The goal of this study is to generate new information for safety net hospital leaders seeking to build and maintain trust among vulnerable populations. In the first phase of the study, the researchers will conduct a consumer panel survey of up to 1,000 Medicaid, Medicare, and uninsured patients, approximating the vulnerable populations served by safety net hospitals in the U.S. The purpose of the survey is to identify factors that affect this population’s trust in hospitals at the organization level. In the study’s second phase, the researchers will select a diverse set of safety net hospitals at which to conduct site visits involving interviews with hospital leadership, focus groups with patients, and review of relevant hospital policies and practices. The researchers will then use standard qualitative data analysis techniques to analyze data from the site visits for themes and patterns. Deliverables will include a project work plan, annual and final narrative reports, and financial reports. The grantee will also produce a checklist and detailed guide for building trust in safety net hospitals and present findings at conferences, professional meetings, and to other stakeholder audiences as appropriate as part of the deliverables for this grant.