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Promotoras and Community Health Workers (CHW's)
play a critical role in promoting
community-based health education and prevention,
particularly in communities that have been
historically underserved by the U.S. health care
system. Promotoras and CHW's represent a rich
spectrum of characteristics that makes them the
bridge between health care institutions,
professional providers and community residents
in need of health care services.
A descriptor
that captures Promotoras' natural capacity to
provide "genuinely holistic health prevention is
the notion of "ecological relevance" (Castro et
al., 1996); Promotoras are indigenous to Latino
immigrant communities they serve, speak the same
language, are intrinsically involved in the host
community, and are committed to providing "servicio
de corazon" (heartfelt service). As a result,
they are able to provide culturally sensitive
service, establish trust in the community and
receive feedback from communities.
The Promotora/CHW continuum includes diverse
titles and roles within health and human service
agencies such as peer educator, health advocate,
outreach worker, block parent, community health
worker, and Promotora, among others
In times of health program cutbacks,
skyrocketing healthcare costs, and increasing
health disparities among the Latinos in
California, community-based alternatives to
healthcare prevention are necessary.
Consequently, Promotora and CHW programs are
being used increasingly across California and
the U.S.; they are prominent in both rural as
well as metropolitan areas. Nevertheless, they
often express to feel undervalued, as one focus
group CHW/Promotora noted:
"We serve as translators, counselors,
educators, community mobilizers, and advocates
for policy changes…We have ample experience and
skills and yet we are not recognized as
legitimate healthcare workers. We are often
ignored and deserve to be acknowledged as an
effort to lift the quality of the health care
delivery system."
For this reason, through grounded theory
methodology Vision y Compromiso integrates the
Promotora/CHW perspective into its mission,
vision, objectives and activities. Vision Y
Compromiso support Promotoras as integral to
community well being and by maintaining the
integrity and authenticity of their work.
The Promotora/CHW Network uses the term
Promotoras to honor the high female
representation in the Promotor/a workforce. It
is also recognized that males are an important
part of this labor force and both males and
females are important elements to the network.
The Promotora/CHW Network is the first statewide
effort in California to respond to the support,
development, communication, and legitimacy
issues of Promotoras and CHW's.
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