Practice Concepts.

Practice Concepts. Nancy L. Wilson, MA, Editor

Copyright 1996 by The Cerontological Society of America The Cerontologist

Vol.36, No. 3,406-408

This article reports on the use of a Puerto Rican Elder Advisory Committee and the role it played in the development and implementation of a four-year research project. The use of an advisory committee composed of the ultimate beneficiaries of a study increases the likelihood that the results will meet their needs. This article provides suggestions for how best to utilize this important resource in all phases of a research project. Key Words: Advisory committee, Puerto Ricans, Research

Aging Research and the Puerto Rican

Melvin Delgado, PhD2

The rapidly increasing number of Latino elders residing in the United States, combined with a wide range of social and health needs, necessitates research as well as outreach by human service organizations (Bartlett & Font, 1995; Espino, 1993). This population presents a unique set of challenges to social research organizations in implementing all phases of a research process (Becerra & Shaw, 1984; Daley, Applewhite, & Jorquez, 1989). This article presents a case study of an effort to research the long-term care needs of a specific Latino Group (Puerto Rican), and describes the process, issues, and rewards of using an advisory committee drawn from the population of intended respondents. Although this study focuses on Puerto Ricans, it has implications for other Latino groups in urban areas across the United States. Overview of the Literature on Research and Communities-of-Color (Focus on Latino Elders) Research in urban areas with populations of color, regardless of age, presents a set of issues and challenges for researchers (Andranowich & Riposa, 1993); there is no aspect of the research that will not

1 This project was funded through National Institute on Aging Grant AC11171. The author wishes to acknowledge members of the Elder Advisory Committee and Dr. Sharon Tennstedt for review and comments on an earlier draft of this paper. 2 Address correspondence to Melvin Delgado, PhD, Boston University, School of Social Work, 264 Bay State Road, Boston, MA 02215.

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be affected (Becerra & Zambrana, 1985; HummDelgado & Delgado, 1986; Marin & Marin, 1991). The literature is in agreement that communities must play a role in the research, with the nature and intensity of the role depending upon the researcher's level of comfort and philosophical approach towards empowerment. Marti-Costa and Serrano-Carcia (1987) recommend establishing a "core" group of key community persons that has responsibility for planning, coordination, and evaluation of a research endeavor. Humm-Delgado and Delgado (1986) note that use of an advisory committee may be the most important step in determining the success of research focused on Latinos. Marin and Marin (1991) suggest seeking community consultation when undertaking research in Latino communities/settings. Research focused on elders must be undertaken with elders rather than for them; this necessitates the development of a mechanism that systematically and meaningfully involves them. The use of an advisory committee is not new to human services. However, an advisory committee of intended respondents provides a different perspective on participatory research with Latino elders, and has implications for both the empowerment of elders and community development. Context of Study This four-year cross-sectional study, funded by the National Institute on Aging, investigated ethnic The Gerontologist

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Community: The Use of An Elder Advisory Committee of Intended Respondents1

Role of the Professional and Elder Advisory Committees The project utilized two advisory committees, with both being staffed by the project co-investigator. The Professional Advisory Committee consisted of seven members deliberately selected to represent key Latino and African American senior organizations in the city. The Committee fulfilled seven roles: (1) Review of methodology and instruments; (2) identification of, and access to, key community informants; (3) input on the socio-political context of services to seniors; (4) identification of research resources (staff, sites, etc.); (5) assistance with publicity; (6) interpretation of data; and (7) dissemination of findings. This committee provided access, information, and advice on how to avoid potential "turf" issues as well as technical support on the development and implementation of research. The Elder Advisory Committee was the second committee and the subject of this article. This committee assisted with: (1) Planning — input on key questions to be included in questionnaire development; reactions to key informant comments on demographic changes, including dispersal patterns within the city; identification of Puerto Rican religious, civic, and social institutions serving elders; (2) Publicity— identification of sources for publicity on the project and assistance in disseminating information about the study within key organizations that they attend; (3) Problem-Solving — assistance in obtaining subjects using snowballing techniques and identification of institutions to help locate Puerto Rican elders; (4) Data Analysis — review of findings and assistance with interpretations, recommendations, etc.; and (5) Dissemination of Findings — assistance with the identification of, and access to, the best local sources for dissemination of study findVol.36, No. 3,1996

