Cultivar Relaciones: Exploring Trust and Transparency in Building Relationships in an Action Research Study Within a Community-Based Participatory Research Project

Date of Degree


Document Type


Degree Name

Doctor of Philosophy (PhD)




Ashley Love


Alfredo Ortiz Aragón


C. Daniel Mullins


Research Focus. In San Antonio, Texas, health disparities are a critical issue, shaped by a range of social determinants impacting health and contributing to inequities in healthcare. The World Health Organization defines healthcare inequity as unjust and avoidable differences in health status observed across different population groups. The Centers for Disease Control and Prevention (CDC) further clarifies that disparities are evident when health outcomes or determinants vary significantly between populations. These disparities not only impose a toll on human life but also have profound societal costs affecting its citizens’ morbidity and mortality. The focus spreads across entities working in silos not working collaboratively. An opportunity exists to approach a notable fragmentation in these initiatives. This action research study sought to explore and discover ways to intentionally build productive, trusting, and transparent relationships between the University of the Incarnate Word (UIW) Dreeben School of Education and Ila Faye Miller School of Nursing and Health Professions research team, the San Antonio Metro Health District Healthy Neighborhoods (HN) city organization and select communities in an RWJF-supported participatory action research project in San Antonio, Texas.

Research Methods. Combining an action research approach with qualitative features permitted active engagement in an actual community-based participatory action research (CBPAR) project to collaboratively seek a solution for a practical problem. I used basic action research and social constructivist grounded theory-lite design regarding improving relationship development within the project, emphasizing trust and transparency. Participants were grouped into three distinct categories: (1) AR4CHW Team (2) Community Members (3) National CBPAR Thought Leaders. Data collection consisted of three primary participatory methodologies: rewriting the script for equitable healthcare (RWTS), digital storytelling (DS), and photovoice. Data collection methods involved observation, semi-structured interviews, meeting and workshop attendance, and facilitation. Data analysis focused on the participants’ concerns regarding what could be done to build productive, trusting, and transparent relationships.

Research Results/Findings. The study produced five key findings that are instrumental in cultivating trusting, transparent, and productive relationships within CBPAR. These findings are encapsulated in the following themes: (1) Trust: Authentic Belonging and Respect, (2) Transparency: Facilitator of Trust and Inclusion, (3) Participatory Methodology: Remarkable Potential, (4) Equitable Inquiry: Reflection and Focus, and (5) Multiverse: Relationship Enabler and Inhibitor. Key findings or core concepts of the five findings included (1) intentional development of the research team, (2) participatory methodology, and (3) equity-minded inquirers. The core findings support a model that responds to how this SA-based research team can build productive, trusting, and transparent relationships.

Conclusions From Research. I identified three key strategies to build trusting and transparent relationships to improve building productive alliances. (1) Deliberate Team Development, (2) Use of Participatory Methodologies, and (3) Equity-Focused Inquiry. This study has potential limitations regarding generalizability as it is contextual and relevant to a local practice problem only, and bias since the researcher was also a participant. Recommendations from this study support the AR4CHW team and CBPR/CBPAR practice.

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