Building Trusting Relationships to Support Implementation and Evidence Use in Human Services: Can We Build the Skills of Implementation Stakeholders to Foster Trust?

Background and Purpose: Professionals who provide implementation support in human service systems describe relationships as being at the heart of what they do to support evidence use; however, developing trusting relationships and addressing power differentials are not strongly featured in implementation science literature. The aims of this study were to (a) assess the feasibility and acceptability of a training and coaching curriculum for building trusting relationships among implementation stakeholders within a public child welfare system and (b) gauge the initial efficacy of the curriculum in terms of the development of trusting relationships among members of an implementation team who were supporting the implementation of an evidence-informed program.

Methods: Sixteen individuals participated in the curriculum between October 2022 and April 2023 in a public child welfare system. Curriculum content emphasized theory-derived technical and relational strategies for building trusting relationships to support implementation, consisting of a kick-off training event, five monthly training modules, and five monthly coaching sessions with implementation team leads. Curriculum feasibility and acceptability was assessed using brief satisfaction/reaction surveys following each training and coaching input. Initial efficacy was measured using an adapted version of the Trusting Relationships Questionnaire following each training input, enabling participants to report on (a) their perceptions about whether their team members trusted them (8 items; α = 0.91; 1 = Never, to 5 = Very Frequently) and (b) their level of trust toward other team members (8 items; α = 0.85). We used multilevel linear mixed-effects modeling to assess average within-person change trajectories (and between-person variability) in trusting relationships over the course of the program (79 total observations; average of 5.3 observations per respondent).

Results: With respect to program feasibility and acceptability, 100% of respondents indicated they agreed or strongly agreed that they (a) were satisfied with the kick-off training event and (b) would recommend the training session to peers or colleagues. For the remaining inputs, levels of agreement ranged between 86% and 100% for participant satisfaction (overall average of 94%) and between 80% and 85% for participants’ indication that they would recommend the training to peers or colleagues (overall average of 87%). On average, participants reported significant increases over the course of the program (0.30 units) in their perceptions that they were trusted by their team, with significant between-person variability. On average, participants reported statistically negligible increases over time (0.09 units) in the trust they had for their team, with significant between-person variability.

Conclusions and Implications: Findings highlight the general feasibility and acceptability of a training and coaching curriculum intended to support relationship-building among implementation teams in a public child welfare system. Findings also provide some tentative evidence for the efficacy of the program, particularly with respect to gains in participants’ perceptions that members of their team trusted them. Change in trusting relationships over time varied significantly across participants, and sources of such variability warrant attention in future analyses. Next steps in the evaluation process also include assessing program impacts on implementation processes and a qualitative exploration of participant reactions to program content.