Research Original Research: Brief| Volume 118, ISSUE 9, P1687-1699, September 2018

Download started.


Latino/Hispanic Participation in Community Nutrition Research: An Interplay of Decisional Balance, Cultural Competency, and Formative Work



      Latinos/Hispanics are among the populations at high risk of nutrition disparities. Adequate participation of this group in community nutrition research is necessary to better understand such disparities and propose sensible solutions.


      To identify factors influencing participation and strategies to effectively reach Latinos/Hispanics for community nutrition research.


      In-depth interviews with experienced community nutrition researchers across the United States, conducted from February to June 2013.


      Nine academics, including four registered dietitian nutritionists with extensive experience in community nutrition research with Latino/Hispanic groups, were interviewed in person (n=3) or via telephone/Skype (n=6).

      Main outcome measures

      Perceived participation barriers, facilitators, and structural factors affecting Latino/Hispanic participation were explored. Successful and unsuccessful recruitment strategies to reaching this group were identified.


      A Grounded Theory approach was applied for inductive identification of relevant concepts and deductive interpretation of patterns and relationships among themes.


      Formative work, cultural competency, and decisional balance emerged as the three interdependent factors influencing participation of Latinos/Hispanics in community nutrition research. Several approaches to influence participation were reported to be operationalized at the interpersonal, community and settings, and systems levels of influence. Trust, time, and tailoring were central concepts, postulated to moderate the relationship between the main themes and influence the effectiveness of recruitment tactics.


      Experienced community nutrition researchers identified actions ascribed to formative work as the bedrock of successful reach of Latinos/Hispanics. A robust formative work plan is necessary to achieving a functional level of trust, time, and tailoring tactics, which appear to critically influence participation.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. Coleman-Jensen A, Rabbitt MP, Gregory CA, Singh A. Household food security in the United States in 2016. 2017. Accessed April 26, 2018.

        • Ogden C.L.
        • Carroll M.D.
        • Fryar C.D.
        • Flegal K.M.
        Prevalence of obesity among adults and youth: United States, 2011-2014.
        NCHS Data Brief. 2015; : 1-8
      2. US Department of Health and Human Services, National Center for Health Statistics. Health, United States, 2016: With Chartbook on Long-Term Trends in Health. Hyattsville, MD; 2017.

        • Qiao Y.
        • Tinker L.
        • Olendzki B.C.
        • et al.
        Racial/ethnic disparities in association between dietary quality and incident diabetes in postmenopausal women in the United States: The Women’s Health Initiative 1993-2005.
        Ethn Health. 2014; 19: 328-347
        • Bruening M.
        • Udarbe A.Z.
        • Yakes Jimenez E.
        • Stell Crowley P.
        • Fredericks D.C.
        • Edwards Hall L.A.
        Academy of Nutrition and Dietetics: Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (Competent, Proficient, and Expert) in Public Health and Community Nutrition.
        J Acad Nutr Diet. 2015; 115: 1699-1709.e39
        • Ford M.E.
        • Siminoff L.A.
        • Pickelsimer E.
        • et al.
        Unequal burden of disease, unequal participation in clinical trials: Solutions from African American and Latino community members.
        Health Soc Work. 2013; 38: 29-38
        • Fisher J.A.
        • Kalbaugh C.A.
        Challenging assumptions about minority participation in US clinical research.
        Am J Public Health. 2011; 101: 2217-2222
        • Vernon S.W.
        • Roberts R.E.
        • Sul Lee E.
        Ethnic status and participation in longitudinal health surveys.
        Am J Epidemiol. 1984; 119: 99-113
        • Vincent D.
        • McEwen M.M.
        • Hepworth J.T.
        • Stump C.S.
        Challenges and success of recruiting and retention for a culturally tailored diabetes prevention program for adults of Mexican descent.
        Diabetes Educ. 2013; 39: 222-230
        • Coakley M.
        • Fadiran E.O.
        • Parrish L.J.
        • Griffith R.A.
        • Weiss E.
        • Carter C.
        Dialogues on diversifying clinical trials: Successful strategies for engaging women and minorities in clinical trials.
        J Womens Health (Larchmt). 2012; 21: 713-716
        • Trevino M.
        • Padalecki S.
        • Karnad A.
        • et al.
        The development of a minority recruitment plan for cancer clinical trials.
        J Community Med Health Educ. 2013; 3: 1000230
        • Reidy M.C.
        • Orpinas P.
        • Davis M.
        Successful recruitment and retention of Latino study participants.
        Health Promot Pract. 2012; 13: 779-787
        • Strauss A.
        • Corbin J.M.
        Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory.
        Sage Publications, Newbury Park, CA1998
        • McLeroy K.R.
        • Bibeau D.
        • Steckler A.
        • Glanz K.
        An ecological perspective on health promotion programs.
        Health Educ Q. 1988; 15: 351-377
        • Maykut P.S.
        • Morehouse R.E.
        Beginning Qualitative Research: A Philosophic and Practical Guide.
        Psychology Press, London, UK1994
        • Patton M.Q.
        Vol 4. 2nd ed. How to Use Qualitative Methods in Evaluation. Sage Publications, Newbury Park, CA1987
        • Sandelowski M.
        Real qualitative researchers do not count: The use of numbers in qualitative research.
        Res Nurs Health. 2001; 24: 230-240
        • Strauss A.L.
        • Juliet C.
        Grounded Theory Methodology: An Overview.
        in: Denzin N.K. Lincoln Y.S. Handbook of Qualitative Research. 1st ed. Sage Publications, Newbury Park, CA1994: 283-284
        • Lincoln Y.S.
        • Guba E.G.
        Naturalistic Inquiry.
        Sage Publications, Newbury Park, CA1985
        • Bonevski B.
        • Randell M.
        • Paul C.
        • et al.
        Reaching the hard-to-reach: A systematic review of strategies for improving health and medical research with socially disadvantaged groups.
        BMC Med Res Methodol. 2014; 14: 42
        • Mayan M.J.
        • Daum C.H.
        Worth the risk? Muddled relationships in community-based participatory research.
        Qual Health Res. 2016; 26: 69-76
        • Sankaré I.C.
        • Bross R.
        • Brown A.F.
        • et al.
        Strategies to build trust and recruit African American and Latino community residents for health research: A cohort study.
        Clin Transl Sci. 2015; 8: 412-420
        • Israel B.A.
        • Schulz A.J.
        • Parker E.A.
        • Becker A.B.
        Review of community-based research: Assessing partnership approaches to improve public health.
        Annu Rev Public Health. 1998; 19: 173-202
        • Graham P.W.
        • Kim M.M.
        • Clinton-Sherrod A.M.
        • et al.
        What is the role of culture, diversity, and community engagement in transdisciplinary translational science?.
        Transl Behav Med. 2016; 6: 115-124
        • Jagosh J.
        • Bush P.L.
        • Salsberg J.
        • et al.
        A realist evaluation of community-based participatory research: Partnership synergy, trust building and related ripple effects.
        BMC Public Health. 2015; 15: 725
        • Resnicow K.
        • Baranowski T.
        • Ahluwalia J.S.
        • Braithwaite R.L.
        Cultural sensitivity in public health: Defined and demystified.
        Ethn Dis. 1999; 9: 10-21
        • George S.
        • Duran N.
        • Norris K.
        A systematic review of barriers and facilitators to minority research participation among African Americans, Latinos, Asian Americans, and Pacific Islanders.
        Am J Public Health. 2014; 104: e16-e31
      3. Torres L, Hyra A, Bouchet S. Hispanics and family-strengthening programs: Cultural strategies to enhance program participation. 2013. Accessed September 12, 2017.

