Moving toward Barrios Saludables:Lessons Learned from Promotora Interventions in Latino Neighborhoods

A goal of the Vias de la Salud Health Promoter Program of the Latino Health Initiative of the Montgomery County, Maryland Deparment of Health and Human Services is to promote "barrios saludables"(healthy neighborhoods) in areas where Latino population is concentrated. Central Americans immigrants are the majority of the 125,000 County Latino residents,whose health status is widely disparate from that of the non-minority population. The promotoras are trained volunteer lay health educators, who reside in and carry out their interventions in these neighborhoods. Over the last three years, the promotoras have carried out 17 caminatas-multiple-session interventions that encourage adults, children, and families to incorparte physical activity and healthy eating in their daily lives. Promotoras hold the caminatas in elementary schools, adults English as Second Language classes, and low income housing services. More than 300 Latinos (108 adults and 195 children) have participated to date.In post-intervention survey of parents whose choldren participated, 54% reported their children increased physical activity, 64% reported their children increased consumption of fruits and vegetables, and 72% reported and increase drinking water(vs soda). This paper will present, from the perspective of both the promotoras and the program management, an analysis of the factors that contribute to the move toward healthy neighborhoods and those that still represent challenges, including the current ant-immigrant movement in the nation. Quantitative and qualitative data are drawn from promotoras'reports of each caminata session, supervisor's observations, and routine feedback sessions with promotoras.