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Latino populations remain vastly underrepresented in clinical and translational research. This study aims to characterize the most common sources of successful participant engagement within our sample. Between February 2022 and March 2023, research staff systematically recorded how participants learned about an ongoing study (which we term source of successful participant engagement) designed to co-create and implement a COVID-19 testing program in a U.S./Mexico border community. Demographic characteristics were correlated with each source of participant engagement at the univariate level using a chi-squared test and, if significant, were included in a multinomial logistic regression model to determine the association between participant characteristics and source of participant engagement. A total of 2836 individuals responded to questions regarding source of participant engagement; the most common responses were: Word of Mouth (32%), Clinic/Provider referral (32%), and Walk Up to the testing site (21%). Males were 35% less likely than female participants to report having heard of the study through their Clinic/Provider compared to Walk Up (p < .01). Participants 54 years of age to have learned about the study through Word of Mouth compared to Walk Up (p < .01). Compared to Walk Up, participants who lived outside San Ysidro were 2.36 times more likely to be recruited through their Clinic/Provider (p < .01) and 2.11 times more likely through Word of Mouth (p < .01), compared those in San Ysidro. Education and clinical symptoms were not significantly associated with engagement source. Advancing our understanding of sources of successful participant engagement in marginalized communities is necessary to increase equitable participation in clinical and translational research.

Background Wearing a mask was a crucial component in slowing the COVID-19 pandemic. However, little is known about the intersectionality between mask usage, risk perception, and infection. The purpose of this study was to investigate whether risk perceptions and masking behaviors are associated with contracting SARS-CoV-2 and how contracting SARS-CoV-2 subsequently changes masking behaviors in specific situations. Methods This cohort study utilized survey data from the UC San Diego ZAP COVID-19 study ( n  = 1,230) to evaluate the risk of contracting SARS-CoV-2 in relation to baseline risk perceptions and masking behaviors in various situations and how contracting SARS-CoV-2 affects subsequent masking behavior. Results We found that more consistent self-reported mask use in indoor public spaces ( p  = 0.03) and in other people’s houses ( p  = 0.002) was associated with remaining free of SARS-CoV-2 infection. We also found that contracting SARS-CoV-2 was associated with a subsequent increase in mask use in other people’s houses ( p  = 0.01). Conclusions Our findings suggest that consistent mask use is correlated with decreased infection and that contracting SARS-CoV-2 may modify mask use behaviors in high-risk situations. These findings may help inform future public health messaging for infectious disease prevention. Trial registration This study has not been previously registered as it is an observational study. There was no pre-registration of the analytic plan for the present study.

Background The COVID-19 pandemic exacerbated existing disparities in healthcare access and outcomes, particularly among underserved communities. As one site participating in the NIH-funded Community Engagement Alliance Against COVID-19, our focus was to address COVID-19 disparities by training immigrant and refugee communities to advocate for their needs by increasing capacity to campaign for policy-level changes. Objective To evaluate the impact of a train-the-trainer policy advocacy program for ethnically-based community leaders within San Diego County using a mixed-methods evaluation. Methods We partnered with a non-profit social change, intermediary organization to adapt a five-session, 4-hour per session training that was conducted over five weeks. A baseline survey, pre- and post-training surveys, and ethnographic documentation were employed during each session. Results Among participants ( n  = 16), 50% were Latino(a), 25% were Somali Bantu, and 25% were Karen. Training results were relatively stable with slight variations in perceptions within and between sessions. The first session showed a slight decrease in confidence by the training participants, while sessions 3, 4, and 5 showed increases in confidence. Ethnographic documentation revealed that engagement patterns evolved over time, with the Latino(a) participants having the highest levels of engagement initially but with more equitable engagement across participants by the final session. Conclusion These findings provide valuable feedback which will aid in the improvement of the training sessions for future use. This study also underscores the potential for community leaders to effectively advocate for policy changes and offers insights for future empowerment initiatives.

