The Impact of Promotoras on Social Support and Glycemic Control Among Members of a Farmworker Community on the US-Mexico Border

Mel and End Zuckerman College of Public Health, University of Arizona, PO Box 245163, Tucson, AZ 85724, USA.
The Diabetes Educator (Impact Factor: 1.92). 07/2007; 33 Suppl 6(Supplement 6):172S-178S. DOI: 10.1177/0145721707304170
Source: PubMed

ABSTRACT The purpose of this study is to describe the effect of a promotora-driven intervention to build social support as a means to affect self-management behaviors and clinical outcomes in a farmworker community on the US-Mexico border.
Promotoras implemented a community-based intervention that included support groups, home/hospital visits, telephone support, and advocacy to people with diabetes. A 12-month pre/post study design was used to investigate the relationship between promotora contact, perceived support, and clinical outcomes. Clinical data were gathered from 70 participants during routine physician visits. A pre/post questionnaire was used to measure perceived support and self-management practices.
Glycosylated hemoglobin (HbA1c) levels decreased 1% among high-risk participants. Improved HbA1c level was associated with promotora advocacy and participation in promotora-led support groups. Participants reported increased support from family and friends and more comfort speaking about diabetes (la enfermedad) with family and friends.
These findings document improvement in both clinical and social health indicators for Mexican Americans in a farmworker community when a promotora model is used to provide and facilitate culturally relevant support for diabetes self-management practices.

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Available from: Maia Ingram, May 15, 2014
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    • "The present study is one of the first to show the efficacy of using CHWs to implement successful active living and healthy eating interventions among a pediatric population as well as adding to growing literature that demonstrates the effective use of CHWs among persons living in low income communities to promote health and disease management strategies [18]-[20]. Our study is subject to the limitations of participants serving as their own controls; hence issues of self-selection and generalizability may exist. "
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    • "Confirming Peek's work (2007), we also found that the use of community health workers and promotoras facilitated improvements in diabetes intermediate outcomes, processes of care, knowledge, and social support (Babamoto et al., 2009; Ingram et al., 2007; Joshu et al., 2007; Lujan et al., 2007; Sixta & Ostwald 2008; Thompson et al., 2007). Our update also provided evidence that promotoras can successfully reach out to patients with diabetes on the fringes of the traditional health care system (Ingram et al., 2007). All six community health worker studies were conducted in majority Mexican-American populations. "
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    • "Diabetes self-management interventions for Mexican Americans in the border region have been tested (Lujan, Ostwald & Ortiz, 2007; Brown, Blozis, et al., 2005; Sixta & Ostwald, 2008); however, only two studies reported promotoras as a social support intervention source for improving T2DM self-management behaviors. In the first study (Ingram et al., 2007) promotoras delivered a 1-year intervention for rural Mexican farmworkers with T2DM. The number of promotora support groups attended and the number of advocacy contacts were significantly correlated with improved glycemic control. "
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