Promotores program to increase Hispanic/Latino(a) participation in Alzheimer's disease research

Hispanic/Latino(a/x) (H/L) representation in Alzheimer's disease and related dementias (ADRD) research remains low, limiting generalizability of findings and interventions to this growing population. H/L community health workers ("Promotores") can enhance awareness of brain health and help guide their communities toward ADRD research opportunities; however, the effectiveness of recruitment through Promotores compared to traditional clinic-based approaches remains unknown. This study evaluates our Promotores training and compares the two approaches on recruitment success and characteristics of those recruited into a longitudinal study of ADRD.

Nine Promotores completed Building Research Integrity and Capacity (BRIC) training on research concepts and ethics, and video training modules on ADRD-related research procedures. Training effectiveness was evaluated via pre-/post-tests to evaluate content knowledge and program satisfaction was evaluated by a self-report survey. Recruitment success was compared between Promotores-based and clinic-based approaches, assessing numbers referred and enrolled in ADRD research, and participants' demographic and clinical characteristics and agreement to specific research procedures (i.e., lumbar puncture, brain donation).

Promotores showed significant gains in knowledge of research concepts (Wilcoxon test, p = 0.005; median increase = 52%, 95% confidence interval [CI] = 30%-70%) and ADRD content (p = 0.042; median increase = 10%, 95% CI = 5%-40%). Promotores strongly agreed (on a 5-point Likert scale) that their training improved understanding of researcher responsibilities (x̄ = 4.88 ± 0.35), participant rights (x̄ = 4.25 ± 1.49), and ADRD research procedures (x̄ = 3.88 ± 1.36). Satisfaction with training materials (x̄ = 4.63 ± 0.74) and perceived community benefit (x̄ = 4.75 ± 0.46) were high. Promotores and clinic pathways had similar enrollment proportions (12.6% vs. 16.5%; Χ ² = 0.92, p = 0.34) and participants were comparable across demographic, clinical, social determinants of health, and willingness to undergo research procedures.

The Promotores training program was well received, improved research literacy, and was as successful as clinic-based recruitment in enrolling older H/L adults into ADRD research. Results validate our Promotores training strategy and support a multipronged community-oriented approach to H/L participation in ADRD research.