"Trust has been undervalued in health systems, but the Immokalee experience shows that it may increase participation in community health efforts through operationalizing the factors listed in the trust determination theory."

"The Immokalee coalition upheld the notion that while technical expertise is critical for building public health infrastructure, community knowledge is equally important for adapting interventions to local needs."

A new study published in a leading medical journal highlights the importance of strong community ties and trust to ensuring a more resilient and safe community – one that can respond effectively to disasters like the COVID-19 pandemic. Co-written by the CIW’s own Gerardo Reyes Chávez, Greg Asbed, and Julia Perkins, the study contains practical wisdom from the CIW's collaboration with local and international public health leaders to fight the spread of COVID-19 and immunize thousands of Immokalee community members during the height of the pandemic.  The article provides a wealth of lessons for other communities to use to keep their own members safe.

When COVID-19 first began raging through cities and towns across the U.S., Immokalee was one of the hardest-hit, with little medical infrastructure to serve its residents. But Immokalee came together and, together with key partners, forged a path to protect itself against COVID, saving countless lives in the process. This study describes that effort in detail in the hopes that others may be able to replicate its successful fight against a global pandemic.

Read some of the key takeaways from the study below, or read the full article here:

The Immokalee Community Health Coalition: Operationalizing Trust

Journal of Health Care for the Poor and Underserved, Volume 33, Number 4, November 2022 Supplement, pp. 243-254 (Article)

By Caroline Murtagh; Greg Asbed, MS; Emily Ptaszek, PsyD, MBA, FACHE; Fernet Leandre, MD, MMSc-GHD; Vitina Monacello, MSW; Matthew Hing; Julie Pedretti, MBA, FACHE, APR; Frantzso Marcelin; Gerardo Reyes Chávez; Julia Perkins; Ruth DeYoe; Daniel Palazuelos, MD, MPH

"Summary: The COVID-19 pandemic disproportionately affected migrant farmworker communities in the United States in case rates and deaths. In rural Immokalee, Florida, human rights, health care, and social support organizations with different strengths joined together to form a coalition that provided health information, tests, vaccines, and social supports. This report offers practical advice on how similar coalitions can overcome barriers to care, improve outcomes, and overall increase trust in the health system.

Trust affects how health systems function, how patients engage with those systems, and the health results produced. There is a growing literature on the benefits of institutional and interpersonal trust during pandemics, such as lower fatality rates, increased testing participation, and greater willingness to be vaccinated under the Emergency Use Authorization authority of the Food and Drug Administration. The trust determination model of communication asserts that there are four pairs of factors establishing trust: caring and empathy; dedication and commitment; competence and expertise; and honesty and openness. There is less clarity, however, on how health systems can operationalize these factors to build trust in institutions, especially among those who live in low-income and underserved communities. Immokalee, Florida is exemplary: home to a community of immigrant families, migrant farmworkers, and other essential workers, Immokalee is surrounded by an agriculture system that was founded on slavery and continues to be affected by labor legislation that excludes farmworkers from economic and political protections…

Observation 1: 'With high trust, success comes faster, better, and at lower cost.'

...Recommendation for interpersonal trust. Teamwork is built on reliability and action around a common cause. When organizations share a geographic area, there are myriad barriers to collaboration, from competition for funding to lack of incentive alignment. The urgency presented by COVID-19 required Immokalee coalition members to build trust in each other to act quickly and decisively. For example, the team attended regular meetings to exchange updates regarding staffing, resources, and inter-organizational program implementation. The group also applied for joint funding, which removed competition for limited funding that nonprofits often face…

Coalition of Immokalee Workers
110 S 2nd St
Immokalee, FL 34142
United States

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