Case 2

Involving citizens in health research

Reference: St. John, J. A. et al (2013). Empowerment of Promotoras as Promotora-Researchers in the Comidas Saludables & Gente Sana en las Colonias del Sur de Tejas (Healthy Food and Healthy People in South Texas Colonias) Program. Journal of Primary Prevention: 34 (1-2): 41-57.

 

Relevance to CAR?

This case is relevant to CAR because it …

  • shares in detail the description of seven community-based participatory research projects taking place over five years to help prevent and manage obesity and diet-related chronic diseases
  • describes the tailor-made capacity building and empowerment process of 6 community health representatives (Promotoras), who participated in the seven projects
  • illustrates the iterative process cycle–showing key features of each project, research skills needed for each project, observations or outcomes connecting projects to each other (Figure 1)
  • gives specific insight into how the promotoras-researchers contributed to the life cycle of each project (Table 2) and to the action and outcomes (table 3 &4) as well as sharing a “debriefing interview guide” (table 5)

Short case summary: ‘Colonia residents’ refers to a community of Hispanic and Latino people living in a geographically isolated area at the Texas-Mexican border. The community suffer numerous social, economic and health disparities and they have some of the highest rates of obesity and diet-related chronic diseases. Health workers struggle to implement health intervention and to reach the community. To help bridge the gab 6 experienced female health workers from the community was chosen to provide outreach and education and at the same time actively engage in conducting research in their community. The end result was a mutually beneficial collaboration where the promotoras reported great personal empowerment and researchers gained new insight and knowledge to food security and nutrition, issues and solutions in the colonial community.

Summary reflection: The strengths we see in the case is due to;

  • Health representatives helping to bridge the gab between researchers and colonial residence near the Texas-Mexican border  
  • Clear illustrations of iterative on-going project cycles and the long-term commitment between Promotoras and researchers
  • Tailor-made capacity building to fit the Promotoras and the seven different projects
  • Active involvement of Promotoras in all phases of the project cycle and how their formative feedback informed new projects

The case describes how Promotoras had to manage a dual role as both co-researchers as well as community developers. More insights on the balance of this role of being both developer and researcher would be beneficial as well as the impact the capacity building have had in detail. We believe this case provides great inspiration on how to create iterative project cycles informed by community members and creating on-going formative feedback to help bridge the gab between researchers and a specific community.