De la Mano con la Salud (Lend a Hand for Health): a male lay health advisor network in a new growth community Latinos, the fastest growing population in the United States, experience barriers to quality health care and have worse health outcomes than Whites. Lack of social support puts men living apart from their families at additional risk for depression, substance abuse and STDs. The effectiveness of promotores (lay health advisors) has been documented in communities with high concentrations of Latinos. However, today 20% of all Latinos in the U.S. -10 million people- live in "new growth communities" (NGC), areas with low, yet growing, concentrations of Latinos, where Latinos represent fewer than 5% of the population. Latinos residing in NGC face more health care access barriers because there are few services that address their cultural and language needs and because they face more social isolation. There are no published health promotion efforts using promotores in NGC. Promotores are usually female;there is need for studying the effectiveness of male promotores. The Latino Engagement Group for Salud (LEGS) is a partnership of health and social service providers, grassroots community members and university researchers that has been integral in the preparation of this CBPR proposal. We propose to accomplish three aims. 1. Assess the effect of the CBPR-led male promotores network on increasing health care access and social support for men living apart from their families, as measured by a) obtaining a source of care for 40% of clients without a usual source of care at enrollment;b) achieving a well-health visit for 50% of clients who have not had a well-health visit in the last year;and c) increasing clients'social support from baseline to 3 months after enrollment in the promotores program. 2. Explore qualitatively the impact of the male promotores network on clients in an NGC. 3. Examine the effect of the network in empowering male promotores. Our project will be organized using six steps to conduct CBPR. The LEGS has identified men living apart from their families as a population with critical health service needs. We are currently conducting further needs assessment with focus groups, surveys and key-informant interviews. For this study, we will implement a male promotores network that will include 5 promotores and a super-promotor or coordinator. Promotores will conduct outreach to clients (n=125) and follow up using cell phones. We will use surveys, summary data from our clinical partners, and in-depth interviews with network clients and promotores to gather data for our specific aims. This research will answer critical questions in CBPR: Will a promotores network be effective in improving health care access and social support in an NGC? What are the experiences of clients and promotores in networks with male promotores? Can the CBPR process empower male promotores?
Relevance This study will provide information to fill two gaps in health promotion information: how to reach a dispersed new growth Latino community, and what the dynamics of a male promotores network are. Ten million Latinos now reside in new growth communities;the potential to use these findings to guide new programs in a similar geographical setting is vast.