1. Adam, M. B., & Donelson, A. J. (2020). Trust is the engine of change: A conceptual model for trust building in health systems. Systems Research and Behavioral Science, 39(1), 116–127. https://doi.org/10.1002/sres.2766
This paper proposes reciprocity as a new and measurable dimension of trust, built on the idea that people in health systems test out cooperative relationships in small ways before investing more deeply. The process model shows how common goals, mutual self-interests, and gratitude work together to jumpstart and sustain these relationships.
2. Finegood, D. (2022). Trust and Collaboration. In Complex Systems Frameworks Collection (illustrated by S. Bradd, Drawing Change). https://www.complexsystemsframeworks.ca/framework/process-of-building-trust/
This internationally curated collection of complex systems frameworks selected our trust-building model in our first citation (above) as a featured framework, placing it alongside established models like Collective Impact and Communities of Practice. The visual illustration walks readers a conceptualization of levels of trust, including three core elements of common goals, mutual self-interest, and gratitude, and the role of reciprocity as the driving force behind new levels of trust.
3. Adam, M. B., Minyenya-Njuguna, J., Kamiru, W. K., Mbugua, S., Makobu, N. W., & Donelson, A. J. (2020). Implementation research and human-centred design: How theory driven human-centred design can sustain trust in complex health systems, support measurement and drive sustained community health volunteer engagement. Health Policy and Planning, 35(Supplement_2), ii150–ii162. https://doi.org/10.1093/heapol/czaa129
This paper takes the trust framework from theory into the field, showing how human-centered design helped community health volunteers in Kenya lead their own quality improvement cycles using only locally available resources. The approach breaks from the traditional top-down hierarchy by giving communities a stronger voice in setting their own health priorities. Volunteer engagement was sustained not through payment but through trust and shared ownership; this offers a replicable model for other programs struggling with volunteer dropout and community disengagement.
4. Adam, M. B., & Donelson, A. J. (2020).Innovations in Implementation Research [Interview]. In Innovations in Implementation Research in LMICs [Podcast]. Health Policy and Planning, Oxford Academic. https://soundcloud.com/user-347591104/imp-res-in-lmics
In this companion podcast to the Health Policy and Planning supplement on Innovations in Implementation Research in Low- and Middle-Income Countries, we discuss our work on human-centered design and trust building in Kenyan community health systems. The conversation covers how locally driven quality improvement cycles sustained volunteer engagement without external funding, and how the trust framework moved from theory into practice at the community level. The podcast was produced by the journal in collaboration with the Alliance for Health Policy and Systems Research.
5. Renner, H.-J., Makobu, N. W., Mbugua, S., Kamiru, W. K., Oluoch, D., Donelson, A., & Adam, M. B. (2023). “I am now five steps ahead”: How co-design platforms sustain Kenyan community health volunteer engagement. Progress in Community Health Partnerships: Research, Education, and Action, 17(3). https://muse.jhu.edu/pub/1/article/907965
Published in the leading journal for community-based participatory research at Johns Hopkins, this study centers the voices of the community health volunteers themselves. The title comes from a volunteer describing her own growth through the co-design process. The findings show that when partnerships are built on trust and mutual respect, volunteers do not just stay in their roles but actively grow in confidence and capability. This paper offers direct evidence that trust-based partnerships create motivation that lasts beyond typical project and funding cycles.
6. Adam, M. B., Makobu, N. W., Mate, K., Newman, T., & Donelson, A. J. (2025). How does QI work? A trust-building framework in African healthcare: Primary evidence from Kenya and Malawi. BMJ Open Quality, 14(2), e003330. https://doi.org/10.1136/bmjoq-2025-003330
This is the first study to empirically test the trust-building framework in Africa, with primary evidence from two countries, Kenya and Malawi, using Natural Language Processing and generative AI assisted methods of analysis of qualitative data. The paper shows that quality improvement works not just by solving technical problems but by strengthening trust and relationships across frontline health workers, communities, and health system leaders. The collaboration with the Institute for Healthcare Improvement reflects growing recognition that partnerships and relational trust are essential to health systems.
7. Adam, M. B., Donelson, A. J., Mbugua, S., Ndungu, J., Waithera, C., & Chege, J. (2017). Human centered design for rapid results: Improving quality in close to the community health systems in four Kenyan villages. BMC Proceedings, 11(Suppl 6), 8. https://doi.org/10.1186/s12919-017-0074-9
This was the earliest publication from the program and the first to show that a stakeholder-driven, human-centered design approach could produce rapid quality improvement results at the community level in four villages in rural Kenya. Health professionals had long struggled to create systems-level change that actually reached into household interactions, and this paper showed it was possible when volunteer community health workers drive the process. Presented at the 1st International Symposium on Community Health Workers, it laid the practical groundwork for the work that followed: when partnerships across health professionals and communities are built around shared ownership rather than top-down, change can happen quickly with locally available resources.