Grounded Theory Approach to Examine Trust, Innovation, and Resiliency in Health Security Leadership

<p dir="ltr">Background: The COVID-19 pandemic exposed critical weaknesses in health security leadership. Approximately 40 million Americans lost their local public health leaders due to political interference, threats, and untenable working conditions. This exodus revealed a fundamental gap in understanding how effective health security leaders integrate trust, innovation, and resilience as interconnected capabilities rather than isolated competencies.</p><p dir="ltr">Purpose: This constructivist grounded theory study explores how health security leaders conceptualize and integrate trust, innovation, and resilience as leadership capabilities within contemporary crisis environments.</p><p dir="ltr">Methods: The study employs a sequential mixed methods design within a constructivist grounded theory framework. A systematic literature review of 44 studies, using the Critical Appraisal Skills Programme (CASP) assessment (with an average quality score of 84.5%), informed the development of sensitizing concepts. Data collection includes: (1) a comprehensive survey assessing self-reported competency levels and perceived relevance across trust, innovation, and resilience domains; and (2) semi-structured interviews with purposefully selected participants using theoretical sampling. The quantity of interviews will be determined by theoretical saturation across the identified health security competency domains. The survey captures both quantitative competency assessments and qualitative critical incidents, while interviews explore integration processes, tensions, and contextual factors.</p><p dir="ltr">Expected Results: The study aims to develop a substantive theory explaining how health security leaders integrate trust-building, innovation implementation, and resilience development. Anticipated findings include identifying integration patterns and contextual factors that enable or</p><p dir="ltr">xvi</p><p dir="ltr">constrain capability development, as well as strategies for navigating tensions when external pressures create competing demands.</p><p dir="ltr">Implications: This research addresses the critical gap between technical expertise and the human dimensions of health security leadership. Findings will inform leadership development programs, organizational support structures, and policy frameworks better to prepare leaders for complex, politically charged health crises. The resulting theory will provide actionable guidance for developing integrated leadership capabilities, which are essential for addressing 21st-century health security challenges.</p><p dir="ltr">Keywords: health security leadership, trust, innovation, resilience, constructivist grounded theory, mixed methods, crisis leadership</p>

Author dc:creator

• James Baldock (23516926)

• Health security leadership, trust, innovation, resilience, constructivist grounded theory, mixed methods, crisis leadership

Statement dc:rights

• In Copyright

DOI dc:identifier

https://doi.org/10.25417/uic.32192958.v1

OAI identifier oai:identifier

oai:figshare.com:article/32192958