“Working at the Speed of Trust”

The Roles of Trust and Power in Effective Implementation

Abstract

Availability of effective, culturally responsive interventions is urgently needed to support immigrant and refugee youth resilience and mental health. Critical to successful scale-up efforts is evidence of barriers and facilitators to the implementation of multi-tier interventions that integrate cultural brokers into existing infrastructure. Data sources for this process evaluation included 10 interviews, two focus groups, and team meeting notes from 2021-2024. Modified grounded theory methods, reflective memos, and data triangulation generated a conceptual model that highlights the central role of cultivating trust and attending to power within and across partnering agencies during implementation of a manualized, evidence-informed, and community-engaged mental health intervention. This was especially important for cultural brokers, who are critical to the delivery of culturally responsive services yet vulnerable to marginalization and burnout. This novel conceptual model can inform future efforts to implement and scale culturally responsive interventions, sustain cultural brokers, and avoid replicating marginalizing power structures.