Lay Health Promoter LHP Program Working Group of Creciendo Juntos

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Lay Health Promoter (LHP) ProgramWorking Group
of Creciendo Juntos

• Jan Wolfe, FNP
• Co-facilitator of the Lay Health Promoter
  Working Group, Creciendo Juntos
• Clinical Director, Rural Health Outreach Program
• Nila Saliba
• Co-facilitator of the Lay Health Promoter
  Working Group, Creciendo Juntos
• UVA Cancer Center
• Katie Burke, MS
• Co-facilitator of the Lay Health Promoter
  Working Group, Creciendo Juntos
• Community Educator, Planned Parenthood Health
  Systems

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• Creciendo Juntos (Growing Together) is an
  inter-agency and inter-community network for
  issues related to the Latino/Hispanic community
  in Charlottesville City, Albemarle County, and
  surrounding areas. www.cj-network.org
• Lay Health Promoter Program (LHP) is a working
  group of Creciendo Juntos. The LHP has been used
  successfully in Latin America to enhance health
  services to underserved populations. The model
  utilizes informal support systems in communities,
  typically training several members as
  promotoras who, in turn, engage and inform
  their families, friends, and neighbors on
  important health issues and connect them to their
  medical services.

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Activities to date

• May 2007, start of LHP working group meetings.
  Linda Hemby, Dilcia Colindres, Jan Wolfe, Martha
  Trujillo, Ivonne Lopez, and Lindsey Holcomb.
• Discussion with Karen Bunn, Director of LHP
  program at Cross Over Health Center in Richmond,
  VA.
• Creciendo Juntos September plenary with LHP group
  and Karen Bunn.
• Hispanic outreach fair in Southwood, September
  2007.
• Began conducting health needs assessment among
  residents in Southwood, November 2007-present.

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US Census Bureau stats on Latinos in
Charlottesville/Albemarle

• In 1990, the Latino population was at 1.16 of a
  total population of 108,381.
• In 2000, grew to 2.52 of a total population of
  124,258 individuals.
• In 2005, grew to 4.25 of a total population of
  161,712 individuals.
• Census figures show that during the last decade,
  the Latino population in Virginia increased
  105.6, compared to the overall population growth
  of 14.4. (Nowak 2004)
• Similarly, while the total population of Central
  Virginia grew by 21.6, the increase for Latinos
  was 151.8. (Nowak 2004)
• A recent report indicates that Latino growth may
  be even higher in our area. School enrollment is
  a strong indicator of the trends in the general
  population, and these figures represent a 384
  increase in the LEP student body over the past
  nine years in Albemarle, and a 555 increase over
  ten years in Charlottesville. (Charlottesville/Al
  bemarle Commission on Children and Families,
  2005) Most of these LEP students are Latinos.

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Southwood

• The 100-acre Southwood Mobile Home Park is
  located off of 5th street extended, about a mile
  from the 120 exit of interstate 64. It was opened
  in the mid 1970s and contains some 360 trailers.
• Actual number of residents is unknown estimates
  are between 1,800 and 3,000. All of its residents
  are low income over half are Spanish speaking
  Mexicans, Salvadorans and Hondurans.

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Overview of Southwood Health Survey

• Latino residents of 65 trailers were interviewed,
  between October 20th and November 15th, 2007.
• Comparison 19 Latinos in 3 focus groups in
  January.
• A draft report February 16th
• Report presented March
• Linda Hemby, sociologist coordinating survey and
  tabulating results.

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Already recognized health needs from
conversations with Latinos in Southwood

• Mental Health
• -stress, anxiety, and depression related to
  immigration, language barriers, and other
  unknowns.
• Chronic disease management
• -respiratory diseases, diabetes, kidney problems.
  
• Birth control

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Top ten leading causes of death in the U.S. in
2002 for Latinos

• Heart disease
• Cancer
• Unintentional injuries
• Stroke
• Diabetes
• Chronic liver disease and Cirrhosis
• Homicide
• Chronic lower respiratory disease
• Pneumonia and Influenza
• Birth defects
• Source http//www.vdh.virginia.gov/healthpolicy/m
  inorityhealth/hispanic/index.htm

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Goals of the LHP program

• Initiated as a means to meet the obvious need for
  basic health knowledge of Latino residents in
  Charlottesville/Albemarle area.
• Established to empower and equip Latino citizens
  to be involved in the process of improving their
  health, the health of others, and the health of
  their communities.
• Program based on the idea that individuals who
  understand disease prevention and wellness are
  more likely to remain in good health, become
  efficient health educators in their communities,
  and good health care consumers when they do
  require medical attention.

