Community-engaged Research with Rural Latino Adolescents: Design and Implementation Strategies to Study the Social Determinants of Health

Abstract

The health of adolescents, perhaps more than in any other period of their life, is shaped by the social determinants of health (SDH). The constellation of SDH that disadvantages a specific group’s health may also make members of that population unable or unwilling to engage in health research. To build a comprehensive body of knowledge about how SDH operate within a specific social context, researchers must design studies that take into account how various vulnerabilities and oppressions may affect people’s experiences of being recruited, interviewed and retained in a study. In 2014, we initiated a prospective cohort study with Latino youth living in the agricultural area of Salinas, California. We began this study with the understanding that it was imperative to develop methodological strategies that actively addressed potential challenges in ways that were culturally responsive, community engaged and inclusive. In this article, we describe our approach to developing best practices in four key areas: 1) building community partnerships and engagement; 2) consideration of staffing and staff support; 3) engaging youth’s perspectives; and 4) developing culturally appropriate research protocols. In our sample of 599 participants, nearly all youth identify as Latinx (94 per cent), half (49 per cent) have at least one parent employed as a farmworker, 60 per cent reside in crowded housing conditions, and 42 per cent have mothers who did not complete high school. Given these multiple vulnerabilities, we view a robust number of youth expressing interest in study participation, the willingness of their parents to permit their children to be enrolled, and the achievement of an ambitious sample target as evidence that our efforts to undertake best practices in community-engaged and inclusive research were well received.

Engaging Latino Families About COVID-19 Vaccines: A Qualitative Study Conducted in Oregon, USA

“…From July 2020 through January 2021, we conducted community-engaged research ( Comfort et al, 2018 ) to address social isolation among Latino youth participating in 4-H guided by a 45-person community advisory board (CAB) of Latino youth, parents, and health providers/educators. As part of this study, we conducted multimethod telephone interviews with Latino youth and parents, which included questions about their willingness to receive COVID-19 vaccines.…”

Family and School Connectedness Associated with Lower Depression among Latinx Early Adolescents in an Agricultural County

“…Between November 2015 and March 2017, our team enrolled 599 youth (approximately 150 per school), representing about one‐third of the total eighth‐grade population of approximately 1,800 youth in the school district. Bilingual research assistants recruited participants using strategies developed in partnership with leadership at each school, with the study’s Community Advisory Board, and through our formative research (Comfort et al, 2018). These included approaching youth during lunchtime and through afterschool programs, classroom presentations, and presenting during school assemblies and meetings of established parent groups (“Cafecitos”).…”

“…A Crecer: The Salinas Teen Health Study is a prospective cohort study designed to examine social and structural influences on the health and well-being of youth in Salinas, California, a small urban center in California's agricultural central coast. The study was initiated in collaboration with community co-investigators to investigate the intersection of community violence and reproductive health among adolescents; however, our formative interviews with community advisors, parent groups, and educators highlighted the community's concerns about adolescent mental health (Comfort et al, 2018) and stressors tied to community violence and other sources of structural disadvantage. Thus, this examination, motivated by community priorities for adolescent health needs, focuses on identifying promising directions for addressing mental health in early adolescence (Raymond-Flesch, Auerswald, McGlone, Comfort & Minnis, 2017).…”

Relationship Factors Associated With Early Adolescent Dating Violence Victimization and Perpetration Among Latinx Youth in an Agricultural Community

“…The majority of youth are children of immigrants and have at least one family member engaged in low-paying seasonal agricultural work (Raymond-Flesch et al, 2017). Youth in Salinas are disproportionally affected by pervasive poverty, exposure to community violence, adolescent pregnancy, and social determinants that adversely affect health and well-being (Comfort et al, 2018; Monterey County, 2017; Raffaelli et al, 2016).…”

“…A Crecer study is a prospective cohort study utilizing a community sample of youth, the design and implementation of which was informed by local youth and parents, a community advisory board, and the local health department, described by Comfort et al (2018). In-person study visits took place in community-based locations close to participants' schools every six months over two years.…”