Promotor Learning Institute

Co-training for promotores and institutions wanting to engage them as part of their workforce

Our unique approach to community engagement and health education is solidly based on a highly participatory methodology that brings together principles of adult education and popular education, where the voices and experiences of those affected by health and social conditions are the building blocks of our curricula and teaching materials utilizing daily life metaphors to understand complex topics such as diabetes management.

Our approach to health education, chronic disease management, community engagement, and transformation is designed to work with communities where members have not had access to higher levels of education but whose life experiences are leveraged to achieve health and wellness.

Promotores are community experts and need to be embraced as such to maximize their contributions. Promotoras are community experts and have the potential not just to improve health outcomes, but they can mobilize communities in such a way that they address the roots of health inequity.

We care about social well-being, and not merely the absence of disease or infirmity (World Health Organization).
By this definition, health results from the complex social process that depends on the interplay of socioeconomic, cultural, and scientific factors.

Our work is anchored in the Healthy Cities model, which addresses the social determinants of health. We situate our work in the physical places where people live, work, and play - where health is created, promoted, or inhibited. It is in these places that people’s lives unfold and where health outcomes are determined, depending on access to income, quality education, health services, power, favorable immigration status, and many other social conditions.

Promotor Model Trainings

Overview of the Promotor/ Community Worker Model Intended audience: Directors, managers, coordinators, supervisors, and clinic staff at Latino Health Access offers an interactive overview of the promotor model to institutions working or wanting to include Promotores in their teams and supervisors and administrators working with Promotores.

Latino Health Access has trained Promotores internationally and internationally for 30 years. We have had the honor of working with communities from different ethnic and racial groups: Latinex-US in the majority of states, Asian Pacific Islander, and African American; as well as a wide range of countries and communities from Australia, Canada, the Caribbean, Chile, Mexico, India, and Nepal. For Promotores to succeed, however, the institutions they work with need to develop openness to the promotor model. They need to have the capacity to train and support Promotores in a way that maximizes their contribution. They need to ensure that Promotores’ skills are unleashed, not confined. In sum, it requires that organizations have the right leadership and systems for this partnership.

Promotores operate within
four main areas of action:

  • Area 1 - Outreach

    They look for their community
    members and colleagues in order to
    invite them to exercise their
    leadership and to actively participate
    in decisions that affect physical,
    mental, and social health.

  • Area 2 – Creating Spaces

    They create spaces where they can constantly strengthen relationships and invite others to participate.

  • Area 3 - Services

    They connect, coordinate or provide
    direct, relevant, quality services.

  • Area 4 - Mechanisms

    They create mechanisms for increasing hope, inclusion, and participation in decision making related to health and quality of life.

Overview of basic promotor training.

This training is designed to challenge people’s assumptions about community health, for people to think, analyze, modify their current values and paradigms, and generate new ideas for action.

The training methodology is solidly based on popular education, theme generation, and other non-traditional methodologies intended to bring people’s experience into learning and start where they are.

Training logistics are flexible with community-sensitive schedules and conducted in familiar, non-academic settings where participants can fully express their thoughts and feelings while reducing their levels of anxiety and intimidation. Additionally, an entirely virtual methodology was developed and tested during the pandemic.

Intended audience: Community residents, promotores,
potential promotores, health coaches, patient navigators,
care coordinators, and personnel who may be supervising promotores

The trainer uses critical listening and reasoning skills to guide participants to draw from their personal, professional, and academic experiences to create a dialogue with each other. The trainer will motivate them to develop an ongoing dialogue within their communities to apply new information and form new perspectives of their communities and the issues that affect them.

As a result of this training, these leaders will enrich their capacity to transform the health and wellness of their communities by learning to engage the stakeholders -- individuals, families, and agencies -- from within and outside of those communities who will gain something from the change, in the process of change.

The highly interactive training is organized on a modular structure that allows optimal customization based on each organization’s needs. The model is intended to be enhanced by practical activities and accompaniment by
seasoned CHWs.

The training revloves around developing core competencies:

• Patient advocacy skills, defined as assisting patients in obtaining the care they need, and in navigating health and social service systems; and bringing visibility to each patient’s needs

• Community outreach and engagement

• Communication skills

• Promoting healthy lifestyles (Approaches such as:
Healthy Eating Active Living (HEAL)

• Cultural competence and responsiveness

• Service coordination skills

• Individual and assessment skills

• Health insurance basics

• Teaching skills

• Organizational skills

• Community capacity-building

• Professional conduct and interpersonal skills; and

• Public health

Essential Public Health Services

1. Assess and monitor population health status, factors that influence health, and community needs and assets

2. Investigate, diagnose, and address health problems and hazards affecting the population

3. Communicate effectively to inform and educate people about health, factors that influence it, and how to improve it

4. Strengthen, support, and mobilize communities and partnerships to improve health

Promotores will develop a deep understanding of the essential public health services and find the interaction points with the principles and competencies covered within the basic promotor training described above:

5. Create, champion, and implement policies, plans, and laws that impact health

6. Utilize legal and regulatory actions designed to improve and protect the public’s health

7. Assure an effective system that enables equitable access to the individual services and care needed to be healthy

8. Build and support a diverse and skilled public health workforce

9. Improve and innovate public health functions through ongoing evaluation, research, and continuous quality improvement

10. Build and maintain a strong organizational infrastructure for public health

Basic Promotor Training Content

The Basic Promotor training consists of 40 hours that can be organized in flexible ways. Promotores and supervisors can attend together, with an optimal group size cap of
20 participants.

