For more information:

Dr. Isabel Scarinci
UAB, Division of Preventive Medicine, Minority Health and Research Center
(205) 975-7627
scarinci@uab.edu

Promotores de Salud (Latino Community Health Advisors)

Sowing the Seeds of Health – A Lay Health Promoter Program

Sowing the Seeds of Health (Sembrando Las Semillas de La Salud), a lay health promoter program tailored to Latinos in Alabama, was developed and pilot-tested in 2003 as a collaboration between the UAB Minority Health and Research Center, UAB Division of Preventive Medicine and St. Vincent's Hospital Hispanic Outreach Program under the leadership of Dr. Isabel C. Scarinci and Ms. Lisa Reddington Bandura. The program is based on the following foundation: (a) extensive formative assessment through which members of the target audience were involved in all steps of program development, making it culturally-relevant; (b) true collaboration between two organizations by bringing together resources and expertise; (c) it is manualized; (d) it is theory-based; and (e) it has strong process and outcome evaluation components. This program was pilot-tested and evaluated among a group of lay Latino individuals recruited through local Catholic churches with very positive results, and it has proven the strength of empowering lay health individuals.

Sowing the Seeds of Health empowers natural leaders in the Latino community with the resources and knowledge of where to go and what to do for health services. They help others access needed health services, and they educate the community on important health related topics, such as cancer, diabetes, etc. In doing so, the lay health promoters facilitate the health and wellness of the entire community.

"The goal of training the Sowing the Seeds of Health promoters is to assist the Latino community in the greater Birmingham area in accessing healthcare services, and to increase awareness among Latinos of health and wellness services in their communities," said Lisa Reddington Bandura.

Potential lay health promoters are carefully recruited to participate in the program. Churches have been chosen (regardless of denomination) as the mechanism for recruitment and dissemination of information based on the results of extensive needs assessment which indicates that Latino immigrants tend to trust these organizations. The program consists of an 8-week training as well as monthly booster sessions. It has two major components: knowledge and skills. The knowledge component focuses on health topics and behaviors that have been identified as relevant by Latino immigrants in Alabama (e.g., health care access, breast and cervical cancer, diabetes, depression, alcohol use/abuse, and sexually transmitted diseases). The skills component focuses on skills necessary to carry out the outreach activities such as communication skills, problem solving, etc. Each promoter has a resource manual filled with information regarding services and health topics. The health promoters are then responsible for sharing this information with their congregations through lectures, brochures, announcements, health fairs, etc. Upon admission into the program, promoters are asked to sign a contract committing to donate 100 hours of outreach services to their community during the first year, and this contract is renewed yearly thereafter.

The training is based on the Empowerment Model in which the lay health promoters are “empowered” to design their own plan of action as a group, based on their perceived health needs of the Latino community. That is, after they are provided with knowledge and skills, they are encouraged to identify the health priorities in the Latino community and develop a plan of action on how they will address these priorities (in addition to dissemination of health information and health care access facilitation).

After the eight-week training is complete, the health promoters are commissioned into service in a ceremony that includes a presentation to the congregation announcing the new ministry of health promotion. Following the commissioning, the promoters are available after church services and on a regular basis to answer questions and promote health in their communities. The health promoters continue meet monthly for continuing education, for the opportunity to share ideas, challenges, plan outreach events as well as further education on knowledge and skills that were not covered in the 8-week training.

A key component of this program is empowering community members and giving them the ability to lead and guide others, according to Dr. Scarinci. "The program belongs to the promoters, we just provide the guidance," added Scarinci. Another important component of this program is that promoters do not organize any health education events without assuring that services are available to address identified health problems.

Since the program’s inception in 2003, two trainings have been held, and there are currently 10 active lay health promoters from four area church congregations in the greater Birmingham area. Besides serving as resources in their individual communities, the promoters have planned several community-wide events to educate the Latino community on important health topics and to further promote healthy lifestyles. For two consecutive years, in collaboration with the Susan G. Komen Foundation of North Alabama, the promoters hosted events in the Latina community educating Latinas on the importance of screenings for cervical and breast cancer. In 2005 alone over 300 women attended these events (at three different locations), They attended a luncheon in which a Spanish-speaking healthcare professional talked about the importance of breast and cervical cancer screenings and they then had the opportunity to sign up for free or low-cost Pap smears and mammograms. In the 2005 event, 80% of those in need went on to have low-cost Pap smears and mammograms in area clinics.

Not only have the promoters been successful in promoting women’s health, other outreach services have been provided. In July of 2005 together with AIDS IN MINORITIES and the UAB Sodacap Program, they hosted an event for Latino men to learn about their risks for STIs and how to decrease their risk of contracting an STI. At an area apartment complex, educational talks were given to men and appointments were available to men interested in being tested for STI (including HIV).

With each event that Sowing the Seeds of Health has implemented, there has been an overwhelmingly positive response from the Latino community. In the next year the promoters would like to grow Sowing the Seeds of Health into other areas of Alabama. Their goal is to cover a broader geographical area in Alabama in order to get essential information about health and healthcare access to members of the burgeoning Latino community.