Spanish-speaking parents around California are taking on a leadership role in their communities’ health as promotores. They offer health classes and support for families in their community.

“[Many promotores] are immigrant moms, home with their kids. [Being promotores] gives them an opportunity to grow, learn, and learn a trade. It boosts their self-esteem because they’re instructors. Everybody says they love [the promotora-led] classes. [Participants have] learned a lot, they’ve changed the way they cook,” says Aurora Flores of the Accelerated School, lead agency for the LA Healthy Eating, Active Communities collaborative (HEAC).

“Obesity and childhood diabetes are real problems in the [Latino] community,” adds Lisa Hoffman, Director of the San Diego Prevention Research Center (SDPRC). Community health programs offer health and leadership training (see below) to help promotores address these and other health problems affecting children and families.

Los Angeles: Understanding children’s needs

“I didn’t know what to do,” says Los Angeles mom Maria Tlapaya, when she was worried about whether a mole on her son’s face was cancerous. She also found out he was not eligible for low-cost state health insurance. Then a clerk at a health clinic told her about a community health program coordinated by the Esperanza Community Housing Organization.

Esperanza has trained 336 promotores on health issues over the past 15 years. In turn, the promotores have provided classes and support to over 100,000 L.A. residents. One of these promotores helped Tlapaya get health insurance through Kaiser.

When Tlapaya was diagnosed with post-partum depression after the birth of her second child, she contacted Esperanza’s Best Babies program. “I cried a lot and just wanted the child to be quiet,” she recalls, and she didn’t understand her doctor’s explanation. A promotora gave her support and information in Spanish.

“In Latino culture, women are expected to take care of the children,” says Tlapaya, “but [the promotora] taught me my husband also should take part. She helped me understand my son’s needs without relegating mine to second place.”

Now Tlapaya is taking a promotora-led nutrition course. She’s learning how to help her family get more vigorous exercise, limit TV time, eat more whole grains, and try new vegetables. The assistance she has gotten from Esperanza’s program has also helped her support her son. “My son has much better grades, [he] is not so timid,” she adds.

“I learned how to take better care of myself and my family” by training to be a promotora, says Los Angeles mom Rosa Girón. She found out about the program through her children’s school and learned about health issues, such as asthma, lead, prenatal care, and chronic diseases. “My mother had breast cancer, so I decided to focus on chronic diseases as well as nutrition,” she adds.

Before becoming a promotora, Girón felt too shy to speak up. “[Now], I’ve spoken at conferences in front of a thousand people. This was a huge obstacle that I didn’t know how to overcome alone.” She also learned how to use PowerPoint and other computer software.

San Ysidro: More energy and self-confidence

“I’d never exercised before [becoming a promotora]” says Cecilia López, mother of three in San Ysidro. After completing a training offered by SDPRC, she started teaching a free Zumba class (a fusion of salsa and aerobics). “I have lowered my cholesterol, and my children feel very proud of me. They can’t believe I’m doing this kind of work.”

López is one of several promotores teaching free exercise classes at San Ysidro’s recreation centers, parks, and school gyms through Familias Sanas y Activas, a program of the San Diego Prevention Research Center. The classes target parents as role models for their children, says Hoffman, and parents can bring their kids. Another promotora offers a special class for parents of children with Down’s Syndrome.

“It was a little difficult to be the leader of the group,” López adds. She had never been in charge before and was not familiar with Zumba—but she knew she’d enjoy it because she likes to dance. “The women are very accepting of my limits and grateful for the classes. Your self-confidence goes up…you have more energy to do things,” she adds.

San Ysidro mom Elsa Escalante noticed Lopez’s class at her community center. “The teacher saw me looking in and said in Spanish, ‘Come on in! Welcome!’ She is so warm and friendly. I started taking the class right away. I love it!” Now, after a year, she says, “I’ve lost weight. I feel better.” Her daughter is also a regular in the class.

“We do fitness evaluations of all participants [in exercise classes] at six and 12 months—[we find] their cardio has improved, and they have lost inches in their waist,” says Hoffman.

Statewide: Prepared for advocacy

Visión y Compromiso connects the statewide network of promotores, offering bilingual resources and trainings on health and advocacy. VYC also organizes an annual legislative day for promotores.

“When you’ve never [talked with legislators] before, you’re very nervous—you feel out of your element seeing everyone in suits, [but] VYC made me feel very prepared,” says Gloria Valdes, Case Manager for a family resource center serving Modesto and Salida.

She spoke with legislators in support of SB 810, a bill that would let all residents in California get health coverage through a single-payer health care system. VYC offered information and talking points about the bill, as well as tips for talking with Assembly members.

“The network has empowered me to think ‘Si, se puede’ [Yes, we can],” says Valdes.

Ingredients for success

Service from the heart: “Think of someone who is always helping, an aunt, a grandmother,” says Maria Lemus, Executive Director of Visión y Compromiso. Based on the Latin American community health worker model, the promotora program “has formalized this and focused it toward health,” she adds.  “These are experts in the community that should be respected—though they may not have college degrees or speak English.” Many promotores are unpaid volunteers, though some programs offer stipends and sometimes the experience leads to paid jobs.

In-depth training: Esperanza promotores take a six-month training on lead poisoning, nutrition and diabetes, immunization, oral health, healthy babies, asthma, and food access. SDPRC gives promotores two twelve-hour trainings on physical activity. They can get a stipend for taking additional training. Promotores also learn consensus-building, effective communication, and active listening skills.

Community needs: “A community may want a forum on meth and gangs because they’re worried about [the safety of their] children, even before they want to deal with diabetes or high blood pressure,” says Lemus. The Esperanza program began because of high asthma rates in the community—the first promotores were parents of children with asthma.

Partnerships for health: SDPRC works with a range of agencies, from schools to clinics. Because of this partnership, the San Ysidro Health Center prescribes promotora fitness classes to patients. Esperanza works with Healthy Eating, Active Communities, a California Endowment-funded initiative on childhood obesity.

Trusted channels: Promotores advertise free classes through community centers, clinics, schools, and churches. “People trust these institutions,” says Hoffman.

Statewide training and connections: Visión y Compromiso offers trainings to promotores statewide on budgeting, logic modeling, making and carrying out work plans, and program management language. VYC also convenes regional committees to develop work plans and decide on advocacy and training topics. “[We’re] like a family—working, planning, always doing things together,” says Vanessa Mendoza, a Stanislaus County Health Educator. 

To find a promotora program, contact Visión y Compromiso, Isalia Zumaya, 213-202-5359