Empowering promotoras through community-based participatory research in Latinx and Indigenous Mexican communities during the COVID-19 pandemic

TL;DR

This study shows how involving community health workers in research helps build trust and improve health outcomes in Latinx and Indigenous Mexican communities during the pandemic.

Contribution

The paper introduces a novel model of using promotoras as co-researchers to address health inequities in marginalized communities.

Findings

Mistrust of institutions in the U.S. hindered pandemic response among participants.

Promotoras effectively bridged communities and institutions through dual roles in health and research.

Engaging promotoras as co-researchers strengthened institutional trust and community participation.

Abstract

This study describes an innovative community-based participatory research model that engages community health workers/promotoras as research partners to address health inequities among Latinx and Indigenous Mexican immigrant communities during the COVID-19 pandemic.

Using ethnographic and qualitative research methods, we collaborated with promotoras trained in qualitative data collection and analysis to conduct seven focus groups (six in Spanish, one in Purépecha) with 55 participants in a rural desert region of Inland Southern California. Rapid analytic techniques were applied to identify emergent themes across data sources.

Findings revealed deep-seated mistrust of institutions in the United States, including government, healthcare, and public health, fueling fear and suspicion around COVID-19 testing and vaccination. Promotoras bridged communities and institutions through their dual roles in public health response (contact tracing, testing and vaccination clinics, and health education) and participatory research (data collection, analysis, dissemination).

This capacity-building approach positioned promotoras as trusted leaders such as science and public health education, demonstrating that engaging promotoras as co-researchers can strengthen institutional trust, enhance community participation, and advance health equity.

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