We hope to employ 3 to 6 additional community health workers (promotoras) to identify and overcome cultural, cognitive, and attitudinal barriers to the effective utilization of and access to health care services and preventive screening examinations in low-income women of color, specifically Hispanic women. We expect to serve an additional 450 families consisting of an estimated 1800 new individuals, adding to our present 5200 educational encounters per year.

Our clients are administered a baseline health history and health care/community resource utilization inventory at intake. Barriers to an optimal health status are determined and an intensive peer-based education is tailored for and shared with each client. This baseline survey will be administered on an annual basis for a total of five years to measure outcomes and monitor progress for quality improvement.

Outcome measures to be monitored will include improved health status on both an individual and community level as evidenced by an improvement in disease management and control, increased utilization of preventive screening examinations and community resources including KIDS'CARE (CHIP), AHCCS (Arizona's version of Medicaid), Food Bank, WIC, decreased use of emergency room visits, becoming employed, receiving a GED, gaining citizenship, learning English, acquiring housing, among other identified needs.

This model can be applied to all aspects of our lives across the life span including eldercare, mental health, domestic violence, substance abuse, prenatal and postpartum care, diabetes, cardiovascular disease, cancer and other diseases. Based on the results of other promotora programs the staff of WHPI has administered, we know the model exceeds expectations on building and retaining awareness of categorical diseases and their management. We expect now to go further by working across all areas of a person's life in a holistic, integrative fashion the way people experience health, that is to say, within the context of their lives.

One important outcome of our work will be to offer the model on a national scale. The welfare system, for instance, would have a life-enhancing alternative to work with. The welfare to work program could include training to be a promotora and a system of reimbursement for the newly trained promotora to provide peer education, referral and follow-up to other welfare families. This would allow monies allocated to public assistance to go directly to the community to help it help itself.

The Way Of The Heart: The Promotora Institute