ings. Both committees were kept informed of each other's activities by the staff member. Elder Advisory Committee Members of the committee were recruited through a variety of methods: (1) One of the co-investigators visited a meeting of seniors at CASA, described the goals of the study, and invited participants to be a part of an advisory committee; (2) names were obtained from key informants; (3) names were provided by the Professional Advisory Committee; and (4) key leaders of an elder organization currently utilizing space at the CASA agreed to participate. The latter was the most successful method of recruitment, resulting in seven members. The Committee consisted of nine females and two males, ranging in age from 60 years to 75 years. Members were born and raised in Puerto Rico and had resided in Springfield between 8 and 20 years. Their primary language was Spanish, with no member indicating comfort or preference for speaking English. The level of formal education was low; no member had a postsecondary education. Eight out of the eleven members had received some form of leadership training through CASA or some other organization prior to membership on the advisory committee. The Elder Advisory Committee met a total of five times during the three-year data planning and field work phases of the project — twice during the first year of the project, and then approximately every eight months afterwards. The meetings lasted approximately two hours. Each meeting started on a social note with lunch. Members would then be provided with a review of work accomplished to date and major tasks remaining to be done. They would then be provided with an opportunity to ask questions or share impressions or reactions they had gotten from other Puerto Rican elders whom they knew had been interviewed. The rest of the meeting was devoted to a list of questions the researchers had or requests for specific advice. Attendance at all five meetings was excellent, with each meeting averaging 9.5 members (a high of eleven and a low of eight). In addition, members who could not attend did telephone and state why (illness and medical appointments were the most frequently cited reasons). Members did not receive any monetary compensation for participation. Satisfaction of committee members with participation was addressed as members of the Elder Advisory Committee and as research subjects. Level of satisfaction was obtained through a series of open-ended questions asked at the last formal meeting of the Committee. Members expressed great satisfaction with participation on the Elder Advisory Committee in the following respects: (1) They developed an appreciation for the complexity of undertaking research in the community; (2) their input into the research questionnaire resulted in the generation of data they were interested in or considered useful to the community; (3) their assistance with publicity 407

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differences among African American, Puerto Rican, and white, non-Puerto Rican elders' needs for community-based long-term care, patterns of informal care (natural support systems), and the use of formal services. The study was conducted in Springfield, Massachusetts. The city was selected because of its sufficiently-sized African American and Puerto Rican populations. According to the 1990 U.S. Census Bureau, the city had a population of approximately 157,000 — the third largest in the state, of which Latinos accounted for 16.9% (26,500; Gaston Institute, 1992). The Latino community is predominantly Puerto Rican (89.4%). It has remained virtually unchanged since the 1980 U.S. Census and has doubled in size (92.9%) during that time period (Gaston Institute, 1992; initial migration to the city can be traced back to the 1960s and has its origins with migrant workers picking tobacco in the Connecticut Valley). A Latino community-based social service organization served as the local field-site headquarters for the project. The Spanish American Union (CASA) had a long and distinguished history in the Puerto Rican community (approximately 25 years in existence).

and dissemination of information on the study allowed the exercise of creativity and the taking of ownership of the project. Their participation as respondents to the survey, in turn, provided them with valuable insights into both their own lives and how a research project seeks answers to important questions. They reported that the questions asked of them as respondents provided an opportunity to think about their health, social supports, and their help-seeking patterns.

