LATINAS FOR LATINAS; A PEER TO PEER MODEL TO OVERCOME BARRIERS: PROMOTORAS (PART I)

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LATINAS FOR LATINAS; A PEER TO PEER MODEL TO OVERCOME BARRIERS: PROMOTORAS (PART I) Denys Salas, Assistant Director Voces Latinas www.voceslatinas.org

INTRODUCTION In 2003, a group of Latina social workers alarmed by the escalating rates of HIV/AIDS infection among Latinas recognized the dire need for access to culturally and linguistically appropriate resources in Queens. Many infected Latinas are undocumented and lack access to accurate information, services and care. We launched several bilingual community forums in Queens, extending beyond HIV/AIDS awareness to offer resources around healthcare, mental health, immigration, and legal services to target these hard to reach women. Over 100 immigrant Latinas attended these forums to obtain life-saving bilingual information and materials.

MISSION AND COMMUNITY Grass root organization located in the heart of Jackson Heights - 10 years working in Western Queens. We aim to reduce both violence and HIV among immigrant Latinas. We believe that people from the community are the best educators. Our promotora model is integrated in all of our programs. Non-traditional practices.

The guiding principles are: To meet the women where they are. To provide a safe place for them to gather, ask questions, and to present HIV and other issues that place them at risk (such as domestic violence, substance use and depression) To choose the pace at which they make life changes, and to accommodate their schedules, literacy, and comfort levels. To connect immigrant Latinas to linguistically and culturally appropriate care so they may get access to health screenings and necessary treatments. To nurture leaders among immigrant Latinas so they may become voices for Latinas, and be the agents of change who connect our community to life-saving resources.

HISTORY OF THE PROMOTORA Beginning in the 1950 s Promotores de Salud flourished through Latin America to bring health care to the poor. Late 1980 s Promotores de Salud became well known in the migrant and seasonal farm working communities. In California, Promotoras programs were first used in 1988 by organizations working in AIDS/HIV prevention. Today Promotora programs are used by many organizations to educate people about topics including cancer, diabetes, geriatrics, health (general), HIV/AIDS, housing, lead poisoning prevention, mental health, reproductive health and more.

WHAT IS A PROMOTORA? Promotoras are community members who serve as liaisons between their community and health, human and social service organizations. They work with organizations and institutions formally and informally, as employees or volunteers to bring information to their communities. Promotoras provide a continuum of service in a variety of capacities; Promotores de Salud are neither outreach workers nor untrained volunteers. Promotores de Salud are well trained and are usually, but not always paid for their work.

PROMOTORA CHARACTERISTICS Speaks the same language of the community they are working with Understands Personalismo Personal connection/heartfelt service Lives in the community They do door to door strategy Can be a professional in their country of origin A leader who cares about his/her community

VARIOUS ROLES PROMOTORAS PLAY IN THE COMMUNITY Promotoras make contact with the community via: Intimate group gatherings Individual homes Community gatherings Promotoras make direct contact with target audiences, conveying crucial information to provide community support. There are no statistics on how many Promotores work in the different states, however it is known that the vast majority of Promotores are women

HOW PROMOTORAS BENEFIT FAMILIES? Promotoras provide relevant health information Provide linkages to wide range of services Are the bridge between the families and the healthcare systems Help families navigate the system Advocates

HOW PROMOTORAS BENEFIT COMMUNITY? Promotoras are from the community. They represent the needs and assets of the community Participate in events or committees for the improvement of their communities Promote change in their communities Educate community on policy issues Volunteers

EVALUATION OF PROGRAMS Focus Groups Baseline pre-test Mid focus group Post test after completion Final Focus Groups Individual Interviews (If needed)

WHY PROMOTORAS AT VOCES LATINAS? COMMUNITY DRIVEN To decrease isolation among Latinas/os, VL has been utilizing the Promotora model since 2005. The strength and value of the Promotoras come from their relationships in their community and the trust and respect they have earned. The community identifies with them and helps reduce fear.

WHO ARE THE PROMOTORAS? The Promotoras are community healthcare workers who live in the community. Promotoras are survivors of violence or living with HIV. They receive a12 week leadership training around HIV and violence prevention. They partner with our program staff to conduct outreach and engage community members and bring awareness around violence and HIV. Promotoras identify with the community and always have their pulse on the community s needs. They act as community advisors and help us determine the programming at VL. Promotoras have shown to be the most cost effective intervention serving low-income, ethnic and nationally oppressed, as well as underserved populations.

