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Promotora de Salud/Lay Health Worker Model

In this model, community health workers (CHWs) are members of a target population and share many social, cultural, and economic characteristics. As trusted members of their community, promotoras provide culturally appropriate services and fulfill the following roles:

  • Patient advocate
  • Educator
  • Mentor
  • Outreach worker
  • Translator

They are often the bridge between the diverse populations they serve and the healthcare system. The promotora model is often used in the United States and Latin America to reach Hispanic communities. This model is also appropriate in rural communities to improve the health of migrant and seasonal farm workers and their families. For more resources related to establishing a migrant health promoter program, see Migrant Health Promoters resources. In rural border communities, promotoras often conduct environmental health and home assessments, and deliver education about environmental health hazards.

Examples of Promotora/Lay Health Worker Models

Implementation Considerations

This model is most effective when promotoras are members of the target population, not just people who speak the same language or share some characteristics with the communities they serve. Even in cases where promotoras are members of the target population, they may encounter barriers to providing services. A common barrier in border communities includes distrust of the program. Additionally, many promotora programs serve rural and frontier communities, where transportation is limited and travel to the target population is difficult.

Resources to Learn More

Incorporate Lay Health Workers to Promote Health and Prevent Disease
Essay
Essays that highlight evidence-based management and policy options of using lay CHWs for improving quality of care.
Organization(s): Canadian Health Services Research Foundation
Date: 9/2007

Improving Quality of Care for Latinos Project: Community Health Worker/Promotoras Network
Document
Description of the building of a statewide network of CHW/Promotoras to improve the quality of care received by Latinos in California.
Organization(s): California HealthCare Foundation

MHP Salud Online Resources
Website
This organization maintains a portfolio of English and Spanish health promotion materials specifically for isolated and/or underserved Latino(a) communities.

Migrant Health Promotion has a series of free, downloadable resources for planning, implementing, and evaluating CHW programs. There are both guides and templates of documents available, many of which are also in Spanish. Some particularly helpful resources are highlighted here.

NOTE: To access all Migrant Health Promotion materials, you must create a free user account with them.

Promotoras: Lessons Learned on Improving Healthcare Access to Latinos
Document
An issue brief exploring the promotora model to increase healthcare access to immigrant elders, adults and their children in Central Valley, California.
Organization(s): Central Valley Health Policy Institute
Date: 2009

Texas A&M University - Border Health Environmental Coordination Program
Document
Describes a program that explores childhood exposure to pesticides in colonias along the border of the United States and Mexico and investigates the utility of health education as an intervention to reduce pesticide exposure.
Organization(s): Texas A & M University - Border Health Coordination Program
Date: 8/2007

The Way of the Heart: The Promotora Institute
Website
Non-profit that provides free services to a rural community on the Arizona/Mexico border. Services include outreach, education, training, and advocacy for women and their families.
Organization(s): The Way of the Heart: The Promotora Institute

Migrant Health Promoters

Bilingual English and Spanish Survey
Document
A bilingual English and Spanish survey for farmworkers to provide feedback on in-clinic health services.
Organization(s): Bi-State Primary Care Association
Date: 2017

Protocols for Health Promoters
Document
This resource provides best practices for Migrant Health Promoters when distributing health education materials or coordinating healthcare.
Organization(s): Bi-State Primary Care Association

Care Coordinator Privacy and Confidentiality Documents
Document
This resource is a confidentiality agreement for the care coordinator.
Organization(s): Bi-State Primary Care Association
Date: 8/2012

Client Encounter Form
Document
This is a resource for the care coordinator to use to document information during a client encounter.
Organization(s): Bi-State Primary Care Association
Date: 12/2013

Consent to Release Information
Document
This is a bilingual English and Spanish consent form for the release or exchange of information.
Organization(s): Bi-State Primary Care Association
Date: 12/2013

Farmworker Important Contacts Cards Instructions
Document
A bilingual English and Spanish resource for farmworkers to have important information in the case of an emergency.
Organization(s): Bi-State Primary Care Association
Date: 12/2013

Position Description for Migrant Health Promoter
Document
This resource provides a description of a Migrant Health Promoter position as advertised on a human resources website. It includes the job skills and responsibilities, as well as the qualities of the successful candidate.
Organization(s): Bi-State Primary Care Association
Date: 12/2013

A Quick Guide to Working with Interpreters
Document
This resource explains how to effectively work with interpreters.
Organization(s): Bi-State Primary Care Association
Date: 12/2013