Promotoras as facilitators of change: Latinas' perspectives after participating in a lifestyle behaviour intervention program

Abstract

Aim To describe immigrant Latinas’ perspectives of a lifestyle behavior intervention, focusing on their interactions with and perceptions of the promotoras who delivered the program in the United States. Background Immigrant Latinas in the United States have high obesity rates, which contribute to increased risk for cardiovascular disease and other chronic diseases. Interventions using the promotora model appear to be effective in reducing cardiovascular disease risk by improving dietary habits, physical activity, and selected clinical variables among Latinas. However, there has been very limited inquiry into what it is about these interventions and promotoras that facilitates behavior change, from the perspective of participants. Design Grounded theory methodology guided the data collection and analysis. Methods This qualitative study was completed in 2012 in California, after the end of a lifestyle behavior intervention. Four focus groups and seven one-on-one interviews were conducted with a total of 18 immigrant Latina intervention participants. Results Women described promotoras as helping them change by motivating them through three interconnected elements: tools, support, and knowledge. Latinas viewed their ability to make lifestyle changes as connected with their emotional and psychological health, and saw promotoras as counselors who provided emotional and social support. In this respect, the intervention was emotionally therapeutic for this sample of Latinas, although this was not the original intention of the program. Conclusion Promotoras provided the backbone of the intervention and were crucial in motivating Latinas to implement lifestyle changes. Future lifestyle behavior interventions should include a strong component of mental and emotional well-being.

A community health worker-led lifestyle behavior intervention for Latina (Hispanic) women: Feasibility and outcomes of a randomized controlled trial

“…To achieve target goals for lipids, greater intensity and/or duration of the lifestyle behavior intervention with structured moderate physical activity and healthy dietary habits may be needed. For those women reporting depressive symptoms, increased emotional support also may be required to enhance their ability to make lifestyle changes (Albarran et al, 2014). Studies show depression is associated with non-adherence to dietary (Aggarwal et al, 2010) and physical activity (Mazzeschi et al, 2012) recommendations.…”

“…Through follow-up interviews and focus groups with 18 women in the intervention, we gained enhanced understanding about the important role promotoras fulfilled in the intervention (Albarran et al, 2014). The women shared how promotoras facilitated behavior change by motivating them through three interconnected elements: tools (e.g., pedometers); knowledge (facts and ideas transmitted within an interactional process); and emotional and social support.…”

Awareness of Cardiovascular Disease and Preventive Behaviors Among Overweight Immigrant Latinas

“…Our understanding about the valuable role of promotoras in imparting knowledge was enhanced through qualitative interviews of a subsample of participants. 42 We learned that knowledge was not simply perceived as cognitive content (facts and ideas) by Latinas; rather, knowledge development included an interactional process experienced by participants while engaged in dialogue with the promotora and other women.…”

Academic-Community Partnership to Develop a Patient-Centered Breast Cancer Risk Reduction Program for Latina Primary Care Patients

“…Promotores/as are lay health advisors that provide community health education and generally are culturally and linguistically aligned with the target population, of the same age, and have had personal or close experience with the disease (e.g., cancer) for which s/he is providing education. Promotores/as are formally trained to provide group or one-on-one education to build knowledge using local resources and services, aid with patient navigation, and increase health-care service access and utilization [92–94]. Recent research shows that the integration of community health workers (i.e., promotoras ) as part of the patient-care team can assist primary care settings to become more patient-centered [95].…”