Promotoras Voice Their Challenges in Fulfilling Their Role as Community Health Workers

Orpinas, Pamela; Matthew, Rebecca A.; Alvarez-Hernandez, Luis R.; Calva, Alejandra; Bermúdez, J. María

doi:10.1177/1524839920921189

Cited by 6 publications

(9 citation statements)

References 41 publications

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“…In the traditional Latinx cultures, these cultural and gendered related values intersect with boundary setting, as Latinas are often socialized to be self-sacrificing, yielding, and accommodating, which centralizes their roles as caretakers. For example, the promotoras have verbalized the need to balance participants’ demands with family responsibilities (Orpinas et al, 2021). They wanted to be caring and responsible yet felt bad when they had to say “no” or make time for themselves.…”

Section: Introductionmentioning

confidence: 99%

“No queremos quedar mal”: A qualitative analysis of a boundary setting training among Latina community health workers.

Alvarez-Hernandez¹,

Bermúdez²,

Orpinas³

et al. 2021

Journal of Latinx Psychology

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Community health workers (CHWs)-or promotoras de salud in Spanish-have successfully addressed the health needs of Latinx and immigrant populations. However, for promotoras, setting boundaries is particularly difficult given challenges like residing in the same communities as their participants. The purpose of this study was to describe the development and impact of a boundary setting training to support the emotional well-being of immigrant promotoras. The training (four 1-hr sessions) was informed by social cognitive theory and a Chicana feminist framework. The promotoras who participated in the training helped create Lazos Hispanos, a community-based participatory research (CBPR) study and CHW program located in the Southeastern United States. The goal of Lazos Hispanos is to increase access to health and social services among local Latinx community members. Five promotoras completed the training after 1 year of participating in the program. Thematic analysis was used to interpret findings from two semistructured group interviews. Two themes emerged: (1) the promotoras negotiated gendered and cultural expectations when setting boundaries, and (2) they felt a stronger sense of personal and professional agency. Findings suggest that this boundary setting training had a positive effect on their sense of professionalism, emotional well-being, and ability to establish boundaries. They reported having less guilt and anxiety as they navigated gendered and culturally informed expectations. Similar training could be adapted to other immigrant and minoritized groups. Public Significance StatementPromotoras de salud often experience challenges when setting boundaries with participants. Gendered and cultural values and expectations often complicate this process. We developed gender and culturally responsive training for establishing professional boundaries. The training resulted in enhanced emotional well-being among the promotoras as they learned to set limits, expectations, and goals early in the relationship with community participants.

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Section: Introductionmentioning

confidence: 99%

“No queremos quedar mal”: A qualitative analysis of a boundary setting training among Latina community health workers.

Alvarez-Hernandez¹,

Bermúdez²,

Orpinas³

et al. 2021

Journal of Latinx Psychology

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“…The promotoras identified several challenges of their new role: work‐family balance, emotional impact of hearing participants' problems, power imbalance with men, language barriers, lack of transportation among promotoras and participants, perception of ethnocentric beliefs and discrimination of some providers, cultural beliefs of some Latinx community participants, and data collection. Details of these challenges have been described elsewhere (Orpinas, Matthew, Alvarez‐Hernandez, Calva, & Bermúdez, , under review).…”

Section: Resultsmentioning

confidence: 99%

A multistakeholder evaluation of Lazos Hispanos: An application of a community‐based participatory research conceptual model

Orpinas

Matthew

Bermúdez

et al. 2019

Journal Community Psychology

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The goal of Lazos Hispanos is to enhance the health and well‐being of the Latinx community through promotoras, who connect community members with service providers for multiple health and social needs. A community‐based participatory research conceptual model framed the multimethod evaluation of promotoras, service providers, and community participants at baseline and at the 1‐year follow up. The promotoras increased their self‐efficacy and knowledge, felt a strong sense of commitment to the community, viewed themselves as a bridge between participants and providers, and felt empowered by their new role. Service providers valued the promotoras as their ambassadors in the community and Lazos Hispanos as central to connecting service providers, promotoras, and community members; they noted that this collaboration increased their accountability with the Latinx community. This multistakeholder evaluation highlights the depth of positive changes achieved during the first year and the challenges of a community‐embedded project and the benefits and possibilities of calling upon theoretically informed evaluation models.

