Scheduled for Research Coordinating Board Oral Presentations: Women's Health Issues, Friday, March 16, 2007, 7:30 AM - 8:30 AM, Convention Center: 338


An Evaluation of a Home Visiting Promotora Outreach and Education Program (POEP) for Hispanic Pregnant Women

Debra E. Bill, West Chester University of PA, West Chester, PA

Purpose of study: The purpose of the study was to determine the effectiveness of a POEP to help low-income mainly Hispanic women access prenatal care and improve birth outcomes. High rates of infant mortality and low birth weight continue to persist among minority groups. This program was a part of the National Healthy Start Initiative to eliminate ethnic and racial disparities in perinatal health outcomes in underserved minority communities. Promotoras or community health workers are trusted community residents who serve as bridges between the medical establishment and the community. In this program, promotoras were both bi-lingual and bi-cultural (Spanish speaking) indigenous women who participated in a comprehensive 112–hour training program to connect low-income pregnant women with needed perinatal support and health promotion services. Promotoras identified pregnant women through community outreach, and then helped them access prenatal care by providing them with a panel of support services such as medical interpretation, transportation, insurance application and enrollment, health education as well as emotional support and guidance. Methods: Qualitative and quantitative methods were employed to assess outcomes and impact. Twelve promotoras delivered services to more than 3000 pregnant women. Results: Data analyzed from 1996-2003 compared electronic birth record outcomes of 1,073 participants and compared them to birth records from two groups of demographically similar non-participants from the same time period. Program participants had better rates of low pre-term birth, low birth weight and birth spacing, when compared to the comparison groups. The qualitative data revealed the program was highly rated and valued by many Hispanic women and demonstrated the need for medical interpretation services (at perinatal clinical appointments), transportation assistance and insurance assistance to help these women access timely prenatal care. Many participants were recent immigrants from Mexico who were low-income, uninsured and largely monolingual Spanish-speakers. Promotoras provided a plethora of health education services in the home and community to include a series of childbirth classes and parenting classes in Spanish. Implications for practice are discussed, as well as lessons learned from this type of culturally appropriate model of health care and health promotion. Learner Objectives: 1.) Audience members will be able to better understand the promotora model for health promotion and under what circumstances it can be implemented for Latino groups 2.) Audience members will be able to state three methods to evaluate a promotora health promotion program in a maternal and child health community-based setting.
Keyword(s): community-based programs, health promotion, multiculturalism/cultural diversity

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