Latino populations remain vastly underrepresented in clinical and translational research. This study aims to characterize the most common sources of successful participant engagement within our sample. Between February 2022 and March 2023, research staff systematically recorded how participants learned about an ongoing study (which we term source of successful participant engagement) designed to co-create and implement a COVID-19 testing program in a U.S./Mexico border community. Demographic characteristics were correlated with each source of participant engagement at the univariate level using a chi-squared test and, if significant, were included in a multinomial logistic regression model to determine the association between participant characteristics and source of participant engagement. A total of 2836 individuals responded to questions regarding source of participant engagement; the most common responses were: Word of Mouth (32%), Clinic/Provider referral (32%), and Walk Up to the testing site (21%). Males were 35% less likely than female participants to report having heard of the study through their Clinic/Provider compared to Walk Up (p < .01). Participants <18 years of age were 2.78 times as likely compared to individuals >54 years of age to have learned about the study through Word of Mouth compared to Walk Up (p < .01). Compared to Walk Up, participants who lived outside San Ysidro were 2.36 times more likely to be recruited through their Clinic/Provider (p < .01) and 2.11 times more likely through Word of Mouth (p < .01), compared those in San Ysidro. Education and clinical symptoms were not significantly associated with engagement source. Advancing our understanding of sources of successful participant engagement in marginalized communities is necessary to increase equitable participation in clinical and translational research.

Introduction Meaningful engagement of partners in co-creating and refining health-related programs can increase the initial uptake, sustained implementation, broad reach, and effectiveness of these programs. This is especially important for underserved communities where resources are limited and need to be prioritized. Brainwriting premortem is a novel qualitative approach to partner engagement that combines the strengths of individual idea generation with the concept of premortem exercise that addresses failure points prior to the implementation of new programs. Methods An adapted form of brainwriting premortem was used to inform iterative refinements to a COVID-19 testing program at a Federally Qualified Health Center (FQHC) in San Diego. Patients and providers from the FQHC participated in interviews at two time points (early- and mid-implementation of the program). Interview data were transcribed, translated, and analyzed using a rapid qualitative approach. Key themes and sub-themes were identified and used to inform refinements to the program. Results A total of 11 patients (7 Spanish- and 4 English-speaking) and 8 providers participated in the brainwriting premortem interviews. Key themes related to possible reasons for COVID-19 testing program failure: advertising/sharing information; access to testing; handling of test results; staff and patient safety; patient beliefs and views regarding the SARS-CoV-2 virus; and COVID-19 testing options offered. Proposed solutions were offered for the key failures except for patient beliefs and views regarding the SARS-CoV-2 virus. Additional solutions offered were related to education, physical operations, and recruitment strategies. Real-time changes to the program flow and components were made in response to 7 suggestions from patients and 11 from providers. Changes related to the process of returning results were the most common, and included sending results via email with distinct workflows based on the test result. Conclusion The implementation of the adapted brainwriting premortem technique allowed us to incorporate the perspective of key partners in the delivery and iterative refinement of the COVID-19 testing program. This was an effective tool in the context of an FQHC and can be a promising and approach to incorporate iterative input from patients and providers to ensure successful program implementation. Future studies, particularly those requiring rapid response to public health emergencies, should consider the use of this technique.

Background The COVID-19 pandemic exposed several health disparities experienced by underserved and Latino/a communities, including inequitable access to COVID-19 testing. Objective and Goals To describe the utilization of a community-driven and culturally-tailored testing model on COVID-19 testing in an underserved Latino/a community in San Diego. Methods The Community-driven Optimization of COVID-19 testing to Reach and Engage Underserved Areas for Testing Equity (CO-CREATE) project implemented a community co-designed COVID-19 testing program in partnership with a Federally Qualified Health Center in a US/Mexico border community. Results Between May 2021 and March 2023, 24, 422 COVID-19 PCR tests were administered to 13,253 individuals, among whom 93% percent identified as Latino/a, 57% spoke Spanish in the home, and 38% resided in our target community adjacent to the US/Mexico border, San Ysidro. Based on a subset of available county testing data, CO-CREATE accounted for nearly 12% of all COVID-19 tests reported for San Ysidro residents. Over the course of the project, we estimated that nearly 17% of all San Ysidro residents were tested for COVID-19 through the CO-CREATE project. Conclusion These findings highlight the success and reach of this culturally responsive and community co-designed COVID-19 testing program, within a Latino/a border community. Future public health interventions should focus on identifying testing barriers and design appropriate strategies to ensure equitable access to resources and testing uptake for all community members.

