Abstract
U.S. Latinos face multiple inter-related barriers to access health and social services. Researchers and practitioners have called upon community-based participatory research (CBPR) to address such challenges and health disparities, with the community health worker—or promotoras—model evidencing positive outcomes. What is less clear, however, are the promising strategies to support the development of a multisystem, community-based promotoras program. In response, the current study applied a CBPR conceptual model as an organizing framework to develop a promotora program. Lazos Hispanos (Hispanic Links) was developed to enhance the health and well-being of Latinx residing in low-income communities in the Southeastern United States. This study highlights 16 lessons learned, anchored in the first two dimensions of the CBPR conceptual model: community context and partnership development. First, the community assessment and activities leading to Lazos Hispanos took nearly 2 years but were crucial to develop a strong basis for the program. Second, the development of a multicultural and interdisciplinary research team enriched every aspect of the program and enhanced culturally responsive community engagement. Selection, training, and ongoing support of the promotoras were fundamental to program success. Particularly important were the following: receiving mentorship from a successful promotora organization; delineating mutually agreed upon roles and responsibilities; following national training standards for community health workers; and, holding monthly meetings for training, support, and data collection. The engagement of community service providers as partners was facilitated by building upon existing community relationships, signing a memorandum of understanding that specified roles and responsibilities, conducting tours of provider facilities with the promotoras, and keeping providers abreast of the program via bi-annual community gatherings. The development process showed fidelity to the conceptual model. Lazos Hispanos has proven an asset to participants, the promotoras, and service providers as the program continues to develop a community-based, health supportive infrastructure.
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Acknowledgements
The authors acknowledge las promotoras—las fundadoras de Lazos Hispanos—who individually and collectively exemplify the ways in which community-based knowledge and leadership can shift the health and social service landscape in more health-supportive and culturally responsive ways. We would also like to extend our gratitude to PASOs and our additional research team members, without their knowledge, expertise, and commitment to Latinx health and wellbeing this project would have lacked the multidisciplinary foundation from which it has flourished. We thank Carmen Kraus, MS, BFA, for the design of the figure, and Charles Ashley Warnock, BS, and Vineet Raman, BA, BS, for their data entry and processing support. And, to our collaborative community partners, our sincerest appreciation for your willingness and enthusiasm to join this partnership as we strive to enhance access and quality of health and social services in our local Latinx community.
Funding
Formative research was supported by The Sapelo Foundation; The University of Georgia’s Center for Social Justice, Human and Civil Rights, Office of the Vice President for Research, The Latin American and Caribbean Studies Institute; the U.S. Department of Education Title VI Grant #P012A140046; and La Vida Yoga/Work for America Foundation. The current program is supported by the University of Georgia’s 2017–2018 Office of the President’s Interdisciplinary Seed Grant and by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR002378. The content is solely the responsibility of the authors and does not necessarily represent the official views of the U.S. Department of Education or the National Institutes of Health, and endorsement by the Federal Government should not be assumed.
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Matthew, R.A., Orpinas, P., Calva, A. et al. Lazos Hispanos: Promising Strategies and Lessons Learned in the Development of a Multisystem, Community-Based Promotoras Program. J Primary Prevent 41, 229–243 (2020). https://doi.org/10.1007/s10935-020-00587-z
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DOI: https://doi.org/10.1007/s10935-020-00587-z