Multilevel Community-Based Mental Health Intervention to Address Structural Inequities and Adverse Disparate Consequences of COVID-19 Pandemic on Latinx Immigrants and African Refugees - Supplement

PROJECT SUMMARY The COVID-19 pandemic has disparately impacted immigrants and refugees, particularly those who are Latinx, Black, and low-income due to longstanding structural inequities. The goal of the parent community-based participatory research (CBPR) study is to test a multilevel approach to reduce adverse consequences of the COVID-19 pandemic (psychological distress, daily stressors, and economic precarity) and increase protective factors (social support, access to resources, English proficiency, cultural connectedness, and mental health service use) among Latinx and Black immigrants and refugees by observing and implementing three nested levels of intervention: 1) an efficacious 6-month peer advocacy and mutual learning model (Refugee & Immigrant Well-being Project, RIWP); 2) engagement with community-based organizations (CBOs); and 3) structural policy changes enacted in response to the pandemic. The parent study is ambitious - involving in- depth community participation, multilevel interventions, and longitudinal data collection from large samples of newcomer participants. Our research team has worked diligently and flexibly to ensure the success of the study, adjusting to several unforeseen issues related to needing to assume responsibility for data collection and retention of the representative sample of Latinx immigrant participants, which was originally contracted to a survey firm. Transition from timepoint 1 data collected by the survey firm to in-house data collection for subsequent timepoints also required development and implementation of a time-intensive data verification protocol for quality assurance. These unforeseen circumstances required our research team to take on numerous additional responsibilities and costs. First, we had to identify, train, support, and pay a team of bilingual interviewers to conduct timepoint 2 surveys (and all subsequent timepoints) with up to 900 additional participants. Although this change was challenging, it also resulted in an innovation of hiring former study participants to conduct surveys, which has contributed to genuine CBPR processes of mutual learning, capacity-building, and involving newcomer community members in the research in additional meaningful ways. To pivot quickly and ensure we could still carryout our study successfully within our existing budget (maintain rigor and fidelity to original study aims and planned analyses), we had to change our research design to collect 5 timepoints of data instead of having 7 timepoints of data. The proposed Unanticipated Costs Administrative Supplement would provide critical funds to enable us to return to our original even more ambitious research design of 7 timepoints over 36 months, and overall to ensure we are able to fulfill all study goals. This is important not only in terms of collecting the original number of data points over the initially planned longer time (36 months vs. 28 months in adjusted plan), but also because we could maintain the original plan of having 2 timepoints of data collection after the TAU waitlist control group participates in the RIWP intervention, which would increase our ability to examine whether the RIWP effects are also realized for those in the TAU group.