Durango Herald file photo
Durango Herald file photo
A 6½-year program to orient Latino adults about the benefits of preventive health care produced significant results, an outside evaluator found.
But that didn’t prevent it from falling victim to budget cuts at the San Juan Basin Health Department. The program ended Sept. 30.
Karen Forest, a registered nurse at the health department who guided Promoviendo la Salud (Promoting Health), is pleased.
“We demonstrated that a ‘promotora’ model is effective,” Forest said. “We showed with numbers that we can improve outcomes.”
The promotora approach used native Spanish speakers to recruit community members for the preventive health-care program.
“If there was a downside, it’s cost,” Forest said.
Former clients may find care at the new La Plata County Community Clinic, Forest said. The clinic, which will open early next year through a foundation grant and volunteer medical services, will treat the poor and uninsured, but everyone will pay something.
“We’ll have to wait and see,” Forest said. “How things play out will depend on demand and the ability to recruit volunteers.”
Promotoras aren’t gone entirely. The health department’s community care team has just hired a liaison to the Spanish-speaking population.
Promoviendo la Salud opened its doors in March 2006. Forest oversaw a health educator and three part-time community workers (promotoras) – two in La Plata County, one in Archuleta County.
The name of the program identified the target population – Latinos.
Client behavior changed as evidenced by improved lab results through retesting, Lauren Patterson, the evaluator, said.
Patients received treatment for acute problems and help managing chronic problems associated with high blood pressure, elevated cholesterol, smoking, poor diet, excess weight and lack of exercise.
The three Spanish-speaking community workers scoured the two counties to invite Latino adults to classes on how to get their health on track. Incentives included free passes to the Durango Community Recreation Center.
Clients whose test results went off the chart were counseled by a promotora or scheduled to see a physician or nurse practitioner.
The program operated on a combination of foundation and government funding.
Promotoras contacted thousands of people. A list of 636 unduplicated names were recorded as patients, but many of the clients were seen multiple times.
Program data were computerized only in the final two years.
Patterson said the emphasis on lifestyle changes to improve overall health brought good results.
A follow-up screening of 207 clients with elevated cholesterol showed that 115 had their condition under control.
Other indicators of health showed similar improvement.
Now, officials in the participating counties face a quandary – how to provide health care for hard-to-reach populations, Patterson said.
“Pilot programs such as Promoviendo la Salud need a clear path for partners to identify shared goals and have the partners commit to the piece they will undertake in the long run,” Patterson said.