Participant engagement in community based participatory research among Latino immigrant men

From the Ornelas Group and Torres Group

Based on previous literature, Latino immigrant men have poorer physical and mental health compared to other race counterparts. Latino immigrant men have been consistently underrepresented in research focused on the development of public health interventions.  Similar to African Americans, Latino immigrant men have been exploited in past research studies.  This gives rise to mistrust of health and research institutions among Latino immigrants. The current administration has advocated and enforced antiimmigrant policies; this act increases division among researchers and the Latino immigrant community and makes it difficult to establish trust.  Various approaches in Community Based Participatory Research (CBPR) aim to increase participation in underserved populations with objectives of reducing health disparities. 

CBPR is a collective approach between the researchers and community members’ perspectives, skills, knowledge, and expertise to address health issues.  Positive effects of CBPR approaches include equitable and culturally appropriate research protocols created by honest communications and cooperation with communities. It is important to integrate CBRP approaches in underserved populations; these principles can enhance knowledge sharing, decrease fear and discomfort with health and research institutions, and increase culturally relevant interventions. This will ultimately increase participation in underserved populations and optimistically improve health outcomes. There are four CBPR domains that help shape the collective research process – contexts, partnership process, intervention and research, and outcomes.  In this study, the Dr. Ornelas’ research team from the Division of Public Health Sciences, described how specific domains in CBPR conceptual model influenced participant engagement in the Vida PURA Study. This study was published in the Health Education Research.

Vida PURA is a culturally adapted evidence-based intervention; screening and a brief intervention was provided to decrease unhealthy alcohol use among Latino immigrant men in a piloted randomized trial.   Twenty percent of the participants form Vida PURA were recruited for this study (n=25).  Interviews were conducted in Spanish for 30-45 minutes in a private room at Casa Latina. Also, interviews were digitally recorded. The study’s participants sought day labor employment opportunities via Casa Latina. Majority of the participants were from Mexico, lived in the US an average of 19 years, had a mean age of 48, and earned less than a high school education. 

Graphical representation of Domains of participant engagement from the VIDA PURA study
Domains of participant engagement from the VIDA PURA study Image from Dr. Ornelas

The participants were asked about their motives to participate, interactions with research staff, and ways to maintain contact in studies and barriers to participation.  After the data was transcribed verbatim from the audio recordings, it was analyzed using template analysis.  Template analysis uses a priori codes and emergent identification codes to identify prominent themes.  The research team decided upon the final themes. 

The final themes consisted of four themes and three subthemes related to the partnership process. The first theme -participation was facilitated by the relevance of the study topic and a motivation to improve their life and help their community.  The Latino immigrant men were more willing to participate if more information about the study was revealed. Also, because the men struggled with alcohol abuse, they were more likely to seek help for their addiction. The second theme - personal relationships enabled access to resources and facilitated participation and engagement.  Once the men trusted the research staff, they were more likely to remain in the intervention. They felt respected and cared for by the research staff; the staff also assisted the participants with immigration services, health insurance, housing, and other residential support. The third theme - logistical practicalities and financial incentives motivated participation. Because the interview was conducted at a convenient time and place, the men were more likely to participate. Also, the incentive aided the men who were in-between jobs. The fourth theme, related to intervention and research domain, - study design and requirements sometimes inhibited participation and engagement.  Some of the questions were difficult to answer, burdensome to remember, and repetitive. 

The senior author, Dr. India Ornelas explains the necessity of this research, “This work highlights the importance of building trusting and collaborative relationships between researchers, community organizations, and research participants in order to engage Latino communities in health promotion research. The findings have also helped confirm – for our research team - the importance of involving community members in all stages of the research process.  Community engagement in research can lead to the design of more effective health promotion interventions and ultimately help reduce racial/ethnic health disparities.”

The first author, Vanessa Torres summarized the article’s findings “Our findings help us move away from this notion that certain populations are “hard-to-reach” and highlights the importance of listening to community members and adapting research protocols to make it easy for them to participate. Our study findings can help other researchers understand how community-based research partnerships inform health promotion interventions to better address health inequities in underrepresented communities, like Latino immigrants.  Future community-based research should consider whether the research topic is relevant to the participants that are being recruited and how to can make it easy for participants to engage.”

This research was supported by the National Institute of Alcohol Abuse and Alcoholism, the National Cancer Institute, the Latino Scholars Graduate School Fellowship, the Graduate Opportunities, and Minority Achievement Program Dissertation Fellowship.

Fred Hutch/UW Cancer Consortium members Rachel M. Ceballos and India J. Ornelas contributed to this work.

Torres VN, Williams EC, Ceballos RM, Donovan DM, Duran B, Ornelas IJ. Participant engagement in a community based participatory research study to reduce alcohol use among Latino immigrant men. Health Education Research. 2020 Oct 7.