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The Impact of Promotoras on Social Support and Glycemic Control Among Members of a Farmworker Community on the US-Mexico Border

From the Mel and End Zuckerman College of Public Health, University of Arizona, Tucson (Ms Ingram, Ms Bradford); Campesinos Sin Fronteras, Somerton, Arizona (Ms Torres, Ms Redondo); Sunset Community Health Center, Somerton, Arizona (Dr Wang); and the Robert Wood Johnson Foundation Diabetes Initiative, National Program Office, St Louis, Missouri (Dr O'Toole).

Correspondence to Maia Ingram, MPH, University of Arizona, Mel and End Zuckerman College of Public Health, PO Box 245163, Tucson, AZ 85724 (maiai{at}u.arizona.edu).

Purpose

The purpose of this study is to describe the effect of a promotora-driven intervention to build social support as a means to affect self-management behaviors and clinical outcomes in a farmworker community on the US-Mexico border.

Methods

Promotoras implemented a community-based intervention that included support groups, home/hospital visits, telephone support, and advocacy to people with diabetes. A 12-month pre/post study design was used to investigate the relationship between promotora contact, perceived support, and clinical outcomes. Clinical data were gathered from 70 participants during routine physician visits. A pre/post questionnaire was used to measure perceived support and self-management practices.

Results

Glycosylated hemoglobin (HbA1c) levels decreased 1% among high-risk participants. Improved HbA1c level was associated with promotora advocacy and participation in promotora-led support groups. Participants reported increased support from family and friends and more comfort speaking about diabetes (la enfermedad) with family and friends.

Conclusions

These findings document improvement in both clinical and social health indicators for Mexican Americans in a farmworker community when a promotora model is used to provide and facilitate culturally relevant support for diabetes self-management practices.

The Diabetes Educator, Vol. 33, No. Supplement 6, 172S-178S (2007)
DOI: 10.1177/0145721707304170


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