CHP

							  Lay Health Promoter (LHP) Program
       Working 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
• 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.
                    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.
 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/Albemarle Commission on Children and Families, 2005) Most of
these LEP students are Latinos.
                        Southwood


The 100-acre Southwood Mobile Home Park is located off of 5 th
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.
 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.
  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
      Top ten leading causes of death in the
            U.S. in 2002 for Latinos
1.    Heart disease
2.    Cancer
3.    Unintentional injuries
4.    Stroke
5.    Diabetes
6.    Chronic liver disease and Cirrhosis
7.    Homicide
8.    Chronic lower respiratory disease
9.    Pneumonia and Influenza
10.   Birth defects

                               Source:
       http://www.vdh.virginia.gov/healthpolicy/minorityhealth/hisp
                             anic/index.htm
            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.
         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.)
                     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
             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.
• 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.
             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.
  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
                    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.
               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.?
                    Graduation
• Graduation ceremony: November
• Certificates of accomplishment
• Continuing education
                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?