Farmworkers Trained as Health Promoters Sow the Seeds of Better Health Care
From 1995 to 1998, Community Health Care in Bridgeton, N.J., developed a program to train farmworkers in Cumberland County to become lay health promoters.
Staff recruited farmworkers from local farms and poultry and packing houses and provided them with 100 hours of training on topics such as the role of a health promoter, and working with individuals with HIV/AIDS, diabetes, drug and alcohol abuse, and high blood pressure.
The health promoters provided individual and group health care education and referrals for individuals with diabetes, hypertension or HIV, and made follow-up visits to all farmworkers newly identified with these diseases.
- During the course of the project, health promoters had almost 9,000 encounters with farmworkers and their relatives in which they shared information about drug abuse and health.
- Lay health promoters were effective in gaining through training the self-confidence and ability needed to do their jobs.
- Based on evaluation meetings with participants, health promoters determined that participants changed behaviors in order to prevent health problems such as high blood pressure, diabetes and drug/alcohol abuse.
RWJF supported the project with a $245,337 grant between October 1995 and September 1998.
Cumberland County is the seasonal home of more than 6,000 farmworkers, predominantly of Puerto Rican and Mexican origin. In recent years, increasing numbers of farmworkers from Mexico and Central America have come to the region. Many of these farmworkers migrate with large family groups and choose to settle in Cumberland County.
These workers are often an overlooked part of the population and partly as a result of their itinerant lifestyle, they are at a higher risk for many health and social problems. For example, farmworkers' life expectancy is significantly lower than national norms. Their rate of diabetes is two to three times higher than that of non-Latino whites. Among farmworkers, hypertension is a major health problem for those ages 30 to 44, the cause of half the hospital visits of those ages 45 to 64, and a precipitating factor in up to 80 percent of clinical visits for the elderly.
Farmworkers have low rates of immunization and of enrollment in prenatal care. In addition, the boredom, isolation, and poverty of their lives often lead to substance abuse and violence.
This program used lay health promoters recruited from the Cumberland County communities to reach out to farmworkers with a program of education, home visits, outreach and community empowerment designed to improve their health and welfare. The program objectives included using lay health promoters to:
- Recognize health problems in camps and farmworker communities, promote preventive health activities, and reduce unhealthy conditions and behaviors.
- Improve and increase access to existing health care resources.
- Provide education, follow-up home visits, and group educational sessions to educate farmworkers with chronic health conditions such as diabetes, high blood pressure, and HIV/AIDS.
- Create community activities to reduce isolation, stress, and boredom that can lead to substance abuse.
- Disseminate information enabling other organizations in New Jersey and nationwide to implement similar programs with farmworkers or other marginalized populations.
The project recruited farmworkers from local farms, and poultry and packing houses to be trained as lay health promoters under the auspices of CHCI, a migrant and community health center in Cumberland County. These recruits received 100 hours of training on topics such as the role of a health promoter, and working with individuals with HIV/AIDS, diabetes, drug and alcohol abuse, and high blood pressure.
In turn, the health promoters provided individual and group health care education and referrals for individuals with diabetes, hypertension, or HIV, and made follow-up visits to all newly identified farmworkers with these diseases. The lay health promoters also organized recreational, cultural and education activities to reduce levels of stress and boredom among farmworkers.
During the three years of RWJF funding, the project had the following results:
- Lay health promoters were effective in gaining, through training, the self-confidence and ability needed to do their jobs.
- In the three years of the project, health promoters had almost 9,000 encounters with farmworkers and their relatives in which they shared information about drug abuse and health.
- Based on evaluation meetings with participants, health promoters determined that participants changed behaviors in order to prevent health problems such as high blood pressure, diabetes, and drug/alcohol abuse.
Project staff disseminated information about the lay health promotion experience and project findings at national and regional conferences and local meetings. In addition, press and television covered project activities. The project also produced a brochure and a newsletter to present the project at meetings, community presentations, and farmworker group or individual encounters. (See the Bibliography for details.)
AFTER THE GRANT
The project has continued on a reduced basis with six lay health promoters. The project received funding from the International Institute of New Jersey ($3,000), the New Jersey Primary Care Association ($20,000), and a local food company ($20,000). CHCI pays the program coordinator out of its operating revenues.
GRANT DETAILS & CONTACT INFORMATION
Program to Recruit and Train Farmworkers as Health Promoters
Community Health Care Inc. (Bridgeton, NJ)
Dates: October 1995 to September 1998
(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)
Brochures and Fact Sheets
"Farmworker Lay Health Promoter Project and Migrant Program," Lay Health Promoter Program, 1997.
Farmworker Lay Health Promoter Project. Bridgeton, N.J. 2 issues per year from 1995 through 1998. Copies distributed in person.
Presentations and Testimony
Carol J Martin, "Farmworker Lay Health Promoter Program," at the following meetings:
- Second Annual Rural Health Conference, November 1, 1995, Princeton, N.J.
- Eighth Annual East Coast Migrant Stream Forum, November 35, 1995, Tarrytown, N.Y.
- 1996 National Farmworker Health Conference, May 36, 1996, Nashville, Tenn.
- Ninth Annual East Coast Migrant Stream Forum, November 810, 1996, Tampa, Fla.
- Tenth Annual East Coast Migrant Stream Forum, November 2123, 1997, Raleigh, N.C.
- First National Lay Health Promoters Conference, May 2022, 1998, Mesa, Ariz.
- Outreach, Building Healthy Partnerships: Supporting Community-Based Outreach Conference, June 1719, 1998, Washington, D.C.
"Lay Health Promoters," in Vineland Daily Journal, October 22, 1998.
"Perfil Latino," Lay Health Promoter Program, Suburban Cable Channel Two, Cumberland County, March 16, 1997.
"Mexican Fridays," Lay Health Promoter Program, WMIZ, June 5, 1998.
Report prepared by: Robert Mahon
Reviewed by: Patricia Patrizi
Reviewed by: Molly McKaughan
Program Officer: Pamela Dickson