Currently at 11 million, over the next several decades the proportion of Hispanic women in their childbearing years is projected to increase exponentially. The central role women have in Hispanic culture with respect to the health of their families, along with their high fertility rates, make reaching and engaging Hispanic women a critical strategy in efforts to reduce disparities and improve health outcomes for adults and children in these communities. Quality prenatal care is designed to promote health and reduce risks for women, infants, and families before, during, and after pregnancy. This care is often the first introduction Hispanic families have to the American medical system and is also a place where disparities in care begin. Developing the healthcare system's capacity to provide quality, linguistically and culturally appropriate prenatal education and care for Hispanics is critical. As such, this project will determine the feasibility of developing a train-the-trainer program for lay health educators using a patient-centered prenatal education program for Hispanic women. The program will be based on the Teach-With-Stories (TWS) Method"""""""" developed for empowerment-based group education. It will use the De Madre a Madre/From Mother to Mother photonovels, an existing series of easy-to-read, bilingual, culturally appropriate photo-stories designed for prenatal education and literacy instruction. This project will determine the organizational and individual attributes that facilitate or hinder adoption, integration, and sustainability of a TWS lay health educator model among health professionals and in healthcare systems that serve low-income and uninsured Hispanics. It will also identify the components of a web-based TWS photonovel prototype necessary to promote corporate sponsorship, health professional acceptance, and improved outreach and dissemination of prenatal care information in local communities. Guided by a diverse and experienced advisory board, the study team will achieve these aims through a series of key informant interviews with health care administrators and corporate executives, and an electronic survey of health care professionals. Positive, culturally sensitive experiences in prenatal care can have a long-term impact on the use of healthcare services by Hispanic women and their families. An empowerment-based lay educator model designed to address system and provider needs unique to prenatal care could help generate cost-savings to the health care system, improve quality of care, and address the multiple needs of this growing population. A commercially successful model for prenatal education could be adapted for other health topics and potentially for other traditionally underserved populations. ? ? ? ?
