In a paper published in the journal Annals of Behavioral Medicine, experts at the University of Miami’s Miller School of Medicine and School of Nursing and Health Studies describe the challenges and innovative research methods developed to continue Latinx health disparities research amid COVID-19. 

Principal investigators of five pilot studies within the Center for Latino Health Research Opportunities (CLaRO) developed innovative research methods in response to COVID-19 for research continuity. CLaRO, a National Institutes of Health-funded center housed in the School of Health and Nursing Studies, supports and facilitates research addressing substance abuse, violence/trauma, and HIV/AIDS among diverse and underserved Latinx populations.

“In the face of challenges related to COVID-19, we optimized CLaRO funded Latinx health disparities research to protect participant and research staff physical safety, adhere to human subjects protections, address cultural factors related to engaging Latinx populations in research, and capture emerging COVID-19-related health disparities,” said paper lead author Audrey Harkness, Ph.D., research assistant professor at the Miller School of Medicine’s Department of Public Health Sciences. “This resulted in innovative approaches to conducting research with Latinx populations that may enhance future health disparities research, even after the COVID-19 crisis subsides.” 

Amid the pandemic, CLaRO’s five pilot studies that faced challenges and adapted innovations included Mobile Intervention Prototypes, Feasibility and Acceptability of the Family Acceptance Project (FAP), DÍMELO, Happy Older Latinos are Active (HOLA), and PROGRESO-II. 

Challenges found were the following: 

• COVID-19 prompted college-aged Latinx youth to move in with their families, potentially exacerbating stressors that may be addressed in the interventions
• COVID-19 likely impacted key variables, such as sexual behavior, mental health, substance use, use of HIV-prevention, and behavioral health services
• Data collection by phone led to the difficulty in collecting biological/physiological outcomes
• Digital divides, such as the use of flip phones, affected participants who were older Latinos

Despite the challenges COVID-19 presented to Latinx health disparities research, it also presented opportunities to innovate. Innovations established by project investigators included: 

• Remote recruitment through phone, email, and word of mouth
• Informed consent and assent by videoconferencing
• Adolescents providing feedback on intervention prototypes by videoconference focus groups
• The Family Acceptance Project designed as a home-based intervention, transitioned to a videoconferencing format, creating the opportunity to reach Latinx families across Florida and the U.S.
• Developed Pandemic Stress Index to assess COVID-19 psychosocial and behavioral impacts, protecting the scientific integrity of the project and potentially contributing to knowledge about Latinx health disparities related to COVID-19
• Participants and community health workers met by phone during group walk time to motivate physical activity and activity scheduling, modeling personalism and emphasizing trust
• Explored how Latinx cultural factors remain central to engaging Latinx participants in research, particularly during a global pandemic.

“Innovative and tailored research approaches are needed to solve scientific, public health, and clinical challenges related to ongoing and emerging health disparities brought about by the pandemic,” said paper senior author Victoria Behar-Zusman, Ph.D., professor at the School of Nursing and Health Studies and principal investigator of CLaRO. “We hope the examples presented in the paper provide a launching point for other investigators to meet COVID-19 with innovation to support the goals of achieving health equity for those who are most impacted by past, present, and future health crises.”

Written by Amanda Torres

Published on September 9, 2020