A Relationship-Based Resilience Program for Promotores: Protocol for a Randomized Controlled Waitlist Trial

Community service providers (CSPs) play an integral role in the health care of low-income Hispanic or Latinx (HL) communities. CSPs have high-stress frontline jobs and share the high-risk demographics of their communities. Relational savoring (RS) has been associated with lower cardiovascular reactivity and psychosocial benefits, with particular promise among HL participants. In this study, we aim to identify RS's potential in promoting CSPs' cardiometabolic health and, in so doing, having broader impacts on the community they serve. This randomized controlled waitlist study aims to examine the effect of an RS intervention on (1) CSPs' cardiometabolic health (cardiometabolic risk factors and outcomes) and (2) CSPs' threats to leaving the workforce. We will recruit a sample of 80 CSPs from community health agencies serving low-income HL populations. Participating CSPs will be randomized into an experimental or a waitlist control. Participants will complete 1 or 2 baseline assessment batteries (before the intervention), depending on the assigned group, and then complete 2 more assessment batteries following the 4-week RS intervention (after the intervention and at a 3-mo follow-up). The RS intervention consists of guided reflections on positive moments of connection with others. Electrocardiogram data will be obtained from a wearable device (Polar Verity Sense or Movisens) to measure heart rate variability. The primary outcome is cardiometabolic health, consisting of cardiometabolic risk (obtained from heart rate variability) and cardiometabolic health behaviors. The secondary outcomes include CSPs' threats to leaving the workforce (assessed via psychological well-being), intervention acceptability, and CSPs' delivery of cardiometabolic health programming to the community (exploratory). Analyses of covariance will be used to examine the effects of RS on cardiometabolic health and on CSPs' threats to leaving the workforce, comparing outcomes at baseline, postintervention, and at follow-up across participants in the experimental versus waitlist group. The study has been approved by the University of California, Irvine, Institutional Review Board and is currently in the data collection phase. By May 2023, 37 HL CSPs have been recruited: 34 have completed the baseline assessment, 28 have completed the 4 intervention sessions, 27 have completed the posttreatment assessment, and 10 have completed all assessments (including the 3-mo follow-up). This study will prov