Recruitment. — It is helpful to approach established groups/agencies to identify individuals likely to be interested and motivated to participate. Community-based organizations may have existing committees that can be supplemented with additional members to form an advisory committee. This procedure saves time and serves to enlist members with experience, knowledge, and commitment to participation. Location and Scheduling of Meetings. — Meetings should be scheduled and held in a community setting that is geographically, culturally, and psychologically accessible. Elders, as a result, will not spend valuable energy and time early in the history of the committee developing trust with the institution and setting. Scheduling of meetings should accommodate elder scheduling and transportation needs. It is preferable to schedule meetings early in the day and no later than mid-afternoon because many Puerto Rican elders are fulfilling important family functions such as taking care of grandchildren after school or preparing evening meals. Last, it is necessary to either provide transportation or schedule meetings during periods when elders can arrange their own transportation.

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Committee Member Support. — Provision of food serves to "deformalize" meetings and encourages more casual and open conversation, facilitating the group process. Researchers must be prepared to make necessary referrals or provide information on social services to committee members. Elder members provide expertise and time, and researchers must ensure that member needs are met. Finally, members should be compensated for their participation in the form of a gift certificate or stipend. Payment conveys a sense of respect for the elder's knowledge and time. In conclusion, this experience confirmed the value of involving members of a study population in planning and implementing a study (Delgado, 1995). References Andranovich, C. D., & Riposa, G. (1993). Doing urban research. Newbury Park, CA: Sage Publications. Bartlett, M., & Font, M. E. (1995). Hispanic men and long-term care: The wives' perspective. Journal of Multicultural Social Work, 3, 77-88. Becerra, R. M., & Shaw, D. (1984). The Hispanic elderly: A research reference guide. New York: University Press of America. Becerra, R. M., & Zambrana, R. E. (1985). Methodological approaches to research on Hispanics. Social Work, 30, 42-49. Daley, J. M., Applewhite, S. R., & Jorquez,). (1989). Community participation of the elderly Chicano: A model. International journal of Aging and Human Development, 29, 135-150. Delgado, M. (1995). Puerto Rican elders and natural support systems: Implications for human services, journal of Gerontological Social Work, 24,115-130. Espino, D. V. (1993). Hispanic elderly and long-term care: Implications for ethnically sensitive services. In C. M. Barresi & D. E. Stull (Eds.), Ethnic elderly and long-term care. New York: Springer Publishing. Caston Institute. (1992). Latinos in Springfield. Boston, MA: University of Massachusetts. Humm-Delgado, D., & Delgado, M. (1986). Gaining community entree to assess service needs of Hispanics. Social Casework: The journal of Contemporary Social Work, 67, 84-89. Marin, G., & Marin, B. O. (1991). Research with Hispanic populations. Newbury Park, CA: Sage Publications. Marti-Costa, S., & Serrano-Garcia, I. (1987). Needs assessment and community development: An ideological perspective. In F. M. Cox, J. L. Erlich, J. Rothman, & J. E. Tropman (Eds.), Strategies of community organization. Itasca, IL: F. E. Peacock Publishers. Received June 26, 1995 Accepted October 25, 1995

The Gerontologist

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Discussion and Recommendations The Elder Advisory Committee fulfilled very important roles in the project. The high participation rate of Puerto Rican elders (97% of eligible respondents contacted) in the study was greatly influenced by the assistance provided by the committee. In addition to providing information from an elder viewpoint, a missing perspective on the Professional Advisory Committee, the Elder Advisory Committee provided information on ethnic institutions that were not well recognized in the broader community but who proved to be useful sources of information about this population. Much was learned about how to improve advisory committees composed of members of a study population that can be integrated into any comparable effort at undertaking research with Latino elders.

Training. — Prior elder involvement on advisory committees serves to facilitate participation. In the absence of any prior or similar committee involvement, consideration should be given to providing some brief training on expectations of committee members. For a research advisory committee, it is particularly important to provide an overview of research design, sampling issues, etc. In our experience, valuable time had to be set aside during early meetings to discuss various aspects of sampling, questionnaire construction, etc. It is preferable to spend the equivalent of a day of training, divided over several short periods of time, to review research goals and design and answer members' questions about field-based research.

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