Participatory group prenatal education using photonovels: Evaluation of a lay health educator model with low-income Latinas.

OBJECTIVE: The objective of this research was to examine the effectiveness of a participatory prenatal education program for low-income Latinas. Lay health educators facilitated groups using photonovels and experiential learning activities. METHODS: We used a community-based participatory research approach with a mixed method evaluation. Data included participant pre- and post-test surveys, focus groups, and a medical record review of participant outcomes and a control-match group who received usual care. RESULTS: Participants (n=43) showed a significant increase in their knowledge of pregnancy, childbirth, and breastfeeding (P < .001) and a significant increase in confidence at being able to navigate their pregnancies, care for themselves and their babies, and interact with health professionals (P ≤ .05). They reported an increase in social support, a deeper understanding of information from medical providers, greater engagement, and behavior changes. There were no statistically significant differences in health outcomes between the participants and the control group. CONCLUSIONS: This study demonstrated that 1) a participatory prenatal education program can be an effective way to foster health literacy and empowerment among low-income Latinas; and 2) trained lay educators can be effective group facilitators. The intervention's tripartite approach offers a vehicle for health professionals to partner with Latino communities to promote active participation and capacity building for health and change. This strategy could be adapted and tested with other topics and communities.

Mexican immigrants' attitudes and interest in health insurance: a qualitative descriptive study.

Mexican immigrants to the U.S. are nearly three times more likely to be without health insurance than non-Hispanic native citizens. To inform strategies to increase the number of insured within this population, we elicited immigrants' understanding of health insurance and preferences for coverage. Nine focus groups with Mexican immigrants were conducted across the State of North Carolina. Qualitative, descriptive methods were used to assess people's understanding of health insurance, identify their perceived need for health insurance, describe perceived barriers to obtaining coverage, and prioritize the components of insurance that immigrants value most. Individuals have a basic understanding of health insurance and perceive it as necessary. Participants most valued insurance that would cover emergencies, make care affordable, and protect family members. Barriers to obtaining insurance included cost, concerns about immigration status discovery, and communication issues. Strategies that address immigrants' preferences for and barriers to insurance should be considered.