Trust-Building Across Levels of Care: A Conceptual Framework for Nursing Practice.

This paper adapts Anderson and Griffith's Trust-Building Process in Healthcare Organizations Framework to a nurse-led framework, illustrating how trust influences engagement in preventive health among structurally marginalized populations. Using cervical cancer screening among Appalachian women as an exemplar, the framework conceptualizes trust-building as a multilevel process operating at intrapersonal, interpersonal, and institutional levels. By situating trust as both a relational and structural construct, this adaptation underscores nurses' essential role in cultivating trustworthiness within healthcare systems and advancing equity. The framework offers a conceptual pathway for developing trustworthy systems of care that foster sustained preventive health engagement.