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Promotoras as Research Partners to Engage Health Disparity Communities

Published:February 01, 2013DOI:https://doi.org/10.1016/j.jand.2012.11.014
      There is an urgent need to improve nutritional health in health disparity communities such as the growing Hispanic and Latino populations. However, efforts focused on complex nutritional health issues, such as obesity and food insecurity, can be more difficult in underserved and at-risk communities, such as Mexican-origin residents living in communities along the Texas–Mexico border.
      • Johnson C.M.
      • Sharkey J.R.
      • Dean W.R.
      It's all about the children: A participant-driven photo-elicitation study of Mexican-origin mothers' food choices.
      • Sharkey J.R.
      • Dean W.R.
      • Johnson C.M.
      Association of household and community characteristics with adult and child food insecurity among Mexican-origin households in colonias along the Texas-Mexico border.
      Some of these challenges include:
      • establishing trust and rapport with community residents who are markedly different from the university-based research team;
      • working with communities to recruit from a specified sampling frame and to minimize attrition across the life course of a study;
      • adapting data collection protocol and instruments to culturally appropriate and reliable measures of dietary and environmental exposures;
      • accommodating logistics-related challenges of study participants (eg, family, social, employment conflicts, and transportation challenges) to acknowledge the time commitment, minimize attrition, and complete timely and comprehensive assessments; and
      • capturing contextual factors for understanding food- and health-related behaviors.

