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— Propensity to trust 6 0.15 * 0.01 0.02 0.32 0.09 0.21 Other factors Trustworthiness 32 0.17 * 0.004 0.04 0.10 0.15 0.19 Propensity to trust 7 0.17 * 0.004 0.005 0.75 0.13 0.22 General trust 1 0.70 — — — — — Global Trustworthiness 136 0.27 * 0.003 0.05 0.07 0.26 0.28 Propensity to trust 43 0.10 * 0.003 0.01 0.36 0.08 ...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10083508/
How and why humans trust: A meta-analysis and elaborated model - PMC
pmc.ncbi.nlm.nih.gov
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Building and Maintaing Trust
topic
2026-03-21T02:35:57.976427
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, however, still did not contain a value of zero. This result indicates that the identified relationship is consistent, albeit a small one. Trustee factors related to the propensity to trust also showed a significant correlation ( r = 0.16), as again did contextual factors ( r = 0.13). Though an individual’s propensity...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10083508/
How and why humans trust: A meta-analysis and elaborated model - PMC
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2026-03-21T02:35:57.976460
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stee, and contextual factors remains consistent and quantitatively demonstrable. All of these findings are enumerated in Table 3 . For most of the correlations shown in Table 3 showing the trustor predictor variable, the proportion of total variance due to sampling error is below 0.75, suggesting heterogeneity of the e...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10083508/
How and why humans trust: A meta-analysis and elaborated model - PMC
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2026-03-21T02:35:57.976488
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ze estimate, this can be interpreted to mean that the effect sizes are homogeneous (e.g., see the correlation between propensity to trust and trustworthiness). From the surveyed literature, we were able to define general trust in instances where trust could be described neither as an individual’s propensity to trust no...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10083508/
How and why humans trust: A meta-analysis and elaborated model - PMC
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2026-03-21T02:35:57.976517
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s did show a significant correlation ( r = 0.16). Here, again the associated confidence interval here did not include zero. The relationship between general trust and contextual factors ( r = 0.15) did not, however, prove to be significant since it did contain zero in the related confidence interval. There were no code...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10083508/
How and why humans trust: A meta-analysis and elaborated model - PMC
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2026-03-21T02:35:57.976546
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lation between trustee factors and general trust. That is not to say that such trustee factors are not associated with general trust, only that our present search was not able to identify any admissible data so as to determine whether such an effect exists. The decomposition of variables thus far is informed by, and gu...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10083508/
How and why humans trust: A meta-analysis and elaborated model - PMC
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2026-03-21T02:35:57.976575
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; Schaefer et al., 2016 ; and see also Hancock et al., 2021a , b ). However, the three general predictor categories can themselves be further sub-divided. Contextual factors, for example, are able to be parsed into two sub-categories: (i) task-based characteristics (e.g., task type, task complexity, and level of uncert...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10083508/
How and why humans trust: A meta-analysis and elaborated model - PMC
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2026-03-21T02:35:57.976603
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interaction conflict, and role interdependence). Trustee dimensions are also able to be further parsed into two sub-categories: (i) trustee characteristics (e.g., demographics, personality, appearance, and reputation), and (ii) trustee performance (e.g., behavior, reliability, predictability). Trustor factors were simi...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10083508/
How and why humans trust: A meta-analysis and elaborated model - PMC
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2026-03-21T02:35:57.976631
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t proved to be of particular interest was gender. Many studies examined correlations between gender (of both trustor and trustee) and trust. Although gender was coded differently in many studies, we were careful to assure that all of the correlations used in our meta-analysis were consistent. Thus, males were always co...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10083508/
How and why humans trust: A meta-analysis and elaborated model - PMC
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2026-03-21T02:35:57.976659
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= −0.07) was not significant, this effect containing zero within its confidence interval. Both the relationships between gender and propensity to trust ( r = 0.04) and gender and perceptions of trustworthiness ( r = 0.1) also proved small and non-significant. Discussion of the overall pattern of correlations Overall co...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10083508/
How and why humans trust: A meta-analysis and elaborated model - PMC
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2026-03-21T02:35:57.976693
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zed relationships with perceived trustworthiness. Trustor, trustee, and contextual factors also exerted significant but quantitatively smaller correlations with the propensity to trust. Trustor and contextual factors had significant but small correlations with general trust. As these proposed factors represent over-arc...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10083508/
How and why humans trust: A meta-analysis and elaborated model - PMC
