day lives and in how they achieve better health. 

Demonstrating the importance of community trust, we recently partnered with Bristol City Council to deliver an insight project, with the aim of connecting with local communities and understanding the wider factors that impact health for the people in Bristol.  

Established in January 2022, the project team developed a number of approaches to build trust in the community: 

1. Employing local people – Our approach started with ensuring that we employed local trusted people from within the community, and upskilled them in areas like data collection, analysis and asset-based community development (ABCD). These people were knowledgeable and representative of the communities we were engaging with; their intent was clear, and their integrity was already well known. This allowed trust to be built more readily during the insight gathering process.

2. Being seen in the community – As well as making use of local connections to broaden our reach, we also attended many community events and meetings to connect with members of local communities. These regular appearances gave people plenty of opportunities to validate our intent, integrity and competence, thus developing trust.

3. Community-Led Asset Mapping As well as traditional desk-based asset mapping, we got out to talk to people about what they consider to be strengths in their communities, using ABCD informed questions. Building relationships with “assets” in the community, whose integrity is already well-established, helped foster trust.  

4. Gathering insight in community spaces We conducted interviews with people in places they already go. This demonstrated our intent to truly hear what they had to say, and ensured participating felt familiar, comfortable and easy to do. This, alongside a robust data collection strategy, was key for generating depth of insights.  

5. Flexibility around time and language We provided flexibility in terms of time of day, location and whether interviews were conducted online or face to face. We drew upon the interpretation skills we had in the team from those who were able to speak different languages, Arabic for example. We often met at cafés and restaurants, providing food and drinks if it aligned with the normal social etiquette for the meeting place and behaviours within different groups. For example, local taxi drivers often met in the mid-afternoon when work was quiet in a cafe outside the taxi rank.  

The sweet spot: people-centred actionable insights 

Alongside building trust and generating insight, the project was founded on robust and systematic approaches to generate in-depth, reliable, nuanced data.  

The evidence-based approach was designed to connect with people on a human level and find the sweet spot between what people say they do (and what motivates them) and what they do (what underpins their actions and motivations to behave in a certain way).  

Here, elements of psychology, sociology, marketing and wider behavioural science are crucial. Through triangulation of methods and approaches, we were able to generate evidence-based, people-centred actionable insights. 

The future of public health is community led… 

The evolution of the Bristol City Council project provided a great opportunity to combine strategic whole systems thinking with community insights. Only by taking a holistic approach and being alongside communities can we begin to develop real understanding of local people’s contexts, circumstances and experiences in order to co-produce effective strategies, policies and approaches towards a better system.  

The present and future of public health lies within local communities. There is talent, skill and contagious enthusiasm in lived experience; local communities are the experts in community life. They are teeming with insights, ideas and assets to move public health forward and create environments where healthy living and healthy weight are the default.  

It is our joint role and responsibility to give a voice to local people, and work alongside them to uncover and amplify these assets and include them in how we see, think about and work in public health.  

02 August, 2023