      Keywords

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      References

        • Johnson C.M.
        • Sharkey J.R.
        • Dean W.R.
        It's all about the children: A participant-driven photo-elicitation study of Mexican-origin mothers' food choices.
        BMC Womens Health. 2011; 11: 15
        • Sharkey J.R.
        • Dean W.R.
        • Johnson C.M.
        Association of household and community characteristics with adult and child food insecurity among Mexican-origin households in colonias along the Texas-Mexico border.
        Int J Equity Health. 2011; 10: 14
        • Health Resources and Services Administration
        Community Health Worker National Workforce Study.
        US Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Washington, DC2007
        • Ayala G.X.
        • Vaz L.
        • Earp J.A.
        • Elder J.P.
        • Cherrington A.
        Outcome effectiveness of the lay health advisor model among Latinos in the United States: An examination by role.
        Health Educ Res. 2010; 25: 815-840
        • Peña S.
        • Rosenthal E.L.
        Colonias health issues in Texas.
        in: Donelson A.J. Esparza A.X. The Colonias Reader: Economy, Housing, and Public Health in U.S.-Mexico Border Colonias. The University of Arizona, Tucson, AZ2010: 176-189
        • Andrews J.O.
        • Felton G.
        • Wewers M.E.
        • Heath J.
        Use of community health workers in research with ethnic minority women.
        J Nurs Scholarsh. 2004; 36: 358-365
        • Ayala G.X.
        • Elder J.P.
        • Campbell N.R.
        • et al.
        Longitudinal intervention effects on parenting of the Aventuras para Niños Study.
        Am J Prev Med. 2010; 38: 154-162
        • Love M.B.
        • Gardner K.
        • Legion V.
        Community health workers: Who they are and what they do.
        Health Educ Behav. 1997; 24: 510-522
        • McCloskey J.
        Promotores as partners in a community-based diabetes intervention program targeting Hispanics.
        Fam Community Health. 2009; 32: 48-57
        • Cornejo E.
        • Denman C.A.
        • Sabo S.
        • de Zapién J.
        • Rosales C.
        Scoping Review of Community Health Worker/Promotora-Based Chronic Disease Primary Prevention Programs on the U.S.-Mexico Border.
        The University of Arizona Mel and Enid Zuckerman College of Public Health, U.S.-Mexico Border Center of Excellence to Counter Chronic Disease, Tucson, AZ2011
        • Witmer A.
        • Seifer S.D.
        • Finocchio L.
        • Leslie J.
        • O'Neil E.H.
        Community health workers: Integral members of the health care work force.
        Am J Public Health. 1995; 85: 1055-1058
        • Forster-Cox S.C.
        • Mangadu T.
        • Jacquez B.
        • Fullerton L.
        The environmental health/home safety education project: A successful and practical U.S.-Mexico border Initiative.
        Health Promot Pract. 2010; 11: 325-331
        • Nuño T.
        • Castle P.E.
        • Harris R.
        • Estrada A.
        • García F.
        Breast and cervical cancer screening utilization among Hispanic women living near the United States-Mexico border.
        J Womens Health. 2011; 20: 685-693
        • Ryabov I.
        • Richardson C.
        The role of community health Workers in combating type 2 diabetes in the Rio Grande Valley.
        J Prim Care Community Health. 2011; 2: 21-25
        • de Heer H.D.
        • Balcazar H.G.
        • Castro F.
        • Schulz L.
        A path analysis of a randomized promotora de salud cardiovascular disease–prevention trial among at-risk Hispanic adults.
        Health Educ Behav. 2012; 39: 77-86
        • Ortiz L.
        • Arizmendi L.
        • Cornelius L.J.
        Access to health care among Latinos of Mexican descent in colonias in two Texas counties.
        J Rural Health. 2004; 20: 246-252
        • Ramirez A.
        • Perez M.
        • Muñoz O.
        • Garcia P.
        • Treviño L.
        • Lara P.
        Family-based health needs along the Texas–Mexico border.
        J Public Health. 2011; 33: 579-586
        • Ramos I.N.
        • Davis L.B.
        • He Q.
        • May M.
        • Ramos K.S.
        Environmental risk factors of disease in the Cameron Park Colonia, a Hispanic community along the Texas-Mexico border.
        J Immigr Minor Health. 2008; 10: 345-351
        • Rhodes S.
        • Foley K.
        • Zometa C.
        • Bloom F.
        Lay health advisor interventions among hispanics/latinos: A qualitative systematic review.
        Am J Prev Med. 2007; 33: 418-427
        • Ruiz Y.
        • Matos S.
        • Kapadia S.
        • et al.
        Lessons learned From a community-academic initiative: The development of a core competency-based training for community-academic initiative community health workers.
        Am J Public Health. 2012; : e1-e8
        • Otiniano A.D.
        • Carroll-Scott A.
        • Toy P.
        • Wallace S.P.
        Supporting Latino communities' natural helpers: A case study of promotoras in a research capacity building course.
        J Immigr Minor Health. 2012; 14: 657-663
        • Sharkey J.
        • Dean W.
        • St. John J.
        • Huber J.
        Using direct observations on multiple occasions to measure household food availability among low-income Mexicano residents in Texas colonias.
        BMC Public Health. 2010; 10: 44
        • Dean W.
        • Sharkey J.
        • Johnson C.
        • St John J.
        Cultural repertoires and food-related household technology within colonia households under conditions of material hardship.
        Int J Equity Health. 2012; 11: 12
        • Dean W.R.
        • Sharkey J.R.
        • St John J.A.
        Pulga (flea market) contributions to the retail food environment of colonias in the South Texas border region.
        J Am Diet Assoc. 2011; 111: 705-710
        • Texas Department of State Health Services
        Community Health Workers-Promotor(a) or Community Health Worker Training and Certification Program.
        (Accessed January 7, 2013.)
        • St John J.
        • Johnson C.M.
        • Arandia G.A.
        • Sharkey J.R.
        • Dean W.R.
        Empowerment: Evolution of promotoras as promotora-researchers in a Comidas Saludables & Gente Sana en las Colonias del Sur de Tejas (Healthy Food and Healthy People in South Texas Colonias) Program.
        J Primary Prevention. 2013; (In press.)
        • HRSA Office of Rural Health Policy
        Community Health Workers Evidence-based Models Toolbox.
        Health Resources and Services Administration (HRSA), US Department of Health and Human Services; August, Washington, DC2011

      Biography

      C. M. Johnson is a doctoral degree student in the Department of Nutrition and a research assistant, Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill; at the time of the study, she was a research associate with the Program for Nutrition and Health Disparities, School of Rural Public Health, Texas A&M Health Science Center, College Station.

      Biography

      J. R. Sharkey is a professor of health promotion and community health sciences, and founding director, Program for Research in Nutrition and Health Disparities, Comidas Saludables & Gente Sana en las Colonias del Sur de Tejas, School of Rural Public Health, Texas A&M Health Science Center, College Station.

      Biography

      W. R. Dean is a research scientist and an assistant professor, Comidas Saludables & Gente Sana en las Colonias del Sur de Tejas, School of Rural Public Health, Texas A&M Health Science Center, College Station.

      Biography

      J. A. St John is South Texas regional director and certified community health worker instructor, Comidas Saludables & Gente Sana en las Colonias del Sur de Tejas, School of Rural Public Health, Texas A&M Health Science Center, College Station.

      Biography

      M. Castillo is promotora coordinator and certified community health worker, Comidas Saludables & Gente Sana en las Colonias del Sur de Tejas, School of Rural Public Health, Texas A&M Health Science Center, College Station.