We propose a 3-year study (R24) to facilitate dissemination, uptake, and sustainability of the HoMBReS: Por UN Cambio intervention, a lay health advisor (LHA) intervention found to be efficacious in reducing the HIV risk among immigrant Latino men in the Southeast. Informed by the lived experiences of immigrant Latino men, perspectives of organizational representatives, and social cognitive and empowerment theories, this intervention was developed and tested by a long-term community-university partnership that has used and will continue to use community-based participatory research (CBPR) principles throughout all phases of the research process. In the proposed study, 3 community-based organizations (CBOs) that represent typical community-level providers of HIV and STD prevention interventions (i.e., an AIDS service organization, a Latino-serving organization, and a county public health department) will work with our existing CBPR partnership to develop a comprehensive toolkit to guide implementation; implement and evaluate implementation; and disseminate results and materials through multiple channels. Each CBO will hire 1 part-time project coordinator to recruit, train, and support 8 lay health advisors (known as Navigates). These 24 Navigates will promote sexual health among members of their soccer team-based social networks for 12 months. Baseline and follow-up data will be collected from social network members to evaluate impact. Blending both quantitative and qualitative methods, we will explore facilitators and barriers to intervention implementation, fidelity, and potential sustainability by these diverse CBOs. Pre and post-implementation, we will conduct individual in-depth interviews with CBO representatives. Post-implementation, we also will conduct focus groups with Navigates at each CBO. We will use scale-up and spread, a framework informed by diffusion and social normative theories, to guide this study. We also will evaluate the CBPR process, using in-depth interviews with partners, direct observation of partnership meetings and study implementation, and partnership document review.
This study will provide insights to the increasing number of CBOs in the South seeking to reduce HIV/STD-related health disparities among the growing population of immigrant Latinos; and aligns with the Affordable Care Act's emphasis on recruiting and training community health workers to connect marginalized populations with preventive health services.
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