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2026-03-21T02:35:57.976721
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to trust, and general trust were divided into specific characteristics (see Figure 6 ). These are now examined individually in more detail. Figure 6. Open in a new tab Forest plot of factors found to affect trustworthiness. Line length represents the boundaries of each 95% confidence interval. Diamonds represent global...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10083508/
How and why humans trust: A meta-analysis and elaborated model - PMC
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2026-03-21T02:35:57.976746
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t with larger shapes representing larger effects. Trustor factor
https://pmc.ncbi.nlm.nih.gov/articles/PMC10083508/
How and why humans trust: A meta-analysis and elaborated model - PMC
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2026-03-21T02:35:57.976771
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d, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. PMC Copyright notice PMCID: PMC10012819 PMID: 36925800 Abstract This paper presents a theory of change that articulates (a) proposed strategies for building trust among implementat...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.100766
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usting relationships and implementation outcomes. The theory of change describes how trusting relationships cultivate increases in motivation, capability, and opportunity for supporting implementation among implementation stakeholders, with implications for commitment and resilience for sustained implementation, and ul...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.100823
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stakeholders Authenticity Encourage implementation stakeholders to share their perspectives openly and honestly: support implementation stakeholders to understand the values and beliefs of other implementation stakeholders Bi-directional communication Support feedback loops among implementation stakeholders so that imp...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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Front Health Serv . 2022 Sep 23;2:894599. doi: 10.3389/frhs.2022.894599 Building trusting relationships to support implementation: A proposed theoretical model Allison Metz Allison Metz 1 School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States Find articles by Allison Metz 1, ...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
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2026-03-21T02:35:58.100899
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by Todd Jensen 1 , Amanda Farley Amanda Farley 1 School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States Find articles by Amanda Farley 1 , Annette Boaz Annette Boaz 2 London School of Hygiene and Tropical Medicine, London, United Kingdom Find articles by Annette Boaz 2 , Leah...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.100931
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eah Bartley 1 , Melissa Villodas Melissa Villodas 1 School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States Find articles by Melissa Villodas 1 Author information Article notes Copyright and License information 1 School of Social Work, University of North Carolina at Chapel Hi...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.100962
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dicine, London, United Kingdom Edited by: Erin P. Finley, VA Greater Los Angeles Healthcare System, United States Reviewed by: Sarah E. Parker, Virginia Tech, United States; Marie-Therese Schultes, University of Zurich, Switzerland ✉ *Correspondence: Allison Metz Allison.metz@unc.edu This article was submitted to Imple...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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ar 11; Accepted 2022 Aug 8; Collection date 2022. Copyright © 2022 Metz, Jensen, Farley, Boaz, Bartley and Villodas. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original a...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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constructs in the theory of change are provided. The paper highlights how the development of a testable causal model on trusting relationships and implementation outcomes can provide a bridge between implementation research and implementation practice. Keywords: implementation science, implementation practice, trust, r...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.101057
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g patient care in the context of health services. To increase the generalizability of findings from implementation research to implementation practice, the field of implementation science has begun to call for greater conceptual clarity on important aspects of implementation ( 1 ). This call for greater conceptual clar...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.101084
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ation research and implementation practice ( 2 ). Implementation research seeks to understand the approaches that work best to translate research to the real world, whereas implementation practice seeks to apply and adapt these approaches in different contexts to achieve outcomes ( 3 ). Trust is an example of an implem...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
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2026-03-21T02:35:58.101115
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entation practitioners can test strategies to foster and deepen trust among implementation stakeholders. Common definitions of interpersonal trust appeal to McAllister's [( 4 ), p.25] articulation as follows: “the extent to which a person is confident in and willing to act on the basis of the words, actions, and decisi...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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topic
2026-03-21T02:35:58.101145
[ -0.0016000926261767745, -0.039553627371788025, -0.03805505856871605, -0.0661248043179512, -0.04357241466641426, -0.0734209343791008, 0.045934904366731644, 0.010014122352004051, -0.016918454319238663, -0.04398944228887558, 0.03620176017284393, -0.06061171367764473, 0.06235306337475777, -0.0...
