‘She Got Me Through the Toughest Times': Exploring How Strong Relationships Between Families and Community Health Workers Are Developed in Three Non‐Profits in Waitaha Canterbury, New Zealand

Introduction In a context of eroding trust in health care, understanding high‐quality relationships between health care providers and service users is important. Engaged relationships are linked to greater engagement in therapy, increased access and utilisation of services and improved outcomes. This study aimed to examine how unregulated health workers (kaimahi) develop and sustain high‐quality relationships with whānau (families) in three effective non‐profit providers in Waitaha Canterbury, New Zealand. Methods We used a comparative case study design and qualitative methods to explore how kaimahi build and maintain relationships with whānau in three child and youth health services based in Christchurch, Canterbury. We conducted 28 semi‐structured interviews with kaimahi, supervisors, and whānau, and analysed the transcripts using reflexive thematic analysis. Findings Data suggested that relationships were developed and strengthened in these six ways: (1) when kaimahi responded to a family's immediate needs, (2) when kaimahi engaged with long‐term social determinants of health, (3) when kaimahi shared their own life experiences, (4) when families and kaimahi had a long duration of engagement, (5) when kaimahi were supported by peer relationships and professional development, and (6) when whānau perceived that kaimahi and the broader organisation practised their values and showed cultural safety. We synthesised these findings into a three‐circle framework that summarised the key factors that support the development of trusting relationships. Conclusions Trusting relationships between kaimahi and whānau are central to improving health equity. Our findings underscore that culturally grounded, relationship‐focused practices that are supported by responsive organisations and flexible contracts can create a virtuous cycle of trust and engagement, which support better health outcomes.