AbstractIntroductionNeighborhoods are often overlooked as a determinant of health. Among recent research, the focus on “place‐based effects,” due to prolonged residential environmental exposure, has been of particular interest. These studies' purpose is to identify and examine how a healthy neighborhood is intentionally created to describe a transferable process‐driven theory.MethodA classic grounded theory approach was used in these studies. Data sources include individual in‐depth interviews, historical documents, and a member‐checking focus group, collected over 3‐years.ResultsAnalysis generated the Four Stages of Neighborhood Trust Model, which is nested within the context of perceived neighborhood safety. The theory outlines a social process of four stages of neighborhood trust: (a) rules‐based agreements, (b) shared values, (c) cooperation, and (d) neighborhood belonging.ConclusionsWe present the development of a process‐driven theory that may be useful for public health nurses as they engage neighborhoods in health promotion activities. The stage of trust development will aid the nurse in identifying what is needed to move to the next stage in a healthy neighborhood process.