that actions will cause no harm and will provide benefit ( 5 – 8 ). Although trusting relationships are commonly described as important by implementation stakeholders involved in leading implementation efforts ( 9 – 11 ), few studies have explored this topic in depth ( 12 – 14 ). The dearth of research in this area lim...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.903
0.856
["networking", "leadership"]
484
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101177
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be effectively built and why they are important. Implementation stakeholders refer to all individuals and groups who have an interest in the implementation result and, therefore, require authentic involvement in the implementation process ( 15 ). In this paper, we describe how professionals providing implementation sup...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.7
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["leadership", "career"]
511
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101206
[ -0.014954865910112858, 0.06227261945605278, 0.05461408197879791, -0.03714079037308693, -0.03887505084276199, -0.018210062757134438, 0.011194390244781971, 0.05096415802836418, -0.012279979884624481, -0.0018589458195492625, -0.02803492173552513, -0.019876670092344284, -0.00011914424248971045, ...
quently leading to improved implementation results. In a recent study, highly experienced ISPs emphasized that high-quality relationships among implementation stakeholders was a—if not the —critical factor for achieving implementation results ( 2 ). Conceptual clarity regarding the role of trusting relationships in imp...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
1
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["networking", "leadership", "education"]
512
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101238
[ 0.0202132947742939, 0.02953488938510418, -0.003956377040594816, -0.02988981083035469, -0.05218219384551048, -0.02183862030506134, -0.034559331834316254, 0.04267076030373573, 0.009407822974026203, -0.022819820791482925, 0.005354379769414663, 0.018775761127471924, 0.05439431592822075, -0.007...
w trust moderates associations between implementation strategies and implementation outcomes. Consistent terminology and definitions are needed to describe the relational aspects of implementation. Research on trust can also produce generalizable knowledge related to trust-building among implementers, thereby creating ...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
1
0.83
["education"]
512
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101269
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rategies for building trust among implementation stakeholders. The theory of change also explicates how trusting relationships promote motivation, capability, and opportunity for supporting implementation among implementation stakeholders, with implications for commitment to and resilience for sustained implementation,...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.7
0.83
["motivation", "networking", "philosophy"]
512
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101306
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ion of the theoretical models that have informed the proposed theory of change and the assumptions that underly the connections between trust and implementation outcomes. We will also provide examples of how trust and other key constructs in the theory of change can be measured and how the development of this testable ...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.983
0.828
["networking", "philosophy"]
414
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101338
[ 0.022714966908097267, 0.01799081452190876, -0.0013979297364130616, -0.048735473304986954, 0.00273598893545568, -0.0031935155857354403, -0.007990804500877857, 0.03246646001935005, 0.07631056010723114, 0.019133083522319794, 0.05661124363541603, 0.0796804130077362, -0.003660245332866907, 0.00...
