I was very fortunate to be hired as a health educator, on the streets of San Gabriel Valley, Los Angeles County, and at Pitchess Detention Center, in 2003. My first day, August 2003, I flew to Denver for a conference regarding HIV/AIDS. I went with my co-worker, his first time flying, and with our boss. C and I were prolly the only straight people there; different for him, not for me, I had been going to LBGTQ AA meetings for years [those folks don't play, it's not about losing their yacht, it's about staying sober] and was delighted to be there. One night, I went to my room to dress for dinner. When I opened my door, the sliding glass door was open and my room was filled with Monarch butterflies, no lie. I called C and he came to my room; we both just stood there in shock. I didn't even have my Mana Mariposa tattoo yet, but I did listen to the song ... all the time. It was prolly my boss lol 🦋💔
The next month, I was off to San Francisco for another conference, hosted by Centerforce, an organization that advocates for the incarcerated population and their families. Before I flew up, my boss registered me for relative seminars to job, then left a couple of times open where I could choose what I wanted. I signed up for a class involving everything Madrinas [nope, not what you think, so keep reading].
Madrinas, in the bay area, are a group of women that made outreach calls, in the community, to newly located Latino / Hispanic people and their families. More than likely they were families from Mexico, that started out as agriculture workers ... I am not sure though. The goals of the Madrinas, was to welcome, inform, and educate the families. They let them know who they could trust in the community for services, like beauty salons, markets, hospitals and doctors, etc. For the Madrinas, it is about taking care of their people, love, staying cohesive, & instilling surety where there might be doubt. And you know me, I loved the idea and fell in love with their vocation Can you imagine moving to a new area, not knowing anyone or anything and having some women come to your home with pan dulce to welcome you in to the community? It's amazing to me. My Nuni came to Burbank around 1925. Across the street were the Valentes, also Italian. Mr. Valente taught English to new Italians moving into the area. How did he know? Perhaps, at my Nuni's market down on Flower St. At any rate, it's a great thing & it didn't stop there.
After returning to work and excitedly telling everyone in the office about the Madrinas, my boss approached me stating that he needed me in a few weeks on a Sunday in West Covina for the day. Okay, no problem. I showed up and we walked into a room filled with women, not any women, but Madrinas, the Madrinas for that area and they were having their monthly meeting. Wow! Yep, I cried I was so excited and happy to meet them and hear their stories about how they helped and strengthened their community by doing outreach. Such a basic idea, with benefits and long-lasting positive outcomes. These gals were doing more than bell ringing and door knocking; they evaluated themselves as outreach workers and the efficacy of their impact efforts. Needless to say, I'll never forget that Sunday.
One final word, on these groups. If the group are women, then they are called Las Madrinas and if men are involved, then they are called Los Padrinos.
Fast forward to graduate school, 11 years later; I started doing research and came across the terms, Promotoras [women] and Promotores [men] and CHOW [Community Health Outreach Worker], an extension built on the Madrinas framework. A lot of these folks are not paid, but most are and they are spread out in the United States. Right here in LA, CHOWs go out to households based on need and contract & there cause is not always healthcare based. If you're Spanish speaking consider doing this, if helping people is what you like to do. Here is some info and then I'll explain just how powerful and essential these folks are:
https://www.1degree.org/opp/get-help-controlling-asthma-with-esperanza-community-housing-los-angeles-ca
I can't find the article, but it was either Children's or LA County Hospital that started seeing spikes in ER visits from families with asthmatic children. [Whatever you want to call these outreach angels, they provide a much needed service in many communities, by acting as liaisons between hospitals, urgent cares, clinics, doctors, nurses & the home.] So, the hospital knew they had to do something. They applied for a grant, hired outreach workers, trained them, then sent them out to homes where asthmatic children lived. The workers inventoried the homes for chemicals that might trigger an asthma attack, inspect the sleep area for allergens, discuss the child's activities and their diets, and their medicines, especially adherence. The team would replace household cleaners with non-toxic products, bring in hypoallergenic linens, discuss dietary changes and make their medication something manageable by the child. When a child's asthma is out of control, the entire family is affected.
