African immigrants are underrepresented in health research in the United States. Barriers to research participation may include limited access to culturally and linguistically appropriate information, concerns about privacy, distrust of research institutions, stigma, and difficulty participating in traditional in-person activities. WhatsApp is commonly used within African immigrant communities, but there is limited evidence about how it can support meaningful engagement throughout the research process.
This study will develop and test the WhatsApp Immigrant-Centered Research Engagement (WI-CARE) protocol. WI-CARE will provide researchers and community partners with structured guidance for using WhatsApp to engage African immigrants in research planning, recruitment, data collection, interpretation, and dissemination.
The study has three aims. First, the research team will conduct surveys and focus groups to identify the WhatsApp features and engagement practices that facilitate or hinder participation in research. Second, the study team and African immigrant partners will use these findings to develop and refine the WI-CARE protocol. Third, the protocol will be tested through structured scenarios that simulate activities conducted during different stages of research. Participants will provide feedback about the acceptability, usability, feasibility, cultural relevance, privacy, trustworthiness, and quality of engagement supported by WI-CARE.
The study will include adult African immigrants living in Connecticut, Maine, Massachusetts, Minnesota, Pennsylvania, and Rhode Island. Findings will be used to refine WI-CARE and inform the use of digital platforms to support equitable engagement of African immigrant communities in health research.
Aged 18 years or older
Born in a sub-Saharan African country
Currently residing in the United States
Able to read and speak English, French, or Kiswahili
Younger than 18 years of age
Unable or unwilling to provide informed consent
Does not meet the eligibility requirements for the applicable study component
Single group
WI-CARE Protocol
BehavioralWI-CARE is a culturally and linguistically tailored protocol for engaging African immigrants in research through WhatsApp. The protocol provides structured procedures for onboarding and informed consent, communication, privacy and confidentiality, facilitation, technical support, and participation in research activities. Trained facilitators will use WI-CARE to guide participants through scenarios representing research planning, recruitment, data collection, interpretation of findings, and dissemination. Participants may communicate through text, voice notes, audio or video calls, surveys, polls, group discussions, and multimedia features. Participants will provide feedback on the clarity, accessibility, cultural relevance, acceptability, usability, and trustworthiness of the engagement process.
Quality of Research Engagement
Participant-reported quality of engagement will be assessed using the 22-item Patient Engagement in Research Scale (PEIRS-22). Item responses will be scored according to the PEIRS-22 scoring guidance. Higher scores indicate greater perceived quality of engagement.
Engagement Context
Engagement context will be assessed using survey items based on the Unified Theory of Acceptance and Use of Technology. Separate scores will be calculated for performance expectancy, effort expectancy, social influence, facilitating conditions, behavioral intention, and use behavior. These constructs assess the acceptability, usability, feasibility, and perceived effectiveness of WI-CARE. Each construct will be scored according to the final survey scoring procedures, with higher scores indicating a more favorable assessment of WI-CARE.
WI-CARE Acceptability
Acceptability will be assessed through exit-survey items measuring participants' satisfaction with WI-CARE and the extent to which they consider the protocol appropriate for engaging African immigrants in research. Responses will be summarized using item-level frequencies and mean or median scores, as appropriate. Higher ratings indicate greater acceptability.
WI-CARE Usability
Usability will be assessed through survey items informed by the Unified Theory of Acceptance and Use of Technology. Items will examine the ease of learning and using WI-CARE procedures and WhatsApp features, the clarity of scenario instructions, and the effort required to participate. Responses will be combined according to the final survey scoring procedures. Higher ratings indicate greater perceived usability.
Scenario Participation Rate
The scenario participation rate will be calculated as the number of enrolled participants who enter and participate in each WI-CARE scenario divided by the number of enrolled participants invited to that scenario, multiplied by 100. Rates will be reported for each scenario and across the pilot.
Scenario Task Completion Rate
The task completion rate will be calculated as the number of participants who complete the required activity within each WI-CARE scenario divided by the number of participants who begin that scenario, multiplied by 100. Activities may include completing a survey, participating in a group discussion, reviewing research findings, or providing feedback.
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