lementation research and implementation practice. Conceptualizing trust Historically, efforts to understand trust have incorporated rational choice perspectives that emphasize self-interest as a primary motivating force; however, these perspectives justly have been criticized for failing to fully account for the role o...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.917
0.818
["decision_making"]
435
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101367
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th relational trust-building ( 4 , 7 , 18 – 23 ). The theory of change describes both relational and technical strategies for building trust. Whereas technical strategies are grounded in intrapersonal and cognitive dimensions of trust, relational strategies are grounded in interpersonal and affective dimensions of trus...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.697
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["management"]
487
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101397
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ommitted to the goals of the implementation team. Interpersonal trust refers to the perception of implementation team members and stakeholders that they are in a collaborative and reciprocal relationship in pursuit of the same aims ( 17 ). Similarly, McAllister ( 4 ) highlights key differences between cognitive and aff...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.7
0.844
["management", "ethics", "networking", "economy"]
512
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101426
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others; whereas affect-based trust reflects individuals' feelings of emotional involvement and others' genuine care and concern for their welfare ( 8 ). Thus, trustors often endeavor to observe the following: (a) whether trustees' behavior indicates that they are competent to perform according to expectations, and (b) ...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.685
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["networking", "philosophy"]
423
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101454
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est in and maintain a working relationship ( 7 ). Many researchers agree that trust is cultivated primarily by a combination of these cognitive/intrapersonal and affective/interpersonal factors ( 6 ). Trust in implementation teams Implementation efforts often rely on implementation teams ( 25 ). An implementation team ...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.895
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["management", "networking"]
512
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101482
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y members) that oversees, manages, and is accountable for performing key functions with respect to the selection, implementation, and continuous improvement of a selected intervention ( 25 ). Implementation teams are a group with a common goal and are jointly responsible for ensuring completion of necessary tasks throu...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.7
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["management", "leadership", "philosophy"]
512
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101512
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reby one or more individual leaders operate in siloes and struggle to effectively influence all necessary stakeholders in the context of an implementation effort. Higher levels of interpersonal trust, particularly in the context of teams, has been linked to higher levels of team satisfaction ( 26 , 27 ), proactive idea...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.895
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["management", "leadership", "education", "philosophy"]
512
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101543
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ce ( 32 ), affective commitment ( 27 ), organizational commitment ( 33 ), productivity ( 33 ), cooperation ( 34 ), and team performance ( 8 , 35 – 38 ). Evidence linking trust with team cooperation and team performance is especially compelling, given robust meta-analytic studies that have been conducted on these topics...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
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Building and Maintaing Trust
topic
2026-03-21T02:35:58.101572
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moderate average effect size [ r = 0.26; ( 34 )]. Another meta-analysis of 112 independent studies (including over 7,700 teams) yielded an above-average overall effect size (ρ = 0.30) linking intrateam trust and team performance—defined as the extent to which a team accomplishes its goal or mission ( 8 ). Taken togethe...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.916
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Building and Maintaing Trust
topic
2026-03-21T02:35:58.101601
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vel outcomes associated with interpersonal trust. Trust in implementation practice There is growing interest in the experiences of ISPs, including the strategies they use to support implementation and the skills required to use these strategies ( 39 ). Emerging competencies for this workforce; identified through resear...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.997
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["networking", "education", "philosophy"]
486
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101634
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skill for progressing implementation ( 17 , 40 ). Furthermore, experienced ISPs have amplified the need to focus on relational issues in implementation and have identified trusting relationships as a critical aspect of implementation ( 16 , 17 ). In general, the field of implementation is more routinely acknowledging t...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.905
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["networking"]
479
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101662
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provide implementation support ( 16 , 41 – 43 ). Yet, trust-building is not explicitly named as an implementation strategy ( 44 ) and is not included in commonly used implementation frameworks. Implementation strategies refer to “the methods or techniques used to enhance the adoption, implementation, and sustainability...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.996
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["strategy"]
479
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101690
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plementation outcomes described by Proctor et al. as acceptability, adoption, fidelity, reach, and sustainability ( 45 ). Trust-building can be considered an implementation strategy in its own right. That is, trust can directly contribute to desirable implementation outcomes. Trust can also be conceptualized as a moder...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.7
