Community health workers as focus group facilitators: A participatory action research method to improve behavioral health services for farmworkers in a primary care setting

Farmworkers living in US-Border communities experience numerous stressors in their daily lives that place them at risk for behavioral health problems, particularly anxiety and depression. Given challenges to accessing care, farmworkers are most likely to receive services in the primary care setting. In this paper, we describe a participatory action research (PAR) approach in which community health workers (CHWs) use focus groups to engage the patient population in discussing behavioral health issues and identifying preferences for care within a Federally Qualified Health Center. The CHWs were trusted members of the community who participated in the articulation of research questions, development and implementation of protocols, participant recruitment, and data collection. CHWs encouraged focus group members to represent their community in the co-construction of knowledge regarding perceptions of behavioral health and priorities for care. This research illustrates that CHWs, as representatives for patients’ needs and a bridge between the health care system and communities, can play a vital role as intermediate actors in generating patient participation in PAR.