Methods of Engagement: Integrating Community Health Workers as Guides in Community-Based Research

The Health Education Awareness and Research Team (HEART) is a university and community-based partnership funded by the National Institutes of Health National Center on Minority Health and Health Disparities. The HEART research pilot assessed the outcomes of a family-centered Community Health Worker/Promotor (CHW/P) intervention based on the Salud Para Su Corazon curriculum. In refining HEART's approach to the randomized clinical trial (RCT), research partners, including CHW/Ps, worked together to identify methods to integrate CHWs/Ps' expertise in their own practice to enhance both the proposed intervention and research design. Several methods were undertaken to engage CHW/Ps in the process. A key approach was a HEART-sponsored Promotor Forum held in Spanish where El Paso area CHW/Ps were invited to present to research partners on their most favored approaches to their work. They were also asked to give feedback on the proposed RCT design itself after active teaching on RCT methods. Another approach undertaken by HEART to integrate CHW/P guidance was to identify area CHW/Ps as consultants who then assisted in the refinement of a cost-benefit analysis plan in order to assure that CHW/P program costs/inputs and benefits/outputs would be fully captured in the analysis. CHW/Ps leading the pilot intervention were also asked to assess the appropriateness of curriculum adaptations undertaken by HEART to increase family involvement such as Photovoice method. The HEART pilot has provided an opportunity to learn about integrating CHW/P guidance and motivations in community-based research and it has illuminated challenges to full integration; this paper will highlight those learnings.