0.832
["strategy"]
501
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101719
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plementation strategy on implementation outcomes. In the context of our proposed theory of change, we foreground trust-building as an implementation strategy. We also acknowledge that when trust is developed, trust can positively moderate the effects of other implementation strategies ( 46 ). Implementation strategies ...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.7
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["strategy", "education"]
512
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101747
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lementation activities that leave ample room for further operationalization and tailoring by ISPs working in the often-complex settings of routine practice and policy implementation. The experiences of ISPs can help to further operationalize what it takes for implementation strategies to effectively contribute to imple...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.7
0.842
[]
504
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101774
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ences of providing implementation support ( 47 ). In a recent study of evidence use ( 2 ), the importance of trusting relationships to enable successful implementation and sustained evidence use emerged as a central theme through interviews conducted with experienced ISPs. Study participants included professionals who ...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.895
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["education", "networking", "career", "interview", "family"]
512
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101807
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c implementation frameworks or methods, focusing more on developing trusting relationships and building teams in order to achieve implementation outcomes. Additionally, in a recent study where experienced ISPs were interviewed ( 2 ), almost all participants reflected on a transformation in the way they provide implemen...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
1
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topic
2026-03-21T02:35:58.101837
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d state of implementation support focused on trusting relationships, driven by community data, and centered in co-creative approaches where both intervention and implementation strategies are co-designed with community members. In summary, growing evidence highlights trusting relationships as a critical element of effe...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
1
0.836
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Building and Maintaing Trust
topic
2026-03-21T02:35:58.101866
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f health services and other related service delivery settings. Valuable opportunities remain to develop theoretical models to guide future research and enrich our understanding of relational elements that optimize implementation efforts. The purpose of this paper is to provide conceptual clarity on the role of trusting...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.99
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450
Building and Maintaing Trust
topic
2026-03-21T02:35:58.101896
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lementation research and implementation practice. In this paper, we present a theoretical model on how trusting relationships ultimately contribute to implementation outcomes. This theoretical model integrates relational cohesion theory ( 48 , 49 ), relational cultural theory ( 50 ), and implementation research finding...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
false
0.997
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Building and Maintaing Trust
topic
2026-03-21T02:35:58.101928
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for conducting relevant implementation research. A theory of change outlines the predicted causal linkages between the activities conducted and the expected short-term, intermediate, and long-term outcomes for the population of interest. Ideally, a theory of change will detail implementation researchers' assumptions ab...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.101953
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outcomes to occur in a particular context ( 52 ). The proposed theoretical model is based on findings from our previous research on trust and evidence use, which demonstrates that building trusting relationships and addressing power differentials among stakeholders may be more important than the selection of specific i...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.101983
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competencies needed to build trusting relationships, (b) the role trusting relationships play in behavior change ( 16 , 53 ), and (c) how changes in individual and team behavior can contribute to implementation efforts in the context of health services and other related service delivery settings. Relational cohesion th...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
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Building and Maintaing Trust
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2026-03-21T02:35:58.102011
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sting relationships to successful implementation. Relational cohesion is defined as the perception by individuals in an exchange relation that their relationship is a unifying element or force in the social situation ( 48 , 49 ). Such perceptions lead to higher levels of commitment and collectively oriented behavior. R...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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public_domain
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2026-03-21T02:35:58.102039
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ontribute to trusting relationships and increased resilience and commitment in the face of challenges. Relational cohesion theory is aligned with cultural exchange theory ( 54 ), and with literature on lessons learned from implementation science on the role of partnerships and relationships. Cultural exchange relies he...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
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Building and Maintaing Trust
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2026-03-21T02:35:58.102068
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ocal perceived trust ( 55 , 56 ). Palinkas et al. ( 57 ) describe cultural elements of successful partnerships including flexibility and sensitivity to the needs of individuals in the partnership, openness and honesty associated with building and maintaining trust, and humility and tolerance in service to mutualism and...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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Building and Maintaing Trust
