Date of Award

1-1-2011

Document Type

Campus Access Dissertation

Department

Health Promotion, Education and Behavior

First Advisor

Daniela B Friedman

Abstract

Obesity-related diseases disproportionately affect Hispanic women. Successful health programs that prevent or control obesity-related diseases have used promotoras de salud to teach and model lifestyle behaviors aimed at reducing obesity. This study explored planners' conceptualizations of promotoras' roles and how they selected and trained promotoras to deliver and sustain community health programs for Hispanic women. Twenty-four program planners of promotora-led obesity-related programs were interviewed and asked for their promotora training materials. Interviews were transcribed, organized using ATLAS.ti software, and analyzed. A content analysis of seven promotora training curricula from 12 planners was performed to examine materials for content and readability. Participants' past experiences and history working with promotoras influenced their expectations and the ways they conceptualized promotora roles, selection processes, training and educational needs, and sustainability. Whether or not promotoras were community volunteers or paid staff influenced recruitment and selection methods, which also differed across organizational contexts and environments. Participants used various promotora training materials and curricula that included communication and program-specific skill-enhancing activities. Participants had different perspectives on how to sustain health programs and about whom and/or what should be sustained at program completion. An interesting finding was how some program planners challenged the notion of sustainability by reframing it as promoting individual promotora well-being and social mobility rather than maintaining their role in the program over time. Funding was the most frequently mentioned challenge to program and promotora sustainability. Practical implications for program planners include the need for program-specific promotora job descriptions, accompanied by the requisite training. Depending on the program's environment and context, it is important that health program planners create position parameters in order to facilitate training and support sustainability. Authors suggest planners create and periodically assess promotora recruitment and selection protocols to assist with selecting promotoras de salud who best fit program and community-specific needs. The development and dissemination of a sustainability plan with details about who and what to sustain and methods to ensure the plan is being followed throughout the program may benefit organizations, program planners, community partners, researchers, and promotoras.

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