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: 1.79). 07/2007; 33 Suppl 6(Supplement 6):172S-178S. DOI: 10.1177/0145721707304170
Source: PubMed


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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    • "Previous studies have reported that the lack of social relationships is a major risk factor for morbidity and mortality, especially among men.24 On the other hand, positive social support has been associated with improved medication, dietary25 and exercise adherence,26 decreased depression,27 smoking cessation,28 good diabetes self-management, and improved clinical outcomes.29 Many similarly encouraging reports have caused greater attention to be paid to the concept of social support, resulting in it becoming a core component of diabetes care in recent years. "
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    • "CHW interventions improve knowledge about this chronic health condition (12,13), self-management (13–15), and self-efficacy (13). CHW interventions have also resulted in significant reductions in A1c levels (12,13,15,16). Although research has analyzed the cost-effectiveness of CHW-based diabetes management interventions delivered in primary care settings (17,18), we know of no cost-effectiveness studies of diabetes self-care interventions that involve CHWs delivering home-based counseling and education. "
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