Although community engagement in health service decision making is a cornerstone of effective planning that meets local population needs, there is limited information on how these practices are being undertaken and their level of efficacy from the perspective of community members. This pan-provincial survey research in British Columbia (BC) considered whether or not there is a gap between rural community voices and their inclusion in health planning through an online survey of rural community residents (N = 707). Responses were analyzed based on an amended IAP2 Spectrum framework and revealed that, despite provincial, regional and interest group mandates around community engagement in healthcare planning, there has been an erosion of trust between rural communities and BC's healthcare system. This has led to low levels of confidence in healthcare decision makers and a lack of meaningful participation in decision-making processes. Rebuilding trust is a precursor to addressing this issue in a meaningful way.

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