After a few months of weekly and monthly visits to these affected homes, the hospital ER reported a significant drop in ER and doctor office visits, as well as reports from parents that extreme asthma events were also on the decline. Life saving, family building, community sustainability ... Promotoras!
Promotores de Salud/Community Health Workers
What are promotores de salud? Promotores de salud, also known as promotoras, is the Spanish term for “community health workers”. The Hispanic community recognizes promotores de salud as lay health workers who work in Spanish-speaking communities.
This is How We Stop Zika
This Is How We Stop Zikaexternal icon (Españolexternal icon) is a communication campaign supported by the CDC Foundation, CDC and several other partners. The campaign seeks to inform and motivate people to stop the spread of Zika (especially to pregnant women and their developing babies) by providing information and resources on how individuals can take action to prevent Zika by protecting themselves, their home, and their community. The effort includes a dedicated Facebook page and several digital and print resourcesexternal icon currently available on the website.
Visit the Stop Zika website at http://helpstopzika.org/external icon for more information.
U.S. Department of Health and Human Services (HHS)
HHS Promotores de Salud Initiative
The goals of the HHS Promotores de Salud / Community Health Workers Initiative are to:
Recognize the important contributions of promotores in reaching vulnerable, low-income and underserved members of Latino/Hispanic populations, and
Promote the increased engagement of promotores to support health education and prevention efforts and access to health insurance programs.
HHS, Office of Minority Health (OMH), Think Cultural Healthexternal icon
Promoting Healthy Choices and Community Changes: An E-learning Program for Promotores De Salud
AMIGAS
Use of training materials by promotoras to improve cervical cancer screening rates in the Hispanic community.
AMIGAS stands for “Ayudando a las Mujeres con Información, Guía y Amor para su Salud.” In English, this means “Helping Women with Information, Guidance, and Love for Their Health.” AMIGAS is a bilingual educational outreach intervention designed to help promotoras and other lay health educators increase
Cervical cancer screening among Hispanics who have rarely or never had a Pap test. A randomized controlled trial recently funded by CDC, showed AMIGAS is effective in promoting cervical cancer screening (Pap tests) among Hispanics aged 21 to 65 years.
Addressing Chronic Disease through Community Health Workers
A Policy and Systems-Level Approach
Second Edition
April 2015
This document provides guidance and resources for implementing recommendations to integrate community health workers (CHWs) into community-based efforts to prevent chronic disease. It sets forth evidence demonstrating the value and impact of CHWs in preventing and managing chronic diseases and describes comprehensive state policies, programs that engage CHWs, and resources to assist state health departments and others.
... want to keep reading?
https://www.cdc.gov/minorityhealth/promotores/index.html
Something you'd like to do?
http://publichealth.lacounty.gov/nut/promotores.htm
LA County to Expand Promotores Program to Reach More Diverse Communities
https://hildalsolis.org/la-county-to-expand-promotores-program-to-reach-more-diverse-communities/
Integrating the Promotores Model to Strengthen Community Partnerships
https://cssp.org/wp-content/uploads/2019/02/CSSP-Toolkit-4-RBA-Integrating-Promotores.pdf
Meet Lead Promotoras
https://www.elawc.org/meet_lead_promotoras
They go one by one, door by door — how a hospital’s ‘promotoras’ are bridging gaps to services
https://www.latimes.com/california/story/2021-05-07/they-go-one-by-one-door-by-door-how-hoags-promotoras-are-bridging-gaps-to-services
BY LILLY NGUYEN DAILY PILOT
MAY 7, 2021 5:20 PM PT
It’s another Thursday morning on Costa Mesa’s Shalimar Drive.
Cars rumble down the road. Distantly, banda music spills out the open windows of a ground-floor apartment. The playground is empty, with all the children having returned to their classrooms. The newest arrivals on the block — this day, at least — clutch clipboards in one hand and a stack of fliers tucked away in clear, plastic bags in the other.
