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Abstract

Salud Para Todos is a three-year project that focused on preventing diabetes, cardiovascular disease and obesity in the Hispanic population, particularly Hispanic migrant/seasonal workers along the U,S./Mexico Border in South Yuma County, Arizona. Strategies included conducting community outreach to farm workers in the field, offering multi-session prevention and education classes, strengthening leadership for policies to reduce health disparities, providing cultural competency trainings to health service and medical professionals and using the Promotora model to improve the quality of health services. Promotoras are community health workers who come from the targeted population and act as liaisons between doctors and patients, and they were instrumental in achieving the objectives of the program since they understand the unique healthcare practices and the needs of the community. The evaluation was conducted using a mixed-method approach that included administering questionnaires to participants before and after the project to track changes in their health attitudes and behaviors and cultural competency, and conducting a survey at the end of project to assess changes in participants' knowledge in leadership and advocacy skills. Analysis of the survey data revealed that participants' families increased their level of physical activity and nutritional intake throughout the course of the project. For instance, participants' frequency of engaging in physical activity increased by 60 percent, from 2.8 to 3.9 times a week. Also, participants' intake of vegetables increased 65 percent, from 1.9 to 3.4 servings per day. The evaluation also found that participating parents reported an 80 percent increase in their level of confidence in being able to engage their children in a positive conversation regarding health. In addition, the evaluation found that there was considerable improvement in clinic staff and medical professionals' overall knowledge of cultural competency. For example, findings show that 63 percent of participating staff members increased their ability to describe elements of culturally competent care and 64 percent increased their ability to practice cross-cultural communication. Project partner San Luis Clinic made great improvements in the level of patient satisfaction across all categories; most notably the percentage of patients satisfied with wait time for an appointment increased from 58% to 95%.

Related NPA Goals:

• Increased awareness, education and outreach to address racial/ethnic minority health and health disparities problems
• Improved access to, and appropriate utilization of, health and other community-based services and systems through user-centered design for racial/ethnic minorities (e.g., health IT, culturally/ linguistically appropriate services, service provider education/ training, workforce diversity)
• Strengthened leadership and coordination to leverage resources and enhance effectiveness and efficiency of individual and collective efforts (including, but not limited to, research and data)

Related Healthy People 2010 Objectives:

• 19- 5 Increase the proportion of persons aged 2 years and older who consume at least two daily servings of fruit
• 19-6 Increase the proportion of persons aged 2 years and older who consume at least three daily servings of vegetables, with at least one-third being dark green or orange vegetables
• 19-7 Increase the proportion of persons aged 2 years and older who consume at least six daily servings of grain products, with at least three being whole grains
• 19-16 Increase the proportion of worksites that offer nutrition on weight management classes or counseling
• 22-1 Reduce the proportion of adults who engage in no leisure-time physical activity
• 22-2 Increase the proportion of adults who engage in moderate physical activity for at least 30 minutes per day 5 or more days per week or vigorous physical activity for at least 20 minutes per day 3 or more days per week