CHAMPAIGN, Ill. — The success of community health interventions targeting Latinos could be hindered by linguistic and cultural gaps unless researchers recognize the diversity that exists among Latino populations and work closely with community members to adapt programming accordingly, a new study suggests.
The use of “promotoras” – volunteers who coordinate health outreach activities in their communities – is a popular method of delivering cost-effective, culturally sensitive health and wellness programs to marginalized populations in Mexico.
While promotora-led community health initiatives have shown promise in addressing health disparities among Latinos living in the U.S., the terminology may carry negative connotations that deter some Latinos from engaging with these programs, according to scholars at the University of Illinois.
The study was associated with a program called Abriendo Caminos-Promotora, an initiative developed at the U. of I. and offered in three nonmetropolitan communities in Illinois with large Latino populations. The program recruits and trains community volunteers to educate Latino families about healthy lifestyles, with the long-term objective of decreasing obesity and related health problems such as diabetes.
In focus groups with Mexican-born women living in those communities, the U. of I. researchers found that many of the participants were unaware that promotoras were community health workers, perceiving these unpaid volunteers to be “unwanted salespeople” engaged in for-profit enterprises instead.
The 36 women who participated in the study were first-generation immigrants who ranged in age from 19 to 64 and had relocated from Mexico to the U.S. as adults.
Published recently in the journal Health Promotion Practice, the paper is believed to be the first study to explore Latinas’ interpretations of the term promotora and document possible semantic, perceptual and cultural differences.
The Latinas in Illinois who said their negative associations with the title promotora made them reluctant to serve in these roles in their communities preferred the title “educadora” – or educator.
Abriendo Caminos-Promotora, which the researchers plan to expand to other Latino communities across the U.S., is led by kinesiology and community health professor Andiara Schwingel; Dr. Margarita Teran-Garcia, a pediatrician and a professor of nutritional sciences; and Angela R. Wiley, a professor of applied family studies. All three are U. of I. faculty members and co-authors of the current study.
The findings were surprising, the U. of I. team said, because the term promotora is commonly used by Latinos living along the U.S.-Mexico border, and there has been significant interest by researchers in designing or adapting health promotion programs to the promotora model to increase these programs’ appeal to Latinos.
“Our findings were unexpected given the frequency with which promotoras are being used in Latino health studies,” Wiley said. “Based upon the responses we obtained in the focus groups, we now know that successful implementation of the Abriendo Caminos-Promotora project will require us to work with these communities to broaden their perception of the term or use terminology that they report more clearly denotes a volunteer community health worker role.”
The findings “underscore the heterogeneity of the Latino population and call attention to the need to engage Latino communities in the development of health programs directed toward them,” the researchers wrote.
“The fact that many of the Latinas in our study didn’t understand the term promotora in the same way the researchers did is just an example of how important it is to work with a community throughout the whole process of research and understand its culture and context,” Schwingel said. “Only by working with community members did we discover this semantic gap. This information is particularly important for recruiting and retaining promotoras in community health programs.”
Additional co-authors of the paper were Jennifer McCaffrey, the assistant dean of family and consumer sciences with the U. of I. Extension; and community health graduate students Patricia Gálvez Espinoza and Marcela Vizcarra-Catalan.
Editor’s note: To reach Andiara Schwingel, call 217-333-5443; email andiara@illinois.edu
DOI: 10.1177/1524839916670576
