#promotora model

[public-health-chronicles]

Biggest Limitation to Study

Lack of Parent Focus Groups

The biggest limitation to this study is the lack of conducted parental focus groups.

The decision to use solely promotoras in the development of the health promotional items materials was to conserve the research team’s modest funds.  

Therefore, the research team relied solely on literature, previous focus groups with promotoras, and the focus groups conducted during the current study. 

Although the promotoras were mostly extremely useful in understanding ways to market and tailor information, some of their responses emphasized the dissimilarities between parents and semi-professional community health workers.

The fact that the promotoras noticed that potential problems could result from some of the original brochure’s specific information (types of autism, causes of autism, treatments) validated our hypotheses that some of the information could instill more questions than answers in concerned mothers. However, the promotoras’ suggested solutions were not expected.  Instead of advising the removal or consolidation of information, the promotoras suggested that more detailed information be included on most topics in the brochure.  We believe this demonstrates the promotoras’ interest in the topics instead of a reflection of the parents’ needs.  

Based on these discussions, the research team believes that it may be difficult at times for the promotoras to separate themselves from their health education role to answer questions on community members’ behalf instead of their personal interests. 

It was therefore concluded that the promotora opinions could not be taken as proxies for the opinions of parents. 

Therefore, although the detailed information is clearly important for the promotoras, it was not necessarily included in the final brochure.  The promotora suggestions were held to the constraints of the available brochure space and the requirements to meet the theoretical framework.  

All of the suggestions given by the promotoras were saved and will be revisited in the construction of the train-the-trainer curriculum.  

[public-health-chronicles]

First Focus Group

This week was hectic in a good way.  I helped screen more participants for the HARC study (the study where we collect bio-samples like teeth, hair, urine, blood etc. to analyze for environmental correlations related to Autism Spectrum Disorders), went to the Border 2012 conference, completed mid-term essay evaluation for USF and HSHPS, and got to the heart of my Autism Spectrum Disorder (ASD) awareness project.

The following is about my awareness project:

After doing a substantial literature review on ASD in South Texas, I was ready to learn more about the needs of the community from community members themselves.  I moderated my first focus groups with eight promotoras in Brownsville to further understand the barriers and challenges that families affected by ASD face.  The promotoras confirmed what I read and have personally witnessed.  There are every few medical resources in the area, no social support systems available and doctors seem to take a long time to diagnose a child with ASD. 

 I also pilot tested an informational brochure with them.  This was extremely helpful- they provided insightful information and suggestions.  For example, they gave me a list of motivating Spanish phrases I could (and will) utilize to encourage parents to seek a medical consultation. Some of the phrases included the following: “que hay apoyo” “que hay ayudas” “que confíen”.  The promotoras also mentioned something crucial about the brochure that I will be changing immediately.  The brochures mention that although there is no known cause for ASD, it is believed to be caused by a combination of genetic and environmental factors.  I learned that by mentioning genetics would create a sense of blame among the mothers.

Last of all, we discussed our idea of incorporating promotoras in our overall project plan.  Since there are so few resources available in the Rio Grande Valley, we are hoping to train promotoras to be a competent resource on the topic.  Affected individuals will then have the option to discuss their concerns with promotoras, who will be able to refer the parents to an appropriate medical provider, put concerned parents in contact with one another, and assist parents with the social services system.  The promotoras were extremely enthusiastic about the idea!  Excellent! 

I facilitated the discussion with 8 promotoras.  We conducted the focus group in Spanish. Dr. Garza, to my left, offered his help when I couldn't understand someone. Carlos, sitting to the right, helped write everything the promotoras said. 

I am listening very hard here.  I'm also hoping that I am truly understanding the conversations.  Although my Spanish is getting better, it is not perfect and I sometimes misunderstand a sentence or two.