Promotores: A community-based health delivery mechanism to reduce health disparities

Reducing health disparities is a public health priority in the United States. Public health programs that use promotores or lay health workers to deliver health services are frequently used to reach Latinos and have the potential to reduce health disparities by increasing access to care. Despite the growing prevalence of promotores-delivered health care, there is little systematic information on the components of effective promotores programs and no well-tested empirical models that explain their common elements. However, systematic information is needed by practitioners in order to build effective promotores programs and by public health and public policy makers who make decisions about the nature and funding of health delivery options. This proposed paper attempts to fill this information gap.

The paper addresses the following research questions: What are the characteristics of effective promotores programs and how should promotores programs be formulated to include key characteristics? We address these research questions by drawing on the results of an environmental scan of scholarly and practitioner literature on promotores programs, including information from Human Resources Services Administration (HRSA) and other national organizations, and primary data collected in telephone interviews from a national sample of key informants at promotores programs and community-based organizations. The result of the analysis is a model that includes programmatic, institutional, and conceptual characteristics of a prototypical promotores program. In turn, the model may be used to inform community-based organizations about best practices in the development of effective promotores programs.