Highlights of Promotora Model A leadership initiative (Promotora training) trains up to 10 Promotoras each year to become peers HIV and violence prevention educators. To identify immigrant Latinas experiencing violence and at risk for HIV. To connect Latinas to linguistically and culturally appropriate services, and to advocate on their behalf. Promotoras are role models and serve as mentors to other immigrant Latinas.

Promotora Training Structure and Topics

RECRUITMENT PROCESS invested participants emotionally healed outspoken nominated interviewed committed non-judgmental, open minded

THE TRAINING SESSIONS During the first training session the women are given a binder that is divided into 12 sections and labeled with each training topic, along with a notebook. Voces Latinas uses a pre- and post-test format (before and after each training) to measure the trainee s knowledge and to assess the effectiveness of our trainings. The pre-test is relevant to that training topic and consists of seven multiple choice questions in Spanish. Some of the Latinas have low literacy levels and feel uncomfortable voicing their difficulty with the pre-test. The trainer reads the questions aloud as the women answer them to help protect the women s sensitivity. The pre-tests are coded and collected before the presentation begins. At the end of the training, a post-test is distributed. Again, the trainer reads the questions aloud. This procedure is done for all training sessions. At the completion of the 12 training sessions, the preand post-tests are tabulated and used to evaluate that cycle s effectiveness. Focus groups with the new trainees and Sr. Promotoras are also conducted in order to hear directly from the Promotoras and learn what was most effective during that particular cycle.

WHY THESE TRAINING TOPICS? Based on the mission of Voces Latinas which came from risk factors most predominant in the community including violence, HIV infection and persons who are positive who do not receive medical care. Through the Promotoras training we tap into their strengths and help them to recognize such strengths. Empowerment begins once they realize they have something to offer someone else. The training provides them with the skills and resources they need to feel equipped engaging other Latinas experiencing high risk and connecting them to services. Promotoras take a role of mentor and model to other immigrant Latinas. Their leadership is constantly observed by others proving that others can also be role models and mentors. The Promotoras voice is one that represents their community.

DATE/FECHA TOPIC/TEMA PRESENTER/FACILITADOR 07/10/16 07/11/16 07/22/16 07/24/16 Entrevistas Entrevistas Orientacion Autoestima/Autodescubrimiento VL VL VL VL 07/31/16 Confidencialidad Queens Legal Services 08/07/16 Comunicacion Efectiva/ Trabajo en Equipo 08/14/16 PRACTICA 08/21/16 Violencia contra la Mujer/Asalto Sexual/Trauma/Depresión VL VL VL & Rita Abadi 08/28/16 Alcohol y Abuso de Sustancias VL and Jovenes Queens 09/04/16 VIH/SIDA I Y II/ Infecciones Transmitidas Sexualmente VL & Carlos Maldonado 09/11/16 PRACTICA VL Movilizacion Comunitaria I, II Y III 09/18/16 Evaluacion de la Comunidad, Sensibilizacion, Integracion y Consolidacion y Construyendo Redes VL

PROMOTORA TRAINING ENVIRONMENT CULTURALLY SENSITIVE Voces Latinas is located in a in Jackson Heights Queens, the epicenter for immigrant Latino settlement. The site is accessible by subway and bus, is near several neighborhood thoroughfares, and has elevator access. We have created a comfortable living room style meeting area for our workshops and trainings, and the women have enthusiastically helped us to maintain a home-like feel by creating cultural crafts to decorate the space. We assure that every Latina who enters our space will see, smell, or feel something they can identify with their home country and culture such as the smell of brewing coffee, a Latino picture frame, a decoration from a Latin American country, and the tables covered with homelike tablecloths. This is the feeling we strive to maintain at Voces Latinas. It offers warmth, identification, and security to the women.

Listen to their needs Give them ownership Let them lead Ask them RETENTION Include them in trainings, programs, focus groups,etc. Mentor them, let them mentor others

The need to continue training Promotoras -As Michalski (2004) observes, The most vulnerable partners include those who are relatively isolated or lacking in social supports in relation to a partner who has extensive social supports (pg. 663). Promotoras incorporate informal networks to support, connect, and assist Latina/o survivors of violence report the violence and safely navigate the criminal justice and victim services systems. Existing research has extensively documented the importance of networks and social integration with regard to situations of domestic violence.

Leadership at its Finest Business Co-op Model Provides economic security Flexibility Options/alternatives to high risk work Business owner

SATURDAY CULTURAL ARTS GROUP Promotora led initiative that offers a network of support for women Involves groups discussions and cultural arts and crafts Over 40 women attend weekly and their children