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Trained LHP will be able to

• Effectively help others access the heath care
  system and resources they need, thus reducing the
  number of individuals who postpone early
  treatment.
• Participate in a variety of community outreach
  events and possibly volunteer with health related
  organizations (depends on a variety of factors)
• Use this educational outreach opportunity as a
  stepping stone to other opportunities (continue
  their education, acquire pt/ft paid position,
  etc.)

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Program Outline

• First class from the Southwood community.
• LHP program offered without charge to Southwood
  residents who are interested in becoming LHP.
• 15 participants per class.
• 32-hour course taught over an 8-week period. 4
  hours/week.
• Begin September 16th, 2008 until October 30th.
  Graduation will be November 6.
• Classes meet twice a week (Tuesday/Thursday) from
  6-8pm.
• The hope is to hold classes at the Boys and Girls
  Club space in Southwood. Awaiting confirmation-
  space unavialable
• Meetings will be held at the ACOB

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Program outline contd.

• Fall 2008 class Fall 2009 class 30
  participants.
• Training content will range from basic
  information about medical resources in the
  community, hand washing and healthy eating
  habits, to more complicated issues such as
  detection of high blood pressure, breast cancer,
  and diabetes to a name a few.
• Classes are structured to encourage participation
  and sharing of experiences.
• Participants recruited from flyers, newspaper
  articles (Nuevas Raices), door-to-door
  solicitation in Southwood, church bulletins, word
  of mouth, etc.

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• Participants receive 32 hours of instruction and
  are required to give back 20 hours within a
  6-month period.
• Record card to keep track of their time.
  Signatures are required.

• 20-hours can be accomplished by
• -talking about what was learned with family,
  friends, and/or community neighbors.
• -helping with outreach events (fairs, screenings,
  etc.) planned by the LHP program or other health
  related organization.
• -volunteering/interning with health related
  agencies who might be in need of an interpreter,
  educator, someone to design handouts/materials,
  etc.

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Volunteer/intern program

• Solicit volunteer/intern positions with local
  health/service organizations.
• Allow trained/graduated lay health promoters to
  select from the options and seek out those
  positions on their own.
• It is up to the local organization and the lay
  health promoter to work out a schedule since we
  only require them to give back 20 hours total.
• Organization signs the record card.

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Other options for documented LHPs.

• Attend ESL classes or go to the
  interpreter/translator training in Harrisonburg
  (out of their pocket)
• Continue to help with outreach fairs and events
  in the commmunity.
• Continue on with education (PVCC, CATEC, etc.
• Apply for PT/FT jobs

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Undocumented

• For those without their papers we will see if
  there are any health/service organizations
  willing to take on an undocumented volunteer.
• If not, undocumented lay health promoters will
  have these options to complete their necessary
  hours
• -educate their families, friends and neighbors
  about what they learned.
• -volunteer with outreach fairs and screenings
  coordinated by creciendo juntos, churches,
  community groups, etc.
• Can work towards getting their papers.
• Take ESL classes if needed.

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Evaluation component

• Creation of pre and post tests for each class
  session to determine learning.
• Community service evaluation creation of a
  simple checklist for agencies or folks they
  worked with re knowledge base, dependability,
  would you participate in our volunteer/internship
  program again, etc.? 
• Evaluation at end of program in November to
  identify pros and cons of program. Ask
  participants if they would recommend program,
  what would you change, favorite parts, etc.?

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Graduation

• Graduation ceremony November
• Certificates of accomplishment
• Continuing education

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Ways to get involved

• Serve as a trainer/instructor
• Logistics
• Creation of evaluation tools
• Financially donate, grant writing, fundraising,
  etc.
• Promotion/marketing
• Other donations food/snacks for LHPs, child
  care, materials, etc.
• Other ideas?