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“…Results from this pilot study suggest that our multifaceted partnership model engaged families and provided support for home visitors yet also point to the need for future work. As in other studies engaging frontline staff in data collection (Orpinas et al, 2019), we experienced data completeness challenges; only 20% of families completed the 1-month follow-up despite text, phone, or online options. This was not surprising given our population of relatively underresourced families experiencing daily stressors and pandemic-related challenges, but results should be interpreted with caution.…”

Section: Conclusion Future Directions and Implications For Practicementioning

confidence: 99%

“…In addition to COFI, we incorporated adult learning principles (Bryan et al, 2008) such as building motivation through addressing personally salient, real-world problems (Peyton, 2013). The Reflective Practice curriculum was designed to support HHC’s home visitors–both staff and peer educators—to reduce burnout leading to high turnover and stress-related impairment (Cocker & Joss, 2016; Orpinas et al, 2019). Home visitors in environmental health contexts often have little formal support to manage the emotional toll of working with families experiencing unavoidable adversity and limited structured opportunity to process these experiences with peers.…”

Section: Conceptual Modelmentioning

confidence: 99%

“…Community–academic partnerships addressing residential household lead exposure reduction are a vital public health strategy to maximize resources and expertise from community and academic partners (Nicholson, 2018). Although home visiting allows for direct connections with families, community-based home visitors often experience strain and burnout given limited resources and exposure to families’ stressors (Cocker & Joss, 2016; Orpinas et al, 2019). The current report describes Parenting and Lead Mitigation at Home , a multifaceted partnership among university, community-based organization, and community-member partners to pilot (a) development and implementation of a peer-delivered education program for parents of young children at risk of residential lead exposure and (2) initial testing of a curriculum to systematically support home visitors.…”

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confidence: 99%

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Parenting and Lead Mitigation at Home: A Multifaceted Community Partnership Model Promoting Parent Engagement in Lead Exposure Prevention

Miller

Stein

2022

Health Promotion Practice

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Young children are at high risk of lead poisoning, which can damage early cognitive and behavioral development and have long-lasting impacts. Home environments are persistent sources of exposure for children in urban, low-income settings. Community–academic partnerships are essential for public health intervention strategies addressing residential household lead exposure, yet community organization staff and home visitors often experience strain and burnout. We describe Parenting and Lead Mitigation at Home, a multifaceted partnership project to (a) develop and implement a community-based, peer-delivered education program for parents of young children in neighborhoods at risk for home lead exposure and (b) support the home visitors delivering programming. We developed, delivered, and initially evaluated Lead 101, a lead-exposure prevention curriculum informed by the Community Organizing and Family Issues (COFI) model. The goals were to educate parents around lead exposure risks and empower parents to reduce their child’s risk. We developed a novel Reflective Practice pilot curriculum designed to provide emotional support to peer educators and community organization staff who delivered home-based programming. We trained 11 peer educators who delivered Lead 101 to 62 families. We pilot-tested the Reflective Practice curriculum with five community organization staff. The implementation process and pilot evaluation data suggest increased parent knowledge and self-efficacy regarding mitigation of home-based lead hazards, and high satisfaction with reflective practice. Using this model to develop multifaceted partnerships among universities, community-based organizations, and focal communities may facilitate community-engaged program development for families and systematic support for individuals working directly with families, thereby indirectly promoting child health and well-being.

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Promotoras Voice Their Challenges in Fulfilling Their Role as Community Health Workers

Cited by 6 publications

References 41 publications

“No queremos quedar mal”: A qualitative analysis of a boundary setting training among Latina community health workers.

“No queremos quedar mal”: A qualitative analysis of a boundary setting training among Latina community health workers.

A multistakeholder evaluation of Lazos Hispanos: An application of a community‐based participatory research conceptual model

Parenting and Lead Mitigation at Home: A Multifaceted Community Partnership Model Promoting Parent Engagement in Lead Exposure Prevention

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