| Latino Paradox Considerations, Limitations and Implications: Despite a decades-long demonstration of its existence, numerous issues persist in the measurement, understanding, and application of the Latino paradox. Summit attendees provided discussion and recommendations on specific aspects of a research agenda to standardize the use and understanding of this concept. |
Research organizations (funders, professional societies, government agencies, etc.), should convene national experts at regular intervals to update a working definition of the Latino paradox with updated scientific rationale. Funders should incentivize investigations prioritizing understanding and documenting heterogeneity among Latinos by incentivizing grantees to name, collect, and report on more granular categories than merely “Latino”. Funders should incentivize rigorous measurement by prioritizing funding to projects that are able to utilize more than a single cross-sectional data source, and when possible, incentivize the use of longitudinal samples. Researchers should articulate and carry out specific research questions regarding how conceptions about the Latino paradox are used or misused by clinicians in health care systems.
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| Data Issues: Essential to a full understanding of the Latino paradox is the ability to accurately and ethically understand the ethnic categories in which patients place themselves. Summit attendees provided discussion and recommendations on data collection in research to provide better and more consistent data categories on Latino patients. |
As above, funders should incentivize investigations prioritizing understanding and documenting heterogeneity among Latinos by incentivizing grantees to name, collect, and report on more granular categories than Latino. Investigations, both quantitative and qualitative, into when and how disaggregated Latino data should be collected in primary care settings are needed. In addition to adherence to Census recommendations, primary care clinics should collect disaggregated data in partnership with Latino communities to meet local needs and evaluate their data collection practice over time. Researchers should develop standards and guidelines that allow the inclusion of all Latino subgroups in research studies regardless of small sample sizes.
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| Bridging Clinic and Community: To have a future research agenda that appropriately addresses primary care equity for Latino patients, Summit participants noted that research, clinic, and community partnerships have to be forged, developed, and maintained to adequately generate and implement knowledge. Summit attendees provided discussion and recommendations on the funding mechanisms and research designs necessary for these partnerships. |
Researchers should articulate, improve and submit research proposals that aim to study effective, long-lasting and deep research–clinic–community partnerships. Funders should prioritize the funding of long term research–clinic–community partnerships and develop infrastructure funding mechanisms that specifically recognize the unique needs (including training) and costs of long term, successful research–clinic–community partnerships. Given the long-standing importance of community health workers in the delivery of health care to Latino communities, research is needed to better understand how to support, utilize and improve community health workers and their impact on Latino health.
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| Primary Care Challenges: In the setting of many of these data challenges and the challenges of increasingly connecting to a heterogenous community, primary care clinics must navigate additional circumstances to appropriately care for their Latino patients. Summit attendees provided discussion and recommendations on the specific research approaches to maximize primary equity for Latinos. |
Funders and researchers should develop practice-based evidence on effective care to Latino communities including payment reform and overall care design in primary care settings. The key features, benefits and challenges of the community health center model, especially as it relates to the care of Latino patients and communities, should be better studied and understood. The utilization of community-oriented, culturally-tailored digital health technology to deliver and coordinate health and social care to Latino communities/social networks should be studied. New and ongoing research should provide insights as to how the COVID-19 pandemic has impacted the Latino mortality paradox, primary care utilization, and their intersection.
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| Social Needs: Social risk is defined as specific adverse social conditions such as financial hardship, food insecurity, housing instability and transportations difficulties that are associated with poor health. Summit attendees provided discussion and recommendations on the implementation and evaluation of social need screening for Latino patients. |
Generate more evidence around the acceptability of social needs screening tools and appropriate approaches in primary care workflows to understand its implementation specifically among heterogeneous Latino populations. The development of social needs screening implementation tools and strategies that are culturally-informed and adaptable for various Latino populations is needed, including healthcare and research paradigms that address religion/spirituality, family characteristics, family cohesion, etc. Research–clinic–community partnerships should address and evaluate approaches that address both individual-level social care needs and structural social determinants.
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| Workforce/Academics, Representation Inequities, & Innovation: The research workforce in Latino primary care equity continues to not be representative of the community. Summit attendees provided discussion and recommendations on training programs and approaches to innovation to expand and diversify the workforce. |
New training programs should be developed that build multidisciplinary capacity: clinical teams, researchers and communities to increase research workforce in Latino primary care health equity. Funders and study sections, when evaluating early-career proposals, should highly value innovative and exploratory research approaches that address the Latino community in order to robustly address long-standing Latino health inequities and expand the Latino research workforce. Scientific peer-reviewed journals should reserve or prioritize space for innovative and exploratory research in Latino health.
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