Many factors can impact survey completion rates, including survey length, sensitivity of the topics addressed, and clarity of wording. This study used cognitive interviews (CIs), a methodological tool that can aid in developing and refining elements for multi-faceted assessments, and previous survey response patterns to refine, streamline, and increase response rates of RADx-UP Common Data Elements (CDEs) for survey/questionnaire use. Ten previously enrolled CO-CREATE study participants were interviewed between May-June 2023. Interviewees identified CDEs that were \"confusing, uncomfortable, and/or not applicable,\" along with their reasoning. Interview data were analyzed using a rapid qualitative analytic approach, resulting in a summary matrix categorized by language. For further contextualization, CDE response rates were calculated for the 9147 surveys administered during the CO-CREATE study (May 2021-March 2023) and compared against their survey position. Of the 94 CDEs evaluated in the CIs, 20 (21.3%) were flagged by one or more interviewees. Nine (9.6%) English while fourteen (14.9%) Spanish CDEs were flagged by interviewees, with some overlap. Also, CDE response rates differed according to position in the survey, with lower response rates for questions positioned later in the survey. Following review by the research team and the RADx-UP program, 10 English and 15 Spanish were revised, and seven were removed in both languages in the final survey. Our findings underscore the importance of integrating community member perspectives to enhance the relevance and clarity of assessment instruments, optimizing the impact of public health research among underrepresented populations.

The COVID-19 pandemic exacerbated existing disparities in healthcare access and outcomes, particularly among underserved communities. As one site participating in the NIH-funded Community Engagement Alliance Against COVID-19, the focus was to address COVID-19 disparities by training immigrant and refugee communities to advocate for their needs by increasing capacity to campaign for policy-level changes. The objective of this study is to evaluate the impact of a train-the-trainer policy advocacy program for ethnically-based community leaders within San Diego County using a mixed-methods evaluation. The academic team partnered with a non-profit social change, intermediary organization to adapt a five-session, 4-hour per session training that was conducted over five weeks. A baseline survey, pre- and post-training surveys, and ethnographic documentation were employed during each session. Among participants (n=16), 50% were Latino(a), 25% were Somali, and 25% were Karen. Training results were relatively stable with slight variations in perceptions within and between sessions. The first session showed a slight decrease in confidence by the training participants, while sessions 3, 4, and 5 showed increases in confidence. Ethnographic documentation revealed that engagement patterns evolved over time, with the Latino(a) participants having the highest levels of engagement initially but with more equitable engagement across participants by the final session. These findings provide valuable feedback to aid in the improvement of the training sessions for future use. This study also underscores the potential for community leaders to effectively advocate for policy changes and offers insights for future empowerment initiatives.

Latino populations remain vastly underrepresented in clinical and translational research. This study aims to characterize the most common sources of successful participant engagement within our sample. Between February 2022 and March 2023, research staff systematically recorded how participants learned about an ongoing study (which we term source of successful participant engagement) designed to co-create and implement a COVID-19 testing program in a U.S./Mexico border community. Demographic characteristics were correlated with each source of participant engagement at the univariate level using a chi-squared test and, if significant, were included in a multinomial logistic regression model to determine the association between participant characteristics and source of participant engagement. A total of 2836 individuals responded to questions regarding source of participant engagement; the most common responses were: Word of Mouth (32%), Clinic/Provider referral (32%), and Walk Up to the testing site (21%). Males were 35% less likely than female participants to report having heard of the study through their Clinic/Provider compared to Walk Up (p < .01). Participants 54 years of age to have learned about the study through Word of Mouth compared to Walk Up (p < .01). Compared to Walk Up, participants who lived outside San Ysidro were 2.36 times more likely to be recruited through their Clinic/Provider (p < .01) and 2.11 times more likely through Word of Mouth (p < .01), compared those in San Ysidro. Education and clinical symptoms were not significantly associated with engagement source. Advancing our understanding of sources of successful participant engagement in marginalized communities is necessary to increase equitable participation in clinical and translational research.

This study analyzes the role of Corporate Social Responsibility (CSR) as a factor that may improve business competitiveness. The results obtained from both qualitative and quantitative studies carried out with key firms involved in the tequila manufacturing industry in Jalisco, Mexico suggest that business competitiveness is improved by the application of a strategic CSR model and the implementation of strategic CSR alliances, both of which enhance the reputation of firms using CSR, while corporate governance strategies and stakeholder awareness of CSR do not have this effect. This article aims to foster the competitiveness of SMEs in emerging markets through implementation of CSR in their business models.