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Sustainability of Promotora Initiatives: Program Planners' Perspectives

Koskan, Alexis PhD; Friedman, Daniela B. PhD; Messias, DeAnne K. Hilfinger PhD, RN, FAAN; Brandt, Heather M. PhD, CHES; Walsemann, Katrina PhD

Journal of Public Health Management & Practice:
doi: 10.1097/PHH.0b013e318280012a
Original Articles
Abstract

The use of promotoras de salud is an increasingly widespread delivery approach for community-based health education and promotion programs targeting obesity-related lifestyle behaviors for Hispanic populations. Addressing a gap in the literature, this research examined the sustainability of promotora-led initiatives from the perspectives of those who plan, implement, and evaluate these programs. We conducted 24 in-depth interviews with program planners representing 22 promotora programs focused on Hispanic women's health in 10 states. Findings illustrated program planners' opinions regarding the components, logistics, and barriers to promotora program sustainability. Several participants challenged the notion of promotora program sustainability by reframing the issue as promoting individual promotoras' well-being and social mobility rather than maintaining their role in the program over time. Implications for community health planning, management, and policy include developing sustainability strategies during program planning stages and implementation of policies to more effectively integrate promotoras into existing health care systems at local, state, and national levels.

In Brief

This article examines the sustainability of promotora-led initiatives from the perspectives of those who plan, implement, and evaluate these programs. Findings illustrate program planner' opinions regarding the components, logistics, and barriers to promotora program sustainability.

Author Information

Department of Health Outcomes and Behaviors, Moffitt Cancer Center, Tampa, Florida (Dr Koskan); Department of Health Promotion, Education, and Behavior, Arnold School of Public Health (Drs Friedman, Brandt, and Walsemann), and College of Nursing (Dr Hilfinger Messias), University of South Carolina, Columbia, South Carolina.

Correspondence: Alexis Koskan, PhD, Department of Health Outcomes and Behaviors, Moffitt Cancer Center, Tampa, FL, 33612 (alexis.koskan@moffitt.org).

Disclosure: The authors declare no conflicts of interest.

Acknowledgment: DB Friedman and HM Brandt were partially supported by Cooperative Agreement U48/DP001936 from the Centers for Disease Control and Prevention and the National Cancer Institute.

© 2013 Lippincott Williams & Wilkins, Inc.