Community-Led Transformation in Practice: A Framework for Trust-Driven Community-Academic Partnerships to Advance Public Health.

Community-academic partnerships are increasingly recognized as essential for advancing equitable public health outcomes. Yet many partnerships struggle to move beyond short-term, project-based collaboration toward sustained, trust-based engagement with communities. This commentary draws on the experience of the University of California San Diego Center for Community Health (CCH) and its long-standing partnerships with immigrant, refugee, and other underserved communities in San Diego County. Over more than two decades of practice, CCH and its community partners developed the Community-Led Transformation (CLT) approach to guide authentic community-academic collaboration. We describe three interdependent pillars of CLT: valuing community expertise, fostering trust-based partnerships, and ensuring fair access to resources and power-sharing. Examples from CCH programs, coalitions, and research collaborations illustrate how these principles are operationalized in practice. We also reflect on structural challenges within academic institutions, including funding instability, administrative barriers, and limitations in partnership infrastructure, and strategies used to navigate these constraints while sustaining community partnerships. We provide specific recommendations for academic partners, community partners, and funders to facilitate community-academic partnerships via increased capacity building, infrastructural supports, and greater relationship and trust building. The CLT framework has therefore been a success within CCH, and can provide practical insights for a variety of partners and institutions seeking to build authentic, durable partnerships that meaningfully advance public health and health equity.