  • Promotores create visions of themselves, their programs, and the community, discuss rights and responsibilities, dialogue and engage in group discussion.

  • Promotores discuss their role in building healthier and safer communities. They dive deep into the root causes of health disparities and the need for comprehensive interventions.

  • Promotores discuss the importance of identifying individual talents and assets within groups and communities; they dialogue about the non-deficit approach, the dominant discourse in society, and how to engage people to increase their interest and participation.

  • Promotores explain how to improve and keep good communication and how perception, values, and attitudes can affect their work with clients or co-workers. They engage in dialogue, role-playing, and group discussion.

  • The Promotores will discuss the main theories of Health Education and Health Behavior. The Promotores will also have deep conversations about the meaning of “helping, self-help and mutual help.”

  • Home visits can range from providing services to residents who are homebound, to following up with a participant to ensure that he/she is receiving the necessary support. Trainees will get a feel for this very intimate and personal interaction between a promotor and a community member. Promotores will become familiar with a visit protocol, and role-play personal interviews.

  • Promotores identify the principal elements that should be taken into consideration when conducting an interview. They learn how to ask open-ended questions, allowing individuals to define their own realities.

  • Promotoras will provide examples of how the universal principles of adult education are applied to interactions with adults at the individual or group level. A case will be provided to practice the application of the principles of adult education.

  • Promotores learn how a group behaves and the different roles people adopt within groups. They learn how to improve individual and group participation and study group dynamics. Promotores practice techniques to involve an audience including group activities and sustaining deep dialogues.

    Small group teaching

    Promotores prepare a class using the essential elements of class organization, principles of adult education and good communication.

  • Promotores learn how to rely on one another, how to address and embrace differences, the importance of peer support when helping others, how to interact with their supervisors, and what to expect from a supervisor.

Training for Participation, Outreach and Referral

The training focuses on meaningful participation, creative outreach and referral pathways.

1. Participation. What is it? Why is important to participate? Who needs to participate? Why people do not participate? How can we increase participation?

2. Outreach 101. Or how to reach the community. What is outreach? Creative outreach. Planning and documenting outreach activities. Dress Code and precautions during outreach.

3. Referral. How to refer individuals in an effective manner? Investigating services and assuring referrals to quality services. Closing the loop in assuring service utilization.

4. Removing barriers to utilization. How to encourage the community to use services? Avoiding losing services. Enabling or supporting? The “whatever it takes” approach.

Training tailored to a diversity of contexts

  • Building Healthy Cities, Strategies to Conduct Outreach, Adult Education, How to Help Effectively, Community Organizing, Improving Communication, Increasing Participation, Building Capacity among Participants, How to Organize Events, How to Do Family Visits, How to Facilitate Educational Sessions or Support Groups, and How to Develop One-on-One Sessions.

  • Prevention and Management of Chronic Diseases, Obesity and Overweight in Children and Adults, Nutrition, Mental Health, Emotional Problems, Helping Parents Create Meaningful Relationships with their Children, Domestic Violence Prevention, Breast Cancer, Substance Abuse, Child Passenger Safety, CPR and First Aid, Poisoning Prevention, How to Gain Access to Services and Health Insurance.

  • Advocacy in the Community, Civics and U.S. Government, Leadership 101, How the Budget in your City is Developed, Knowing your Political Representatives, Mobilizing the Vote, Immigrants’ Rights, Women's Rights.

  • Understanding how health insurance works and the health care system in the United States, Health Care Reform, Services for those without Documents, Where to find Free or Low-Cost services and What are the Requirements for Using Them?, How to Use Service Directories, How to Make a Referral, How to Track the Referral, What Forms Need to be Filled Out?, Who Can and How to Enroll Participants in Health Programs?, How to Request a Restraining Order in Court.

  • What is the data or information, and what is its purpose? What are the most common errors when data is collected? What is, Difference between impact and process, and outcome objectives? What are the objectives, and what is the expected impact of a specific program? How are outreach and contacts documented?, How to get data from another source?, How is information entered into our evaluation database, Laws protecting confidentiality about health information? How to protect the confidentiality of the LHA’s participants.

  • Study of job manual policies, Study of the regulation of financial procedures, Completing forms for reporting mileage, How to complete forms to report hours worked, Preventing and reporting harassment, Managing and resolving conflict.

  • How to prevent accidents, How to report accidents, Disaster preparedness -- including fires and earthquakes, Practicing fire drills.

  • How to be safe while doing community work, including outreach, home visits, surveys and the like.

  • Using computers safely; regulations on the use of computers and private health information;

    Using different programs like Word, Excel, and PowerPoint; use of office phones and projectors, and virtual meeting programs and other technology to facilitate communications and organizing through the use of social media.

  • This training is combined with Basic Promotor Training. Promotores need a certain type of

    supervision. Tradition methods of supervision can undermine a Promotor program. Supervisors benefit

    greatly from learning and discussing:

    How to supervise Promotores

    • Promotores as experts

    • The three dimensions of supervision: Human, technical, and financial/administrative

    • Planning with experts

    • Co-learning and co-teaching: The ongoing effort to develop competencies

    • Documenting and evaluating

    • How to give and receive feedback

    • 18 competencies to improve our work with communities

    • The personal and the professional

Caring4Cal is an initiative by the California Department of Health Care Access and Information (HCAI) that works to increase access to health services for all Californians through free healthcare training, free personal coaching, and paid incentives for care providers in an effort to expand, enhance, and strengthen the Home- and Community-Based Services (HCBS) provider workforce across California.