202881 Healthy Start Programa Madrina: A promotora home visiting outreach and education program to improve health among latino pregant women

Tuesday, November 10, 2009

Debra E. Bill, MPH, PhD, CHES , Department of Health, West Chester University of PA, West Chester, PA
Linda Hock-Long, PhD , Research Department, Family Planning Council, Philadelphia, PA
Maryann Mesure, MSS , Maternal and Child Health Consortium of Chester County, West Chester, PA
Pamela Bryer, MPH , Maternal and Child Health Consortium of Chester County, West Chester, PA
Neydary Zambrano, LLM , Maternal and Child Health Consortium of Chester County, West Chester, PA
Background: Perinatal health disparities continue to persist among low-income, Latinas. A promotora program was designed, implemented and evaluated (1996-2005) to improve perinatal health service utilization and perinatal health outcomes in an underserved, low-income, Latino community in northeastern PA. It is still operational today. In this program, promotoras were both bi-lingual and bi-cultural, indigenous women who participated in a comprehensive 115 hour training program to connect low-income pregnant Latinas with needed perinatal support and health promotion services. This model was based on the promotora model used in Mexico. Social support theory guided program design. The objectives of the program were to provide outreach, case management and health education to low-income pregnant Latino women in the project area with high rates of inadequate prenatal care and adverse birth outcomes. Pregnant women were identified through outreach, and an intervention to help them access prenatal care by providing them with support and health education services such as medical interpretation, insurance, health education as well as emotional support was designed/implemented. Using multiple methods of evaluation, ten year program results show that the program was successful at linking pregnant Latinas (N=2,053), to perinatal health care health education and support services, as well as decreasing barriers to prenatal care. Outcome electronic birth record data (N=1,566) indicates that HSPM participants had fewer babies born early and with low birth weight compared to births in a non-participant group. Implications for practice and research are discussed, as well as strengths and limitations.

Learning Objectives:
Learner Objectives: 1.) Identify and explain some key program components found in a successful perinatal health promotion program for low-income, pregnant Latinas; 2) Discuss possible benefits in using a promotora model for health promotion among Latino groups 2.) Describe how health professionals could plan to apply this type of model in health promotion practice with underserved Latinos.

Keywords: Perinatal Health, Latino Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: 25 years experience in program development/research with Latinos in public health
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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