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2026-03-21T02:35:58.102095
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ed within the exchange relation; it can be used to explain the conditions under which instrumental exchanges of implementation support become more affective, emotional, and meaningful to stakeholders at the implementing site and what type of activities lead to trust among implementation stakeholders. Relational cultura...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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Building and Maintaing Trust
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2026-03-21T02:35:58.102121
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e affect and increased resilience and commitment. Relational cohesion theory also highlights the role of empathy in supporting the growth-promoting relationships needed for implementation. Specifically, relational cultural theory posits that the ability to understand the perspective of others increases a sense of mutua...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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Building and Maintaing Trust
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2026-03-21T02:35:58.102148
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evant to fostering trust on implementation teams. The underlying assumptions of relational cultural theory highlight the role of empathy in producing positive relationships. These theoretical assumptions are also aligned with emerging research findings related to the role of professionals who support evidence use. For ...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
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Building and Maintaing Trust
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2026-03-21T02:35:58.102177
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ng implementation support, with empathy having achieved the highest level of agreement among professionals surveyed about how they approach their work to support evidence use. Findings also highlighted relational strategies, including empathy-driven exchanges, open communication, and demonstrations of authenticity and ...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
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Building and Maintaing Trust
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2026-03-21T02:35:58.102210
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ntations for supporting implementation: professional, motivating, empathetic, collaborative, authentic, flexible and creative, and honest . Also relevant are findings from Metz and Bartley ( 12 ) where bi-directional communication among implementation stakeholders was a contributor to effective and sustainable implemen...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.102239
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ive experiences of those involved in the exchange, it relies on technical strategies (e.g., frequent interactions, provision of expertise) to achieve the positive emotional experience and does not explicitly include relational strategies grounded in the mutuality of the exchange. Thus, pairing relational cohesion theor...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
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2026-03-21T02:35:58.102269
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e affect and increased resilience and commitment. Moreover, many scholars favor viewing interpersonal trust-building as a dynamic, transactional, and interactive process that unfolds over time and across numerous interactions ( 7 ). Both relational signaling theory ( 7 ) and costly signaling theory ( 58 ) emphasize thi...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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Building and Maintaing Trust
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2026-03-21T02:35:58.102306
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lly evidence to each other their trustworthiness. Theory of change The proposed theory of change posits a series of action steps for ISPs that will lead to increased trust between them and implementation stakeholders and increased trust among implementation stakeholders, leading to positive and sustainable implementati...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
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Building and Maintaing Trust
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2026-03-21T02:35:58.102337
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on team members and stakeholders through co-creation and humility. This starting point aligns with the assumption of relational cohesion theory that productive exchanges occur when two or more people seek to jointly produce benefits they cannot achieve alone ( 49 ). Inherent in this assumption is that entering the impl...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.102366
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d for successful implementation and evidence use. The proposed theory of change also posits that, after addressing power differentials, a shared goal for the use of evidence can be established. Relational and technical strategies for trust-building The proposed theory of change includes two core mechanisms of trust-bui...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
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2026-03-21T02:35:58.102395
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gthening the quality, mutuality, and reciprocity of interactions among team members and implementation stakeholders. Technical strategies are defined as strategies undertaken to build trust through demonstrating the knowledge, reliability, and competency to support the goals of the team. Below we describe the assumptio...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
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2026-03-21T02:35:58.102424
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s model for implementation research and practice. Examples of how ISPs may use relational and technical strategies to build trust with and among implementation stakeholders are featured in Table 1 . Table 1. Examples of activities for trust building strategies. Relational Strategies Examples for Implementation Support ...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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public_domain
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2026-03-21T02:35:58.102452
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eholders to describe their expertise and experience so that stakeholders can learn from each other; value different types of expertise and experience that individuals may bring to the implementation effort Empathy-driven exchanges Support an implementation stakeholder to understand the perspective of another stakeholde...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
