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A model frequently used to implement community‐based research involves engaging local community health workers who are trusted members of the community and familiar with local customs, language, and culture. In Spanish‐speaking communities, the CHWs are also known as promotores de salud (“health promoters”). Depending on the study design and nature of the research, promotores facilitate research through community outreach, instrument design, participant recruitment, intervention delivery, data collection, and other research‐related tasks. In 2000, the National Institutes of Health published a regulation requiring training of “key personnel” named on NIH‐supported research involving human subjects. Regardless of whether promotores are technically designated as key personnel on a particular study, they may benefit from training in research ethics. Unfortunately, the educational programs designed for academic researchers in response to the NIH mandate were poorly aligned with the needs of promotores and not suited for learning about human research ethics applied to the community health setting. For example, many promotores in our California‐Mexico border region are monolingual Spanish speakers who have no formal academic research training. Therefore, we set out to develop a training alternative appropriate to our local CHWs. In this essay, we provide overviews of the relevant instructional design principles and our formative research process, including examples of key findings.

Objective Colorectal cancer (CRC) is the third leading cause of cancer death for Latino men and women; and Latinos are more likely to be diagnosed at a later stage, which is most likely due to underutilization of CRC preventive screening. The purpose of this study was to determine whether a brief, clinic-based intervention by a community health advisor (CHA) would increase CRC knowledge compared with traditional educational methodologies (eg, use of print materials). Methods Latino adults 50 years and older attending a San Diego community health center were recruited while waiting for their primary care provider routine visit and were randomly assigned to receive 1 of 3 CRC educational interventions: community health advisor (CHA) plus CRC educational brochure (CHA intervention group), CRC educational brochure (minimal intervention group), or 5-a-day nutrition brochure (usual care). CRC knowledge was assessed before and after the primary care provider visit for 130 participants. Results Results demonstrate that the CRC educational brochure (minimal intervention group) was effective at increasing CRC screening knowledge as compared to usual care. Conclusions Future research is needed to explore innovative health education strategies that improve knowledge and subsequent CRC screening behaviors among low-income, low-literacy, unacculturated Latinos.

We aimed to examine the retention of Hispanics/Latinos participating in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a prospective cohort study of 16,415 adults in 4 US cities who were enrolled between 2008 and 2011. We summarized retention strategies and examined contact, response, and participation rates over 5 years of annual follow-up interviews. We then evaluated motivations for participation and satisfaction with retention efforts among participants who completed a second in-person interview approximately 6 years after their baseline interview. Finally, we conducted logistic regression analyses estimating associations of demographic, health, and interview characteristics at study visit 1 (baseline) with participation, high motivation, and high satisfaction at visit 2. Across 5 years, the HCHS/SOL maintained contact, response, and participation rates over 80%. The most difficult Hispanic/Latino populations to retain included young, single, US-born males with less than a high school education. At visit 2, we found high rates of motivation and satisfaction. HCHS/SOL participants primarily sought to help their community and learn more about their health. High rates of retention of Hispanics/Latinos can be facilitated through the employment of bilingual/bicultural staff and the development of culturally tailored retention materials.

Objective: This study examined perceived satisfaction among Hispanic/Latino individuals who participated in a baseline examination for the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a large cohort study of 16,415 adults living in four selected communities.Method: An estimated 22% (n= 3,584) of participants completed a questionnaire regarding satisfaction with staff attention, the overall experience during the study examination, and the influence of the informed consent digital video disc (DVD). Results:The majority of participants who completed the questionnaire expressed overall satisfaction with the study. Most participants reported that staff were friendly, courteous and respectful and study test procedures were clearly explained. Participants who preferred to complete the interview in Spanish felt that the informed consent DVD positively influenced their ability to make an informed decision to enroll in the study. Participants who preferred to complete the interview in English tended to report that the baseline examination was longer than expected compared with participants who completed the interview in Spanish. Conclusion:Results demonstrate that culturally and linguistically trained staff and the use of the study's informed consent DVD were effective in explaining study procedures and positively influenced decisions to participate in the HCHS/SOL study. These results can inform recruitment and enrollment strategies for future participation of minority groups into longitudinal cohort studies.

Background: There is limited prior research on the association of metabolic risk factors between youth and their caregivers within Latino families despite the high burden of obesity and the young age of onset of metabolic disorders. Hypothesis: Obesity and metabolic risk factors are correlated between youth and their caregivers. Methods: SOL Youth is a cross-sectional ancillary study of boys and girls ages 8 to 16 years old whose parents/caregivers participated in the HCHS/SOL. We studied 728 boys, 738 girls and 1,020 caregivers (86% women) who completed a clinical examination. Body mass index (BMI), waist circumference, systolic and diastolic blood pressure, fasting glucose, hemoglobin A1c (HbA1c) and lipids (total-, HDL-, and LDL- cholesterol and triglycerides) were measured. Obesity was determined as > 95 th age- and gender- specific percentile of BMI in youth and BMI > 30 kg/m 2 in adults. We used weighted logistic regression to determine the odds of obesity in youth when caregivers were obese and we tested the association of each individual risk factor in caregivers with the same risk factor among youth using weighted linear regression. All models were adjusted for field center, youth age and ancestry and adult age, gender and education levels. Results: On average, boys and girls were 12 years old and caregivers were 41 years old. When caregivers were obese (vs. normal weight), girls and boys were 1.5 (95% CI: 0.92, 2.43) and 3.9 (95% CI: 2.44, 6.29) times more likely to be obese, respectively. Among girls, measures of adiposity, HbA1c, SBP and lipids (except triglycerides) were each positively associated with those same measures among caregivers (Table). Among boys, all measures except glucose and HbA1c were positively associated with caregiver measures. Conclusions: There were notable differences by gender in the odds of obesity among youth when a caregiver was also obese. Strong correlations between caregiver and youth metabolic risk factors underscore the need for family based interventions.

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