Community-Based Participatory Research to Promote Mental Health in Underserved Rural Communities

Purpose: Community based participatory research (CBPR) is considered a highly effective approach for connecting with hard-to-reach, minority populations.  Latino immigrants, who comprise the largest minority population in the United States, are increasingly choosing to settle in non-traditional, rural areas of the country. In these locations, Latino immigrants are exposed to adverse, social determinants that detrimentally affect their mental health by acting as chronic stressors. Despite the risk to mental health, these determinants have been largely understudied by social scientists and community health researchers. Thus, this study aimed to present the lessons and challenges of six studies employing CBPR principles to promote mental health among low-income, underserved Latinos in rural areas of North Florida, US.

Methods: This report gathered data from six qualitative or quantitative studies employing CBPR principles with rural Latino families in north Florida. These studies, which used diverse methodologies and population segments, were titled: 1) Assembling a Community Advisory Board (CAB), 2) Developing a Community Assessment, 3) Involving Faith-Based Organizations (FBOs), 4) Understanding Social Isolation and Family Environments, 5) Identifying Latinos’ Social Networks and 6) Developing a Community Intervention to Promote Well-being. In this presentation, the goals, methods, main findings, and lessons of these six studies will be presented, as well as any barriers to progress that were discovered.

Results: The CBPR research trajectory was initiated by building a partnership with key community leaders, or CAB members, who became active partners in the research team and acted as community insiders and advocates for community needs. The community assessment showed that social isolation, which includes psychosocial, linguistic, and cultural factors, was the most significant social health determinant facing rural Latinos. In addition, findings also detailed the recommendations of Faith-Based Organization leaders (FBOs), who endorsed the development of an expansive social network to enhance community cohesion. Finally, results indicated a need to focus on a wellness paradigm, which is more culturally sensitive than an illness paradigm as well as more readily accepted in this population.  Challenges of these studies included:  participant recruitment; intermittent funding; varied expectations between academics and community members; a hospital-based, instead of community-oriented, academic culture; substantial commitment for the development of long-term, trusted relationships; language limitations (e.g. only three members of the research team were bilingual); and contrasts between the aims of service-oriented community members and educational components of the research projects.

Conclusion: CAB members are the cornerstone of the CBPR studies, and as a result, they were involved in all steps of the research projects. Students partially collaborate with the CBPR studies by performing hands-on data analysis in the latter stages of the projects. In doing so, they were provided with a valuable learning experience about the health disparities facing Latinos living in rural communities in the U.S.  In sum, these studies demonstrated that academics and community members can experience equal partnerships using CBPR principles for research with and for Latinos in rural areas of north Florida, in the US.