Use of CHWs in research studies- the PAIL Study

Community health workers (CHWs) have long been recognized for their contributions to broadening access to health care and for improvement of health outcomes in the community setting. A more recent development has been the use of CHWs in research studies. This presentation focuses on the use of CHWs in a promotora- mediated physical activity intervention for immigrant Latinas. Interested women first attended a 20- hour training program which included content in the role and responsibilities of the promotora, Friere's model of popular education, ethical and confidentiality issues, principles and measurement of physical fitness, cross-cultural training, leadership/empowerment strategies, mental health and domestic violence issues and CPR/First Aid training. In addition to delivering the low-impact Latin dance classes, the promotoras were subsequently involved in subject recruitment and community outreach, monitoring adherence to the intervention and problem solving constraints to participation, as well as assisting the PI in adapting questionnaires for use in the research study. Areas of potential concern, including maintaining confidentiality, minimizing threats to validity and rigor of the intervention, identification of specific CHW skill sets, time commitments, building confidence and payment of the promotoras are discussed from the viewpoint of the PI and the promotoras themselves. Preliminary results indicate that promotoras can be highly effective in encouraging adherence to a culturally attuned physical activity intervention.