Community Mistrust and Measures of Institutional Trustworthiness (COMMIT)

In the United States underserved and socially vulnerable populations have endured higher rates and disparities of COVID-19 infection, morbidity, and mortality. This disproportionate burden has shown the light on the root causes of COVID-19 disparities such as longstanding systemic racial bias in health care delivery, discrimination, and poor social determinants of health that lead to health disparities for medical conditions such as asthma, diabetes, hypertension, and obesity, all of which increase risk and susceptibility to COVID-19 and its sequalae. To address these root causes, academic and other research institutions and health care systems must shift their lens from one that focuses solely on changing behaviors among underserved and vulnerable populations. Behaviors among health care and research institutions must change to breakdown the structural barriers to trust, testing, treatment, and prevention of COVID-19. Prior to asking patients and community members to trust in research and researchers, the focus should be on radical institutional transformation to advance trustworthiness.
Trying to address social, ethical, and behavioral issues (SEBI) influencing access acceptability and uptake of COVID-19 testing during a pandemic is extremely challenging, yet achievable when there are existing community-academic partnerships. The distinction between trust and trustworthiness suggests that trustworthiness is an antecedent to trust. Our proposed study will employ a continuous engagement approach to advance institutional trustworthiness and improve the strength of an existing community-engaged research (CEnR) partnership. In collaboration with community and community-based pharmacy partners, our purpose is to codesign a sustainable model for trustworthy CEnR partnerships to address SEBI of COVID-19 testing.