It is time to make their morning rounds.
Shoes hit the pavement, and before they even start heading up the staircases of the nearby apartment buildings, before they make their way into the narrow corridors, the group of four approaches passing residents to ask: Have they had the COVID-19 vaccine yet and, if not, do they know where to get it? Do they have any concerns?
This is routine for the “promotoras” of Hoag Memorial Hospital Presbyterian in Newport Beach — bilingual representatives who connect lower-income families with services such as mental health or rental assistance and, more recently, share information on COVID-19 and how to get the vaccines.
The program started about three years ago, said Arturo Diaz, supervisor of the Melinda Hoag Smith Center for Healthy Living.
The center provides mental health services and food distribution and houses nonprofits such as Share Our Selves. It‘s also where the Newport Mesa Family Resource Center is located.
Diaz said the promotoras program is funded by philanthropists Todd and Linda White. Diaz recalled the team was studying the promotoras program for Latino Health Access, a nonprofit in Santa Ana, when the Whites approached the center.
“The Whites asked us, ‘If we were to fund, what would you do with it?’ and [the promotoras program] was the first thing that came to mind, specifically because it’s grassroots,” Diaz said.
“The thought was we have to go out there and make these services accessible to those who don’t know we’re here,” he said. “We have a lot of people coming through here, which is beautiful, but there’s still those people that — either they don’t know about us or they struggle to get in here. Depression will do that to you.
“It can be very difficult sometimes,” he said. “Sometimes, you hear someone knock on your door. Not to sell you anything, but just to check in and say, ‘Hey, how are you all doing and did you know these services were available?’ and you’d be surprised how many people just need that little bit of encouragement. ... How long have they been waiting to have someone to talk to?”
The promotoras at Hoag go into neighborhoods such as Shalimar and the Oak View neighborhood in Huntington Beach to pass along information about services available at the Melinda Hoag Smith Center for Healthy Living and the changing news of the pandemic.
At one point, they brought their laptops around Oak View to get interested people registered for a vaccine appointment.
The team is made up of four outreach workers — Rosalba Lezo, Rocio Matlabalcazar, Bryan Giraldo-Martinez and Santiago Pedraza — in addition to Diaz and the social workers at the center.
Lezo said she and Pedraza try to make it out to the Shalimar neighborhood at least two days a week for eight hours each day.
“We’re talking about a community that didn’t know where to get tested. Was testing available? Did you have to pay for it? As we started getting news, we came out here and it was literally door to door because a lot of misinformation comes through social media. That’s where they were getting [information],” Diaz said.
“We just started coming out here and saying like, ‘Look, this is the most recent information. As we’re getting it, we’re bringing it to you guys. This is where you can get tested. They do not charge here. If you’re getting charged, you need to let us know so we know not to be promoting this place,’” he said.
“But that wouldn’t happen through a phone call. They wouldn’t trust us. We’re just some random person, but because [the promotoras] are already a face in the community, they’re not strangers or not complete strangers,” Diaz continued.
Data show that Latino communities in Orange County have been hit hard by the pandemic, which experts say is because many work in the service sector or are employed in essential jobs.
The health equity quartile positivity rate was introduced in October as a metric determining a county’s tier to ensure disadvantaged neighborhoods did not significantly exceed a county’s overall positivity rate. It is 1.4% in Orange County.
“Right now, we are promoting food distribution, information about the vaccine, the clinics that we have available. Just getting that information to the community, I think is a great opportunity to help those individuals that are underserved,” Lezo said.
Pedraza added, “Sometimes, the lower income people get lost in such an affluent area, so [we’re] just trying to highlight these pockets [where] they’re not getting the resources that they need.”
“Sometimes, I think as professionals, we think we know what people need, but if you’re not out here hearing from them, seeing it for yourself ... it’s kind of out of sight, out of mind,” Diaz said. “But once you’re out here, doing the footwork, you get to see not only the economical needs but the psychosocial impact of poverty.”
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