Written by John McGinley, undergraduate student at Elon University; SPRIGHT Scholar in the 2020 Institute for Public Health Summer Research Program – Public and Global Health Abbreviated Track
One idea that has come up over and over during the Institute for Public Health Summer Research Program seminars is the idea of developing trust with communities and listening to communities in order to conduct effective research. Krista Milich, PhD, Assistant Professor in the Department of Anthropology, described how past researchers had come into a community in Uganda for short periods of time and implemented projects without the input of the people who lived there. Many of these projects were ultimately not successful, and she spoke about how this happening repeatedly had continuously eroded the trust that community members had in outside researchers, making future work all the more difficult. Kurt Dirks, PhD, Vice Chancellor for International Affairs, talked to students about how trust in institutions across the world is at very low levels. Katie Plax, MD, Ferring Family Chair in Pediatrics at the School of Medicine, explained the importance of building strong relationships of trust with her patients and the impact that being a strong advocate has on patients.
I have recently seen how important trust is in my own research at Elon University. Along with my mentors, Catherine Bush, PhD, Adjunct Assistant Professor of Biology, and Katherine Johnson, PhD, Assistant Professor of Public Health, I have been working with a migrant community in North Carolina called the Montagnards to examine access to mental health care. The Montagnards were an indigenous group in Vietnam who faced persecution by the Vietnamese army. Many were forced to flee into jungle, facing starvation, tiger attack, and the constant risk of capture, before eventually being evacuated to the United States. Now that they have been in the U.S. for a few decades, we are seeing the lasting impacts of trauma, which are compounded by the lack of access to care associated with the language barrier, poverty, and significant cultural differences. The younger generations, who grew up in the US, face mental health challenges as well, with some speaking about how they feel disconnected from both the Montagnard culture that the elders have and the American culture of their peers and colleagues.
Trust has shown up in a big way during this project. While we have focused on listening to community needs from the outset, we still found it very challenging to recruit participants. One young Montagnard had been working with us throughout the project as our translator. He offered to get involved in participant recruitment as well. As soon as he was on board and began working as the person who would reach out to individuals to explain what the project was and how they could participate, we began to get three or four times more participants. This demonstrated to me what I had been hearing during our seminars: you need community buy-in, you need people to trust you, and you need to make sure you don’t betray that trust.