A community-engaged public health research and outreach program for immigrant and racialized workers in meat processing during the COVID-19 pandemic

BACKGROUND: COVID-19 caused major outbreaks among immigrant and racialized workers in meat processing plants in North America, but trust barriers limited engagement with public health and research. This study investigates how community-based participatory research (CBPR) methods were employed to create a Community Scholar (CS) program to facilitate research and public health outreach among immigrant and racialized workers. METHODS: We conducted a qualitative case study of a CS program to describe its co-creation, failures, successes and experiences working across multiple Canadian meat processing plants affected by mass COVID-19 outbreaks. We hired six CSs from racialized ethnocultural minority groups, trained them in research ethics, public health protocols, survey tools, and vaccine operations, then embedded CSs within academic-public health teams. We used administrative document analysis to describe the project setting, training, and roles across research and vaccine operations between March 2020 and February 2022. CSs completed reflexivity activities using narrative analysis to summarize their experiences and impacts on themselves, immigrant and racialized workers, and their communities. Narrative analyses were triangulated with administrative, quantitative, and time-series data. FINDINGS: We summarize three study phases: (1) CS recruitment and training, (2) early engagement, and (3) outreach vaccination. Initial recruitment attempts lacked engagement, seemingly due to mistrust and fear of reprisals. Trust between workers and CSs appeared to increase over time as indicated by increased study engagement. CSs played key roles in nine onsite meat processing plant occupational and community outreach COVID-19 vaccine clinics. They also facilitated 191 surveys and 43 in-depth interviews across 11 meat processing plants in eight languages. CSs described their roles, successful outreach strategies, prerequisite skills and motivations. Key learnings included the skillset of empathetic listening, a greater understanding of meat processing plant workplaces and the role community presence plays in them, and how to empower workers through translating worker stories into advocacy. CS involvement appeared to increase trust, facilitate vaccine access through vaccine outreach clinics, and enable multilingual participation in research. INTERPRETATION: During public health crises, community-academic-healthcare partnerships can rapidly implement multicultural CBPR strategies to engage immigrant and racialized workers concurrently in research and public health outreach.