Abstract
BACKGROUND: Community capacity-building is the cornerstone of many public health initiatives, with increasing attention paid to community engagement, collective impact, and trauma-informed practices designed to support resiliency and promote health equity. Large-scale capacity-building projects proliferated during the global pandemic, highlighting the need for practical guidance and steps for efficiently responding to changing community needs and effectively communicating information across partnership and community members. The present qualitative longitudinal study provides a pragmatic framework for trauma-informed knowledge exchange across stakeholders in a large urban collective impact, capacity-building initiative designed to establish partnerships that engage community members, promote equity through tailored referrals and resource access, and address community needs and aspirations. METHODS: Interviews were conducted with the leads of nine agencies funded to implement regionally responsive strategies addressing adverse childhood experience-driven health needs among their diverse subcommunities, while offsetting the impact of trauma, building capacities and improving resource access. We aimed to capture (1) the socioecological context of traumatic experiences and health barriers that propelled agencies to participate in a trauma-informed initiative; (2) agency leads' vision for community health; and (3) unfolding approaches to the initiatives' complex work, spanning pre-pandemic community needs and pandemic era challenges. RESULTS: Agency leads' vision for healthy communities emerged from the strengths, adversity-driven challenges and health barriers of their communities; while focusing on relationship-building, trust-based engagement and equitable access to trauma-informed resources through knowledge exchange. Results support reflection-based learning practices that are characterized by a flexible mindset and action-oriented adaptability. Mechanisms that power multi-directional knowledge exchange included creative partnering; frameworks and trainings that address partnership and community needs; and actionable skill-building. Incorporating community members directly into the initiative's work exemplified the vision of an informed/resourced community, relationship-based engagement, use of adaptive practices and creative partnering. Lived experience staff provided a credibility bridge facilitating knowledge exchange between community and partnership members and creating power-sharing opportunities. CONCLUSIONS: Engagement in public health initiatives is essential for community well-being and responsive public health initiatives. These data provide an emerging framework for thoughtful engagement and knowledge exchange among partnership and community members, while highlighting knowledge exchange as a key impact for outcome consideration.