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Environmental Factor, August 2013

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Superfund pilots new promotora training module in Mexico and Arizona

By Sarah Wilkinson

Susana Vazquez, Maria Luisa Morales, Florecita Morales, and Denise Moreno Ramírez

Shown, from left, are SERI promotoras Vazquez, Maria Luisa Morales, and Florecita Morales who joined Ramírez, as the training got underway in Naco. (Photo courtesy of Tom Carlson)

Hands-on activities demonstrated important concepts about exposure routes, such as the hazards of placing household chemicals in unmarked containers.

Hands-on activities demonstrated important concepts about exposure routes, such as the hazards of placing household chemicals in unmarked containers. (Photo courtesy of Denise Moreno Ramírez)

The NIEHS-funded University of Arizona Superfund Research Program (UA SRP) and Dean Carter Binational Center for Environmental Health Sciences piloted another module, this summer, in the series “Transferable Training Modules on Environmental Science.” The new module, “Health Risks from Environmental Exposures,” covers topics such as everyday risks, dose response, hazard consequences, and biological variability.

Funding for this chapter of the modules was provided by the UA SRP and leveraged with a Community Connections grant from the University of Arizona Foundation. The risk module was developed collaboratively by promotoras working for the Sonora Environmental Research Institute Inc. (SERI) in Tucson, Ariz., and Denise Moreno Ramírez, coordinator of the UA SRP Community Engagement Core. UA SRP researcher was the expert advisor on the project.

Health advocates provide outreach to the community

Like the other modules in the series, the risk module was developed for use by promotoras de salud, or Latina community health advocates. Promotoras are peer educators who receive specialized training to promote healthy living in their communities, and are a proven method of information transfer, especially within disadvantaged populations. They act as conduits of information between their community and an institution or organization. Because they share a language and a culture with their audience, promotoras are able to provide information in a relevant and accessible manner.

The transferrable training modules are based on a train-the-trainer model. This model is based on providing training to promotoras, who in turn transfer the knowledge gained to other promotoras, and subsequently to their communities at large. Each module is comprised of background information, a PowerPoint presentation, hands-on activity ideas, additional resources, and instructional materials to guide promotoras in the development and implementation of interactive trainings.

The flexible nature of the modules allows for replication and adaptation of the trainings. While the core information remains the same, examples and activities can be modified to fit unique audiences, such as various communities, government agencies, businesses interested in greening their practices, and primary, secondary, and collegiate education, including tribal colleges.

Testing the program on the ground in Mexico

Ramírez, Loh, and SERI promotoras Maria Luisa Morales, Florecita Morales, and Susana Vazquez travelled June 19 to the Naco Wellness Initiative’s Casas Saludables clinic in Naco, Sonora, Mexico, to pilot test the new module and to present an existing module on pesticides. The SERI promotoras led a group that included representatives from Casas Saludables, Naco Library, Mexican Red Cross, Municipal Civil Protection, and Naco Fire Fighters, through a presentation and hands-on activities.

Tom Carlson, president of the Naco Wellness Initiative, was very pleased with the training, and spoke of the benefits it brought to his program. “Everyone loved all of the special attention you gave, from the workshop itself to the snacks and prizes, and especially your friendship. We will be working the materials into our community health education programming,” he said.

While in Naco, the group from Tucson also had the opportunity to provide a special radio interview with Vicente Borquez López, director of the border region radio station Radio Cultural Stereo 106.9 FM, allowing community listeners from the sister cities of Naco and Bisbee, Ariz., to learn about the endeavor.

Carlson said he looks forward to additional opportunities for collaboration. “I know that we can find opportunities to work together that will be of great benefit to the services of the clinic and to the people of Naco. There is such need for additional medical attention and health education programs for both young and old, and we would love to partner with you as we go about reaching out to those people.”

Once finalized, the “Health Risks from Environmental Exposures” module will be available in English and Spanish on the UA SRP and Binational Center websites for free download, along with the currently available modules.

(Sarah Wilkinson, Ph.D., is the UA SRP research translation core coordinator. She writes and edits the UA SRP News and Highlights, where this story first appeared.)

106.9 FM radio station director Vicente Borquez López, SERI promotoras Florecita Morales and Maria Luisa Morales, Casa Saludables president Lupita Sánchez, and UA SRP lead researcher Miranda Loh, Sc.D.

During a radio interview at 106.9 FM, from left, radio station director López interviewed SERI promotoras Florecita Morales and Maria Luisa Morales, Casa Saludables president Lupita Sánchez, and UA SRP lead researcher Loh. (Photo courtesy of Denise Moreno Ramírez)

Participants in the promotora training module

In Tucson, participants used swabs to test for lead in the type of pottery commonly found in homes in the border region. (Photo courtesy of Denise Moreno Ramírez)

SERI promotoras delivered an interactive presentation to community participants.

SERI promotoras, center, delivered an interactive presentation, with plenty of time for questions from community participants. (Photo courtesy of Denise Moreno Ramírez)

Instructors and participants at the promotora training module

Instructors and participants at the training in Naco (Photo courtesy of Tom Carlson)

Back in Tucson for fine tuning

Closer to home, the team held another pilot training July 11 in Tucson. The audience was comprised of volunteer promotoras at SERI. Maria Luisa Morales and Florecita Morales delivered the “Risk Assessment from Environmental Exposures” presentation, while Vazquez led the hands-on activities.

At the end of the training, participants provided input on the content of the information they received, as well as the format of the training. Their responses were captured using hand-held response devices, or clickers, and polling software. Use of the clickers let individuals provide answers anonymously, while the aggregate responses of the group were instantaneously projected on screen. In addition, the participants gave written feedback on improvements for the module, which will be incorporated into the final version.

After the survey, participants were quizzed about what they had learned about risk assessment, by having them select a topic and answering a question. Trainers were able to discuss the answers with participants, and to revisit the information immediately, making the training more effective. It also made it more fun. As Ramírez explained, “It was a lot less scary for the promotoras than the usual pre- and post-test knowledge surveys.”

For additional information about UA SRP programs for community-based outreach training in border communities:

Transferable Training Modules Targeting Promotoras

Bilingual Environmental Science Modules for Communities Available

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