Enhancing the public health academic's role in community engagement: building trusting relationships through support service delivery.

Community engagement processes, specifically when initiated or led by public health researchers/academics often take the form of "outreach," wherein the academic contacts a community experiencing a public health problem to perform a research study about the problem, or "consultation," where the academic content expert is called on by a community to share what is known about a particular public health problem. Both of these forms of community engagement and those involving the public health academic/researcher have the potential to provide elements of community health improvement to the citizens in the community. Consider public health academic approaches to community engagement grounded in research models such as Community-Based Participatory Research, Implementation Research, and Team Science. Each of these models and strategies through which public health academics engage with communities have been widely used with many documented successful conclusions. However, based on work by the authors in communities across Kentucky over the past 10 + years, the possibility exists that specifically in rural communities with multiple public health issues and the frequent existence of a fractured public health infrastructure, another form of community engagement is needed for even better health improvement results. Although many Local Health Departments across the United States serve rural communities, only a small proportion of their directors have a formal public health education. With the increasing public health concerns of many areas, specifically those in rural areas like the majority of communities in Kentucky, the strain on the LHD staff and members of their community partner systems is great. From this perspective, the authors propose that the missing link in the previously discussed community engagement methods of outreach, consultation, and collaboration is support service delivery. Support service delivery, as we propose, would be delivered in a similar mechanism to preceptor guided training in certain health disciplines in which the expert demonstrates, teaches, and supports until the student is ready to practice alone. Through the support service delivery process, trust is built and sustained within communities as an essential component of public health academic community engagement.