Incorporating a Relational Model in Training and Technical Assistance to Promote Trust, Equity, and Collaboration

Training and technical assistance for health departments are essential components of public health infrastructure aimed at enhancing health department personnel’s knowledge, skills, and capabilities. Training and technical assistance (TTA) can be defined as targeted and tailored support for organizations or agencies that includes answering questions, sharing resources, or providing guidance on a specific area. Technical assistance can be a powerful tool for connecting recipients to high-quality and timely resources. Still, it is often a transactional exchange: A question or request met with an answer or set of materials. Conversely, in the context of TTA, a relational model emphasizes the importance of building and nurturing relationships amongst TTA partners and recipients to achieve common goals and address complex public health challenges. In general, the model highlights the interconnectedness of individuals within their social environments and emphasizes the role of relational dynamics in shaping human experiences, identity, and well-being. What would it look like to center a relational model within technical assistance provision to build trust, promote equity, and enhance collaboration?

Building Trust

A business management phrase – slow down to speed up – encapsulates how relationship building can show up in a technical assistance response. While moving quickly might be appealing to preserve limited time and resources and ensure a timely response to a given request, slowing down allows for understanding the problem, gathering information on the context, strategically thinking through possible solutions that can be targeted and tailored, and readying recipients for implementation of the TTA provided. Through these processes and conversations, relationships develop, and trust forms between the TTA provider and recipient.

Additionally, reliability and consistency in fulfilling TTA commitments demonstrate a dedication to partnership goals, while integrity and ethical conduct uphold credibility and confidence among participants. For example, a partnership between a public health department and data modernization focused TTA partner to improve data sharing during disease outbreaks relies on all parties’ integrity to protect privacy and confidentiality. As recipients seek additional TA, they are more likely to return to a trusted source of information that is considerate of diverse voices and opinions, thus deepening the relationship that can lead to long-term collaboration and partnering on more complex initiatives.

Promoting Equity

Equity is a fundamental principle within the relational model, as it emphasizes the importance of fostering inclusive, equitable relationships and addressing disparities in power, access, and opportunity among stakeholders. The relational model prioritizes forming partnerships representing diverse perspectives, experiences, and needs. By actively engaging stakeholders from marginalized or underrepresented communities, the model seeks to address power imbalances and ensure that all voices are heard and valued in decision-making processes.

For instance, in a collaborative partnership between a local health department, community organizations, and a TTA partner focused on addressing food insecurity in a low-income neighborhood, transparent communication ensures that community members are involved in identifying needs. This approach facilitates more effective communication, engagement, and participation, leading to more culturally appropriate and contextually relevant TTA deliverables. Investing in relationships strengthens the foundation of public health infrastructure, enhances responsiveness to emerging challenges, and promotes equitable access to services and resources.

The Center for Healthcare Strategies notes committing to a relationship-centered approach can yield deeper engagement and promote inclusivity and health equity. This connection between relationships and equity has been well-studied in provider-patient relationships and is also an indicator of success for DEI initiatives in workplaces. Practices like active listening, authentic engagement, and demonstrating a culture of care facilitate trust-building, ultimately leading to relational partnerships, rather than transactional ones.

Enhancing Collaboration

Collaboration is at the heart of the relational model in the context of public health training and technical assistance, as it emphasizes the power of building strong, reciprocal relationships among stakeholders to achieve shared goals. This model’s collaboration extends beyond mere transactions to encompass a deep sense of trust, mutual respect, and shared responsibility among partners. For instance, a public health department in a rural area with a majority Black population might collaborate with local community organizations, academic institutions, and TTA providers to plan the development and delivery of culturally tailored training programs on topics such as chronic disease prevention or maternal health.

In this scenario, it would not be fitting for the TTA provider to be the leading voice while dismissing the ideas of the other organizations involved. Instead, by prioritizing equity and empowerment within collaborative relationships, the relational model promotes a more just and inclusive approach to public health training and technical assistance, where all stakeholders have a voice, agency, and opportunity to contribute to positive change and collective well-being within their communities.

The National Network of Public Health Institutes (NNPHI) is built on a relational model of organizations serving to bolster the public health system and workforce. Specifically, the component of enhancing collaboration is embedded in its design. With a network presence in all 50 states, NNPHI has allowed for swift and coordinated responses to national public health challenges while emphasizing the importance of local connections and community power through our bottom-up, grassroots approach of partnering with state-based public health institutes. More recently, NNPHI has employed an innovative Hub model that prioritizes building solid and authentic connections between trainers, technical assistance providers, and governmental public health agencies in service to improve quality, equity, and innovation in public health systems.

Incorporating a relational model into public health training and technical assistance offers a transformative approach to addressing complex public health challenges. By fostering trust in partnerships, promoting equity, and enhancing collaboration, this model improves the effectiveness of TTA-related requests and contributes to broader efforts to promote health equity and social justice. Stakeholders can leverage their collective strengths and resources to drive positive change and improve health outcomes for all. As we continue to navigate the evolving landscape of public health, embracing the principles of the relational model can help us build more resilient, equitable, and sustainable systems that prioritize the well-being of individuals and communities.


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