Prioritizing Competencies for "Research" Promotores and Community Health Workers.

Background. The community health worker (CHW) model is utilized globally to promote health and reduce health disparities in hard-to-reach and underserved communities. The model is deemed successful due to involvement of these natural helpers who are familiar with the local customs, language, and traditions. "Research" CHWs (also known as promotores) serve as cultural mediators between their community and academic researchers and are increasingly involved in the design and implementation of research; yet few of these individuals have received formal training in research methods or ethics. This study identified requisite skills and knowledge needed by research CHWs. Method. Investigators who utilized the CHW/promotor model were recruited to complete a survey and participate in one of four focus group sessions. Participants identified (1) research roles, (2) training received, (3) research competencies, (4) training barriers and facilitators, and (5) assessment preferences. Results. Participants (n = 20) completed a survey with 19 also participating in a focus group session. All participants involved CHWs in research implementation, with nearly half involving CHWs in the study design and/or dissemination of findings phases. Critical thinking skills and application of ethical principles (e.g., demonstrating respect) were prioritized over knowledge of research infrastructure (e.g., institutional review board/ethics review process). Research ethics training designed for academic researchers was deemed inappropriate because sophisticated terminology and web-based delivery were perceived as an access barrier. Self-assessment and contextualized scenarios were recommended to assess critical thinking. Conclusions. Researchers using the CHW model should provide relevant and accessible research competency training.

How can we help African American substance users stop smoking? client and agency perspectives.

Research is needed to better understand barriers to smoking cessation and sustained abstinence among racial/ethnic minority polydrug users. We conducted community dialogue groups involving 49 clients in substance use treatment programs with predominantly ethnic minority clientele and individual dialogues/interviews with seven program providers (stakeholders). Most clients were African American, under 40 years old, women, current smokers, and high school graduates. Smoking cessation services in these programs were considered inadequate and community programs insufficiently culturally tailored and economically and geographically inaccessible. Participants discussed individual "willpower" and choice; agency tobacco-related programs and policies; the relationships between smoking, smoking cessation, and treatment goals; and steps needed to reshape agency services and policies to provide greater support for smoking cessation in this at-risk population.