Bianchi Lara, Kelemen Mihaela, Shivji Alysha Kate, Tallant Jonathan, Timmons Stephen
Department of Entrepreneurship and Innovation, Nottingham University Business School, Nottingham, UK.
Department of Strategy and Leadership, EGADE, Tecnologico de Monterrey, Monterrey, Mexico.
Sociol Health Illn. 2025 Jan;47(1):e13870. doi: 10.1111/1467-9566.13870.
This paper investigates the impact of boundary spanning activities on building trust as a means of tackling health inequalities in hardly reached communities. Lack of trust has been identified as a barrier to engagement with healthcare services, resulting in poorer health outcomes. Engaging with hardly reached communities is challenging due to the social and symbolic boundaries prevalent in community healthcare settings. Drawing on empirical data from a recent year-long collaborative research project with communities from seven economically deprived areas in the City of Nottingham, we identify two boundary spanning activities that facilitate the development of trust: communication across boundaries and intergroup relationship building. By cross fertilising sociological accounts on trust with insights derived from philosophy, the study finds that for hardly reached communities, trusting relevant individuals is more potent and widespread than the trust they have in healthcare institutions. By developing individual trust, hardly reached communities are more likely to consequently perceive the existence of institutional goodwill and competence. This counter-intuitive finding invites us to regard trust as context specific and relational rather than as a binary choice between trusting individuals or institutions and to situate cross boundary activities focused on trust development within the power asymmetries in which they unfold.
本文探讨跨界活动对建立信任的影响，以此作为解决难以触及社区健康不平等问题的一种手段。缺乏信任已被视为参与医疗服务的障碍，导致健康状况更差。由于社区医疗环境中普遍存在社会和象征性边界，与难以触及的社区进行接触具有挑战性。基于最近与诺丁汉市七个经济贫困地区的社区开展的为期一年的合作研究项目的实证数据，我们确定了两种促进信任发展的跨界活动：跨边界沟通和群体间关系建立。通过将社会学对信任的阐述与从哲学中获得的见解相互交融，该研究发现，对于难以触及的社区而言，信任相关个体比他们对医疗机构的信任更为有力且普遍。通过培养个体信任，难以触及的社区更有可能进而感知到机构的善意和能力的存在。这一有悖直觉的发现促使我们将信任视为具体情境下的和关系性的，而非在信任个体或机构之间进行的二元选择，并将专注于信任发展的跨边界活动置于其展开的权力不对称情境之中。
