RESUMEN
Behavioral Parent Training programs (BPTs) are evidence-based interventions that have been shown to be effective when implemented in various contexts and with different racial/ethnic minority families. Despite evidence showing their effectiveness within the Latinx community, disparities in access to BPTs still persist. In addition, fathers continue to show low rates of attendance and engagement despite evidence suggesting positive outcomes for the youth and family when fathers are involved in BPT treatment. Lay health workers (LHWs), community members without specialized metal health training that often live in the communities they serve, have been identified as engagement specialists that are uniquely positioned to reduce racial/ethnic disparities in access to services. The current study utilized a qualitative approach to examine this workforce's perspectives on engaging Latino fathers in parenting services in children's mental health. Qualitative themes revealed that LHWs have generally positive attitudes towards engaging Latino fathers in parenting interventions (i.e., benefits to parent-child relationship) despite experiencing barriers to engagement (e.g., culturally defined gender roles, fathers being less likely to ask for help). Themes also elucidate various engagement strategies that LHWs use to engage fathers in treatment (e.g., adapting treatment setting). Considerations for future LHW trainings and workforce development are discussed with a focus on how to incorporate cultural values in the use of father-engagement strategies.
RESUMEN
Promotoras de salud are community health workers that mostly help the underserved members of Latinx communities. They seek to reduce health disparities through community engagement and work that is voluntary or mostly unpaid. While there is evidence that promotoras aid in prevention, follow-up care, and treatment adherence, little is known about promotoras themselves, specifically, the impact that fulfilling their roles has on their views of themselves and their service identities. Fourteen Spanish-speaking, Latina promotoras were interviewed individually about their experiences and their motivation for the role. Four themes emerged from the content analysis of the participant responses: "Uno Nace Siendo Promotora:" One is Born Being a Promotora, "Poner Esa Semillita:" To Plant a Seed by Sharing Knowledge, "Es un Regalo Ser Promotora:" It is a Gift to be a Promotora, and "Se Hace por Amor pero también Hay Necesidad:" A Labor of Love but there are Needs too. The findings show that assuming and enacting the promotora role had positive benefits, both personal and professional, despite the often-limited recognition they received. The findings have multiple implications for the development of health and prevention programs, particularly for those that involve promotoras de salud.
Las promotoras de salud son trabajadoras comunitarias quienes, en su mayoría, ayudan a las personas que no reciben suficientes servicios en las comunidades Latinas. Las promotoras procuran reducir las disparidades de salud a través de su participación en la comunidad y del trabajo voluntario que llevan a cabo. Aún cuando existen constancias que las promotoras ayudan en la prevención, el seguimiento de los cuidados de salud, y la adherencia al tratamiento, poco se sabe acerca de las promotoras en su carácter más personal, específicamente, el impacto que el cumplimiento de sus funciones tiene en sus identidades, a nivel personal o de servicio. Catorce promotoras Latinas fueron entrevistadas individualmente para conocer más sobre sus experiencias como promotoras y sus motivos para desempeñar el papel de promotora. Cuatro temas surgieron del análisis de contenido de las respuestas de las participantes: "Uno Nace Siendo Promotora," "Poner Esa Semillita" Compartiendo Conocimiento, "Es un Regalo Ser Promotora," y "Se Hace por Amor Pero También Hay Necesidad." Los resultados muestran que el asumir y promulgar el papel de promotora tuvo beneficios positivos, tanto personales como profesionales, a pesar del reconocimiento a menudo limitado que recibieron. Los resultados tienen múltiples implicaciones para el desarrollo de programas de salud y prevención, particularmente para aquellos que involucran a promotoras de salud. PUBLIC SIGNIFICANCE STATEMENT: Latina promotoras de salud (i.e., Latina community health workers) largely enjoy their community engagement and are fulfilled by their roles. They particularly appreciate the opportunity to disseminate health related knowledge and see themselves as uniquely able to reach Latinx underserved communities. While they view their work as a "labor of love" they would appreciate some level of compensation.