Promotores de Salud



Sowing the Seeds of Health
– A Lay Health Promoter Program
for the Latino Community

Principal Investigator: Isabel C. Scarinci, PhD, MPH 
Program Director: Allison A. McGuire, MPH 
Peer Health Educators: Pilar Rincon, Catherine Cartagena 
Program Coordinators: Maria Isabel Hoyos-Hernandez, Sylvia L. Peral 
Funded by: Susan G. Komen North Central Alabama, National Cancer Institute

Sowing the Seeds of Health (Sembrando las Semillas de la Salud) is a community-based educational program conducted by the University of Alabama at Birmingham (UAB), Division of Preventive Medicine. The program educates lay individuals from the Latino community with the knowledge and skills necessary to promote health and connect individuals to affordable health care. The overall goal of the program is to reduce incidence of breast and cervical cancer in Latina immigrants via community health advisors or “promotoras de salud.” 

Sowing the Seeds of Health is based on the following foundation: (a) extensive formative assessment through which members of the target audience were involved in all steps of program development, making it culturally-relevant; (b) true collaboration between organizations by bringing together resources and expertise; (c) it is manualized; (d) it is theory-based; and (e) it has strong process and outcome evaluation components. 

The program is implemented by identifying and recruiting natural helpers (volunteers) in the Latino community. These natural helpers are then trained on health topics (breast and cervical cancer, family planning, sexually transmitted infections, healthcare access) and skills (communication, problem solving, stages of change, public speaking, etc.) through a series of 8 sessions. The empowerment model is used in the training to encourage the promoters to take responsibility for their own health, as well as facilitating a responsibility among other Latinas. These trained “promotoras” then educate and disseminate health information to other Latinas in the community via events and activities. Churches have been chosen (regardless of denomination) as the mechanism for recruitment and dissemination of information based on the results of the extensive needs assessment, which indicated that Latino immigrants tend to trust these organizations. 

For ten consecutive years, in collaboration with Susan G. Komen North Central Alabama, the promoters have conducted yearly luncheons in local churches where a Spanish-speaking physician provides education on breast and cervical cancer early detection and screening and participants are given the opportunity to obtain appointments for low-cost clinical breast exams (CBE) and Pap smears at local clinics. Latina immigrants 40 years of age and older are offered appointments for low-cost mammograms at local hospitals. Over 2,000 women have been screened through these educational luncheons.  

The program is currently being implemented in rural counties within the state of Alabama that contain high percentages of Latinos. Promoters have been trained and yearly breast and cervical cancer screening events occur in the following counties: Jefferson, Shelby, Limestone, Madison, Marshall, and Tuscaloosa. 

As part of the Sowing the Seeds of Health program, we also created an informative DVD for health care providers that frequently see Latino patients. The DVD covers topics such as cultural competence in healthcare for Latinos, expectations of Latino patients seeking care, and common culture beliefs and practices of Latino immigrants. The goal of the DVD is to help health care professionals better understand their Latino patients, thus facilitating a more positive experience for both the providers and the patients. 

References:
White, K., Garces, I., Bandura, L., McGuire, A., Scarinci, I.C. (2012) Design and evaluation of a theory-based, culturally relevant outreach model for breast and cervical cancer screening for Latina immigrants. Ethnicity and Disease, 22(3):274-80. PMC3762980.

McGuire, A. A., Garces-Palacio, I. C., Scarinci, I. C. (2012) A Successful Guide in Understanding Latino Immigrant Patients: An Aid for Health Care Professionals. Family & Community Health, 35(1):76-84.