# Hearts in Action: supporting precarious workers in Arizona, a community-based participatory research approach

## TL;DR

This paper presents a community-driven program in Arizona to support Latine immigrant workers in precarious jobs by combining health education with advocacy for better working conditions.

## Contribution

The study introduces a novel CBPR approach integrating health and workers' rights advocacy led by bilingual community health workers.

## Key findings

- Community health workers played a key role in building trust and empowering workers.
- The intervention was feasible and effective in promoting workplace wellbeing and advocacy.
- Partnerships with legal and academic experts enhanced the program's impact.

## Abstract

Precarious low-wage work, marked by instability, limited protections, and high occupational risk, disproportionately affects Latine immigrant workers, contributing to chronic stress, poor health, and cardiovascular risk. In Arizona, sectors such as agriculture, hospitality, and domestic services expose workers to compounded work- and non-work-related stressors, amplified by right-to-work laws and anti-immigrant policies.

Hearts in Action, developed through the community-based participatory research (CBPR) initiative Aquí Entre Nos, is a community-driven intervention designed to address work as a social determinant of health and empower workers to advocate for healthy workplaces. Six bilingual and bicultural community health workers (CHWs) co-led four group-based sessions with 50 Latine precarious workers, integrating a workers’ rights advocacy toolkit with an adapted evidence-based cardiovascular health program.

CHWs guided recruitment, retention, facilitation, and participatory data collection, ensuring cultural relevance and creating safe spaces for candid discussion. Strategic partnerships with community and academic partners and legal experts further strengthened intervention design and delivery. Pre-post surveys and semi-structured group reflections assessed changes in health outcomes, occupational self-efficacy, and perceptions about workplace wellbeing and advocacy for change in the labor conditions.

Findings underscore CHWs’ critical role in fostering trust, amplifying community voices, and supporting participant empowerment. Hearts in Action offers evidence of feasibility for a CHW-led and worker-centered approach to improve workplace conditions and worker health, offering a model for integrating community perspectives, legal expertise, and public health strategies to promote wellbeing, advocacy, and structural change in the context of precarious labor.