        • Greenlee H.
        • Gaffney A.O.
        • Aycinena A.C.
        • et al.
        ¡Cocinar para su salud!: Randomized controlled trial of a culturally based dietary intervention among Hispanic breast cancer survivors.
        J Acad Nutr Diet. 2015; 115: 709-723.e3
      4. McLeod C. Trust. In: Zalta EN, ed. The Stanford Encyclopedia of Philosophy. Accessed September 20, 2017.

        • Ojeda L.
        • Flores L.Y.
        • Meza R.R.
        • Morales A.
        Culturally competent qualitative research with Latino immigrants.
        Hisp J Behav Sci. 2011; 33: 184-203
        • García A.A.
        • Zuñiga J.A.
        • Lagon C.
        A Personal touch: The most important strategy for recruiting Latino research participants.
        J Transcult Nurs. 2017; 28: 342-347
        • Katiria Perez G.
        • Cruess D.
        The impact of familism on physical and mental health among Hispanics in the United States.
        Health Psychol Rev. 2014; 8: 95-127
        • Ramirez A.G.
        • Chalela P.
        • Gallion K.J.
        • Green L.W.
        • Ottoson J.
        Salud America! Developing a national Latino childhood obesity research agenda.
        Health Educ Behav. 2011; 38: 251-260
        • Wigfield A.
        • Eccles J.S.
        Expectancy-value theory of achievement motivation.
        Contemp Educ Psychol. 2000; 25: 68-81
        • Cook D.A.
        • Artino A.R.
        Motivation to learn: An overview of contemporary theories.
        Med Educ. 2016; 50: 997-1014
        • Ulrich A.
        • Thompson B.
        • Livaudais J.C.
        • Espinoza N.
        • Cordova A.
        • Coronado G.D.
        Issues in biomedical research: What do Hispanics think?.
        Am J Health Behav. 2013; 37: 80-85
        • Wendler D.
        • Kington R.
        • Madans J.
        • et al.
        Are racial and ethnic minorities less willing to participate in health research?.
        PLoS Med. 2006; 3: e19
        • Wallace D.C.
        • Bartlett R.
        Recruitment and retention of African American and Hispanic girls and women in research.
        Public Health Nurs. 2013; 30: 159-166


      L. K. Diaz Rios is a cooperative extension nutrition specialist, Division of Agriculture and Natural Resources, University of California, Merced; at the time of the study, she was a PhD student, Division of Nutritional Sciences, University of Illinois at Urbana-Champaign.


      K. Chapman-Novakofski is a professor of nutrition, Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign.