Community Health Worker-driven participatory action research method to improve behavioral health services for farm workers in a primary care setting

Farmworkers living in U.S.-Border communities experience numerous stressors in their daily lives that place them at risk for behavioral health problems, particularly anxiety and depression.  In this paper, we describe a participatory action research (PAR) approach in which Community Health Workers (CHWs) use focus groups to engage the patient population in discussing mental health issues and identifying preferences for care within a federally qualified health center.  Community Health Workers are well-suited to engage community members in participatory action research because they identify themselves as change agents who seek not only to benefit the health of community members, but also to advocate for their rights.  In our study, the CHWs were trusted members of the community who participated in the articulation of research questions, development and implementation of protocols, participant recruitment and data collection. CHWs encouraged focus group members to represent their community in the co-construction of knowledge regarding perceptions of behavioral health and priorities for care.  This research illustrates that CHWs, as representatives for patients’ needs and a bridge between the health care system and communities, can play a vital role as intermediate actors in generating patient participation in PAR research. In this presentation, CHWs reflect on their capacity to generate meaningful patient participation in PAR projects, or more specifically to elevate focus groups from a conventional qualitative research tool designed to gather input from marginalized populations, to an authentic form of community engagement.