{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:51:57Z","timestamp":1788911517043,"version":"build-2803163510"},"reference-count":10,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T00:00:00Z","timestamp":1780790400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["U54GM104942"],"award-info":[{"award-number":["U54GM104942"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Promotion Practice"],"abstract":"<jats:p>Medical mistrust in rural Appalachia, particularly in West Virginia, originates from a long history of institutional betrayal. Over time, experiences fostered intergenerational skepticism, embedding wariness of health care and research into Appalachian cultural memory. The distrust from structural neglect\u2014hospital closures, provider shortages, and underinvestment\u2014has compounded this mistrust, leaving communities hesitant to engage with outside institutions. Previous initiatives have aimed to build trust through shared decision-making and cultural awareness, but they do not answer all the challenges in Appalachia. To bridge this gap, the West Virginia Clinical &amp; Translational Science Institute (WVCTSI) developed the Ambassadors for Community Health Research (ACHR) program. Adapted from Colorado\u2019s Immersion Training, the ACHR is a year-long initiative that trains residents as liaisons between their communities and research teams. Ambassadors receive structured training in research ethics and health communication, not as recruiters but as relationship builders who facilitate two-way exchanges of concerns, insights, and evidence. The ACHR program transforms research participation from a transactional encounter into a collaborative partnership. This sustained, culturally authentic model offers a roadmap for rebuilding trust and enhancing the relevance, ethics, and impact of clinical research in rural or underserved regions.<\/jats:p>","DOI":"10.1177\/15248399261454695","type":"journal-article","created":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T07:14:00Z","timestamp":1780816440000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Connecting Rural Appalachia to Clinical Research: The Ambassadors for Community Health Research Program as a Model for Trust Building"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1264-3751","authenticated-orcid":false,"given":"Chloe","family":"Hatfield","sequence":"first","affiliation":[{"name":"West Virginia University School of Public Health, Morgantown, WV, USA"},{"name":"University of Cincinnati, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather L.","family":"Henderson","sequence":"additional","affiliation":[{"name":"Wichita State University, Wichita, KS, USA"},{"name":"West Virginia Clinical and Translational Science Institute, Morgantown, WV, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bree","family":"Gustke","sequence":"additional","affiliation":[{"name":"West Virginia Clinical and Translational Science Institute, Morgantown, WV, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Mason","sequence":"additional","affiliation":[{"name":"West Virginia Clinical and Translational Science Institute, Morgantown, WV, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Brianna","family":"Sheppard","sequence":"additional","affiliation":[{"name":"West Virginia University School of Public Health, Morgantown, WV, USA"},{"name":"West Virginia Clinical and Translational Science Institute, Morgantown, WV, USA"},{"name":"West Virginia University Institute for Community and Rural Health, Morgantown, WV, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephenie","family":"Kennedy-Rea","sequence":"additional","affiliation":[{"name":"West Virginia Clinical and Translational Science Institute, Morgantown, WV, USA"},{"name":"West Virginia University Cancer Institute, Morgantown, WV,\rUSA"},{"name":"West Virginia University School of Medicine, Morgantown,\rWV, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,7]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"crossref","unstructured":"Alspaugh A. Swan L. E. T. Auerbach S. L. Bartmess M. Agbemenu K. Ely G. E. (2023). Mistreatment in health care among women in Appalachia. Culture Health & Sexuality 25(12) 1690\u20131706. https:\/\/doi.org\/10.1080\/13691058.2023.2176547","DOI":"10.1080\/13691058.2023.2176547"},{"key":"e_1_3_2_3_1","doi-asserted-by":"crossref","unstructured":"Derickson A. (1989). Part of the yellow dog: U.S. coal miners\u2019 opposition to the company doctor system 1936\u20131946. International Journal of Health Services 19(4) 709\u2013720. https:\/\/doi.org\/10.2190\/M7RW-U2R0-KFL2-NELY","DOI":"10.2190\/M7RW-U2R0-KFL2-NELY"},{"key":"e_1_3_2_4_1","doi-asserted-by":"crossref","unstructured":"Friedman L. S. Rose D. Hart J. E. Hong O. Alif S. Laney A. S. (2021). Association between financial conflicts of interest and outcomes of black lung claims filed to the Federal Black Lung Program. 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The Journal of Rural Health 30(2) 214\u2013220. https:\/\/doi.org\/10.1111\/jrh.12046","DOI":"10.1111\/jrh.12046"},{"key":"e_1_3_2_10_1","doi-asserted-by":"crossref","unstructured":"Pratt B. Cheah P. Y. Marsh V. (2020). Solidarity and community engagement in global health research. American Journal of Bioethics 20(5) 43\u201356. https:\/\/doi.org\/10.1080\/15265161.2020.1745930","DOI":"10.1080\/15265161.2020.1745930"},{"key":"e_1_3_2_11_1","doi-asserted-by":"crossref","unstructured":"Thomas M. K. Amstutz C. Orr-Roderick D. Horter J. Holben D. H. (2023). Medical mistrust among food insecure individuals in Appalachia. 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