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Building and Maintaing Trust
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2026-03-21T02:35:58.102480
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teractions Develop standing implementation meeting schedules that emphasize frequency over duration Responsiveness Acknowledge requests for support from implementation stakeholders and respond to requests as quickly as possible Demonstration of expertise Share accurate and credible information in a timely manner with a...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
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2026-03-21T02:35:58.102512
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mentation stakeholders Open in a new tab Relational strategies Implementation teams involve interdependence; thus, team members depend on each other in various ways to achieve implementation outcomes. The theory of change highlights five relational strategies grounded in relational cultural theory and cultural exchange...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.102541
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t in uncertainty, risk, and emotional exposure) ( 59 , 60 ); (2) approaching interactions with authenticity (i.e., openly, honestly, and in alignment with values) ( 12 ); (3) engaging in co-learning ( 61 ); (4) engaging in empathy-driven exchanges ( 62 ); and (5) using bi-directional communication ( 24 ). These relatio...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.102569
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ning environment, which will promote trusting relationships among team members. A common set of skills for employing all five relational strategies include the ability to actively listen, to offer free attention, and to suspend judgement ( 63 ). Vulnerability, the first relational strategy highlighted in the theory of ...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
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2026-03-21T02:35:58.102600
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risks is common to situations that require trust. Trust requires the willingness of a person or group to be vulnerable to the actions of another person or group, with the expectation that the other(s) will perform a particular action important to the trustor ( 64 ). Trust is the cornerstone for effective implementation...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
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2026-03-21T02:35:58.102630
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ticipate—each other's needs and interests ( 65 ). Studies on emotional acknowledgment demonstrate how authentic and bi-directional communication can foster interpersonal trust. Emotional acknowledgment refers to the verbal communication by which one implementation stakeholder signals recognition of another implementati...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
pmc.ncbi.nlm.nih.gov
public_domain
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2026-03-21T02:35:58.102658
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emonstrated to foster interpersonal trust ( 58 ). Research in this area is rooted in costly signaling theory ( 66 ) and suggests when one person (e.g., an implementation team member or implementation stakeholder) emotionally acknowledges another person, it signals that the person acknowledging the emotion is willing to...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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Building and Maintaing Trust
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2026-03-21T02:35:58.102689
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tional strategies for trust-building, including authenticity and bi-directional communication, as well as the technical strategy of responsiveness. When implementation stakeholders use these types of strategies with others, they imply a willingness to use resources in the future that will attend to the needs of other i...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.102717
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emotion requires sense-making from both parties. In the case of implementation teams, all team members will need to engage in sense-making to see how other team members feel about specific implementation decisions the team will need to make. Metz et al. ( 17 , 61 ) describe how co-learning also contributes to trust. Th...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.102745
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ion of different perspectives and types of knowledge. As implementation stakeholders engage in co-learning processes, they negotiate and build trust and respect for all perspectives, including those that may be at risk of being excluded from dialogue because of race, ethnicity, language, or status. Relational cultural ...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.102773
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he foundation for growth-promoting relationships. Professionals supporting implementation often describe empathy as foundational for developing trusting relationships, which aligns with how they describe their day-to-day activities building affiliation, making personal connections, and recognizing themselves as outside...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.102806
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e implementing site, balancing flexible boundaries with role clarity, demonstrating comfort in a relational context, and recognizing the impact all stakeholders have on implementation activities and decision-making. Technical strategies The theory of change also highlights technical strategies, grounded in structures a...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.102834
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ohesion theory posits are needed for successful exchanges; (2) demonstrating a high level of responsiveness to requests; (3) demonstrating expertise that can help the team achieve results ( 24 ); and (4) planning for and achieving quick wins ( 67 ) in service to longer-term goals. Research demonstrates that trust can b...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.102865
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, learning, and behavior change required to support implementation efforts ( 69 ). Frequent interactions can ensure that information is readily exchanged, making it possible for team members and implementation stakeholders to influence implementation decisions, thereby garnering trust in the process ( 70 ). Frequent in...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.102894
