Consider the following scenario: An academic research team was invited by a tribal community’s public health program to collaborate on a project.
This project was in response to an outbreak related to a sexually transmitted infection (STI). It was suggested by a federal public health analyst that the outbreak was largely attributed to a segment of the population who were infected and cycled in and out of jail.
The community public health program hypothesized that education to this jailed population would increase knowledge of STIs, increase screening and treatment, and decrease the spread of infection.The academic research team was charged with identifying an evidence-based education curriculum for the jail population, training health educators, and working with jail personnel to implement the program. Interorganizational (IO) teams were already in place to manage the adjudicated population. The teams were composed of corrections officials, nurses, social workers, and health educators. The corrections officers were responsible for admitting the client and safety assurances, nurses tended to physical needs like intravenous therapy and dressing of wounds and some health screening, the social workers identified treatment referrals or other social service needs, and the health educators provided health information and, along with the nurses, handed out condoms. From the researchers’ perspective, the teams were collaborative and managed their responsibilities.
Since this project was a directive from the tribal government, the academic research team assumed that project implementation would be smooth and resistance free. A curriculum was identified, and a 2-day training was scheduled. The IO teams willingly attended the evidence-based STI training provided by the Centers for Disease Control and Prevention (CDC). A few days after the training, the curriculum was dismissed because of the time needed for curriculum delivery and the lack of cultural appropriateness. In short, the IO teams firmly believed that curriculum would not work.
The research team did not understand. From their perspective, this was the best solution—the entire curriculum was evidence based. Eventually, the academic team took a step back and reassessed their approach, began dialogue with the teams, and requested recommendations to adapt the curriculum. When the IO teams felt respected, they began providing local knowledge that was instrumental to the project’s progression. During discussions, the academic team learned about significant challenges to project implementation: staff “burnout,” time available for presentation, content of presentation, safety concerns, and STI screening follow-up. The IO teams were understaffed and overstretched and suffered from job burnout. They had a maximum of 10 minutes to deliver any STI presentation, and the presentation had to include mostly pictures because some clients, especially those detoxifying, would have cognitive limitations. The original evidence-based curriculum spanned 45 minutes. It contained some pictures but was mostly discussion based. Initially, the research team and tribal government were expecting that each person receiving the health information via curriculum would be individually tested for STIs. However, each IO team had only two corrections staff members, and due to security concerns, they felt it was difficult for one officer to take one client to be tested while leaving the other officer responsible for the rest of the jailed clients. Similarly, not all clients could be tested together because of confidentiality and safety concerns, nor would the nurse enter the cells for testing. Finally, nurses and health educators were concerned about follow-up. They could screen clients but who would follow up with the diagnosis and treatment? Did clients have insurance or qualify for public assistance? The academic team failed to conduct formative research to learn about the current system, workload and context of the jail management teams, and cultural views related to the health concerns. Because of this failure to learn, listen, and negotiate, the jail IO teams pushed back as hard as the academic team pushed forward, but through participation and dialogue, the teams came to negotiate difference and build a working relationship based on trust.The frame for this chapter is focused on community-academic relationships in the context of health research projects. In the scenario presented above, the shift from tense and unyielding group dynamics to the development of a cooperative partnership occurred when all partners had a role and capacity to listen to and negotiate with each other. The issue of trust has frequently been identified as a mediator to cooperation. Trust facilitates open communication, information sharing, and conflict management (Madhok, 2006).
This chapter explores trust and conflict within community-academic partnerships by evaluating principles of community-based participatory research (CBPR) and applying these principles to Lewicki and Bunker’s (1995) model of trust development and decline. We first define characteristics of community-academic partnerships, conflict, and trust, and then explore three models of trust development and apply them to CBPR partnerships, a unique type of communityacademic partnerships, specifically aligning trust development models with CBPR guiding principles. Wemakerecommendations tofuture community-academic partnerships on how to improve reflection on and consciousness of trust development as a way to reduce conflict, and finally, we present directions for future research.
More on the topic Consider the following scenario: An academic research team was invited by a tribal community’s public health program to collaborate on a project.:
- Consider the following scenario: An academic research team was invited by a tribal community’s public health program to collaborate on a project.
- Oetzel John, Ting-Toomey Stella. The SAGE Handbook of Conflict Communication: Integrating Theory, Research and Practice. SAGE Publications,2013. — 912 p., 2013