The objective of this Fast Track Small Business Innovation Research application, submitted by KDH Research and Communication (KDHRC), is to develop and evaluate an online information clearinghouse to support community-based nonprofit organizations'(NPOs) use of promotores programs to provide health information to underserved Latinos. Promotores programs use community health workers (CHWs) to conduct outreach for health promotion, prevention, and medical treatment, and there is increasing evidence that they improve health outcomes. The proposed Toda Promotora Clearinghouse (TPC) will provide information on the formulation, implementation, and evaluation of promotores programs to Latino-serving NPOs. Through the provision of centralized, scientifically-based information, TPC will support NPOs in the effective use of promotores programs to increase positive health outcomes among the clients that they serve. The need for TPC is significant. Latino populations experience health disparities, or detrimental differences in the presence of disease, health outcomes, and access to care. NPOs are often at the forefront of addressing health disparities because they are key providers of health services, particularly for Latinos that may seek community-based health care because of lack of insurance, language barriers, or distrust of the mainstream medical system. But the recent economic downturn and governmental funding cuts have strained the fiscal capacity of many NPOs, necessitating the development and implementation of low-cost, yet effective, service delivery approaches. One promising approach is the use of promotores programs, but there is a lack of systematic information available to NPOs about their optimal formulation, implementation, and evaluation. Therefore, TPC aims to improve Latino health outcomes by increasing the health delivery capacity of Latino-serving NPOs through a clearinghouse of evidence-based information on establishing effective or improving existing promotores programs. In Phase I of TPC we will conduct extensive formative research with a panel of experts in the field and NPO directors. We will then develop a TPC prototype and conduct a feasibility evaluation using a pretest/post test control group design. The evaluation will to examine the extent to which the TPC prototype changes knowledge, attitudes, and self-efficacy about promotores programming in a group of NPO directors. In Phase II, we will finalize TPC by developing additional content and features for the website. We will then conduct an outcome evaluation that will include two studies. The first study will use similar methodology to the feasibility evaluation. The second evaluation will be a process study of how and to what extent NPOs and their directors use TPC and how its use impacts promotores programmatic outcomes. Together, the two evaluations will provide information for the commercialization of TPC and a wealth of data for publishing.
TPC will significantly impact public health in two ways. First, TPC will provide a publicly available, centralized source of evidence-based, practical information on effective promotores programming. Such a resource will allow nonprofit organizations (NPOs) to maximize their funding and not reinvent the wheel to formulate, implement, and evaluate promotora programs. The ultimate result of TPC will be increased use of effective health outreach programs by NPOs using promotores programs and, subsequently, improved health outcomes for Latinos. Second, the TPC project will generate significant primary data on health delivery by NPO health organizations that serve Latinos. By analyzing these data and disseminating our research results through multiple sources, we will contribute to the scientific literature on NPO effectiveness, promotores programs, and health outreach overall. The innovation of TPC lies in its ability to meet the documented need for systematic, widely disseminated, and replicable information on the formulation, implementation, and evaluation of promotores programs.