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amount and type of information exchanged ( 49 ). Frequent interactions can also enhance team member satisfaction with exchanges and strengthen relationships ( 71 , 72 ). Related to frequent interactions, responsiveness can promote successful exchanges among team members, leading to more “asks” from those involved in th...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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y trust. Responsiveness demonstrates flexibility. Flexibility illustrated at intrapersonal, organizational, and initiative levels can suggest that team members are prepared to respond to shifts in the work as they emerge. These qualities demonstrate sensitivity to both individual members of the team and the collective,...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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dual team members share information and show behaviors that indicate reliability, competency, and commitment to the goals of the team. Responsiveness and credibility allow for team members to constantly learn from and teach one another. Organizations committed to learning are more likely to have successful partnerships...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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be fostered through the attainment of quick wins. A dynamic, bi-directional relationship exists between trust and team performance, with higher levels of trust impacting team performance ( 8 ) and past team performance influencing trust within teams ( 76 ). Intentionally planning for early successes and celebrating tho...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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n turn, impacting future performance ( 76 , 77 ). Reinforcing mechanisms of relational and technical strategies and trusting relationships As noted earlier, ISPs often emphasize high-quality relationships among implementation stakeholders as the most critical factor for achieving implementation results ( 46 ). Indeed, ...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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ful implementation and the sustainability of evidence-based and evidence-informed programs and practices. Trusting relationships were described as “important,” “critical,” “essential,” and “foundational” for fostering an environment in which change efforts were optimized and sustained. Participants also emphasized how ...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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and serves as evidence of trusting relationships. The theory of change presented in this paper highlights the cyclical relationship between the technical and relational strategies overviewed and trusting relationships, whereby strategies to cultivate trusting relationships will become more pronounced as relationships b...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.103097
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ation team members that promote positive implementation outcomes (see Figure 1 for a full visualization of the theory of change). Achieving these changes and the reinforcing cycle described above assumes that implementation team members have the capacity to use these strategies. A testable question is whether the skill...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.103124
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and cultivated among implementation team members. Research in other fields such as business and leadership shows promise for increasing relationship-building and empathy in team leaders. For example, team leaders can use on-the-job interactions as opportunities to practice hearing ideas that differ from their own ( 78 ...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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, and safe to challenge ideas without fear of marginalization or retribution—also indicates that trust can be fostered through relational and technical strategies such as supporting bi-directional communication, increasing frequency of interactions, attaining quick wins, demonstrating empathy, inviting learning, and sh...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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el for trusting relationships and implementation. Trust, mechanisms for change, and implementation outcomes As mentioned previously, the theory of change integrates relational cohesion theory, relational cultural theory, and implementation research findings related to mechanisms of change ( 43 ). In doing so, the theor...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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ibute to use of evidence in health services and other related service delivery settings. Specifically, the theory of change captures how trust-based relationships exert influence on potential mechanisms of change that contribute to implementation outcomes. In this case, mechanisms are the processes through which trusti...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.103561
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ently, sustained implementation and evidence use. Implementation team members provide a resource for change to happen and can support the achievement of implementation outcomes including sustained use of evidence. To fully understand how fostering trust among implementation team members can contribute to implementation...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.103591
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ehavior change among implementation stakeholders. Albers, Metz, and Burke ( 16 ) developed a logic model that hypothesized how implementation support activities may contribute to behavior changes leading to evidence use incorporating the Capability-Opportunity-Motivation-Behavior (COM-B) framework ( 53 ). The logic mod...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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2026-03-21T02:35:58.103620
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e: (1) capability , representing information about changes in the physical, cognitive, or psychological abilities of implementation team members; (2) opportunity for changes in the physical, social, and cultural environments where implementation planning takes place that are prompted through trusting relationships; and...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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collaborate and achieve implementation outcomes. The theory of change posits that trusting relationships contribute to changes in capability, opportunity, and motivation, eventually leading to improved implementation of evidence. Findings from a recent study ( 2 ) identified central themes in how ISPs approach their wo...
https://pmc.ncbi.nlm.nih.gov/articles/PMC10012819/
Building trusting relationships to support implementation: A proposed theoretical model - PMC
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