Background: Promotora/s de Salud (or Community Health Workers - CHWs) are a promising workforce option for overcoming the bilingual mental health workforce shortage that contributes to inequitable access to effective services for Latino individuals in the United States. Given the current Latino mental health crisis in which existing acculturative stressors have been exacerbated by COVID, understanding the most effective roles for CHWs to play in mental health delivery could help to overcome these shortages. More evidence is needed to inform the most impactful roles that Spanish Speaking Community Mental Health Workers (SSCMHWs) can play in mental health prevention/treatment efforts in the United States.
Proposed Solution to the Problem: By building the capacity of Latino patient/community/SSCMHW stakeholder voices to define Latino mental health outcomes sought; barriers to participation in patient-centered outcomes research/comparative clinical effectiveness research (PCOR/CER); and prioritization of screenings/interventions with the potential for effective delivery by SSCMHWs, and therefore priorities for further PCOR/CER investigation the project team will contribute to a Latino mental health PCOR/CER agenda that will improve Latino community stakeholder participation in PCOR/CER in the future and therefore Latino mental health outcomes.
Aim 1: Develop a sustainable Learning Collaborative (LC) of the stakeholders described above.
Aim 2: The LC will collaboratively identify mental health outcomes desired by the Latino community and barriers to Latino patient/community members participation in PCOR/CER.
Aim 3: The LC will prioritize potential screenings/interventions for effective delivery by Latino CHWs as potential topics for PCOR/CER, resulting in a prioritized set of PCOR/CER topics and a roadmap to move the highest priority topic forward.
Aim 4: Establish an ongoing Research Advisory Council in order to continue to build the evidence for the most impactful role of SSCMHWs in Latino community mental health.
Aim 1 Activities: Recruit the Learning Collaborative (LC) members and convene every two months via Zoom. Use El Futuro’s PCOR Toolkit for Community Behavioral Health Organizations Serving Latinos alongside “Module 1: Developing Research Questions” from “PCORI’s Research Fundamentals” as guidance to train LC stakeholders on PCOR/CER. Other modules will also be considered. Each LC session will consist of a didactical teaching component, discussion, questions/answers and targeted feedback.
Aim 2 Activities: Use participatory design methodology to craft the facilitation of the sessions.
Aim 3 Activities: Identify/cluster themes in participant feedback and capture specific, SSCMHW- and patient-endorsed terminology, which will inform dissemination strategies. Use forced ranking activity to prioritize recommended PCOR/CER topics focused on boosting cultural resilience factors and other interventions / screenings appropriate for delivery by SSCMHWs. Train LC stakeholders in clustering / coding for ongoing identification of community concerns / research topics, and how to bring those proposal ideas to community organization partners.
Aim 4 Activities: Recruit members to the enhanced Research Advisory Council. Develop an initial roadmap for bringing the highest priority research topic forward.
Projected Outcomes and Outputs:
Short-term outcomes during the project period include:
- A prioritized list of community-endorsed research topics focused on appropriate interventions/screenings for delivery by SSCMHWs.
- A Research Advisory Council to sustain Latino stakeholder-engaged PCOR/CER in the future.
- A roadmap for moving the highest-priority identified research topic forward.
Medium-term outcomes (0-2 years post-project period) include:
- SSCMHWs and Latino parents/youth will become community advocates for help-seeking and PCOR/CER engagement; patient-centered research topics will be funded and implemented.
Long-term outcomes (3+ years post-project period) include:
- The evidence base for appropriate mental health screenings/interventions for SSCMHW delivery will grow.
Patient and Stakeholder Engagement Plan: The project concept was developed through prior work with SSCMHWs, Latino parents/adolescents and partnering community agencies. Stakeholders will be recruited from existing networks and partnerships and will be compensated fairly for their time on the project. The project team will use co-creation/participatory design techniques to successfully engage stakeholder voices in all LC activities. Stakeholders will directly identify/prioritize research topics, develop the roadmap for moving the top topic forward and populate the ongoing Research Advisory Council. They will also co-create dissemination materials and share them in the community.
Project Collaborators: In addition to the SSCMHW and Latino parent/adolescent collaborators, additional members of the LC will include:
- Latino-serving community organization partner: Spanish Language Acquisition.
- Latino-serving community organization partner: Communities in Schools - Chatham County.
- Research partner: Psychology Department at University of North Carolina at Greensboro, whose head is an El Futuro board member.