This presentation was part of Embody's Safe Healthy Strong 2015 conference on sexuality education (www.ppwi.org/safehealthystrong). Embody is Planned Parenthood of Wisconsin's education and training programs. Learn more: www.ppwi.org/embody DESCRIPTION Institutional and social barriers place Latino families in the U.S. at greater risk for adverse health outcomes, often facing unique challenges to healthy sexuality and access to reproductive health care; the services available are often not linguistically or culturally appropriate. To help Latinos navigate the health care system and address their need for culturally relevant health information, Planned Parenthood of Wisconsin (PPWI) utilizes specially trained lay community members as frontline public health advisors. Promotores de Salud have firsthand knowledge of the issues affecting the communities in which they live and serve, and through direct education and training in homes and other familiar venues, become trusted resources. The workshop described the Promotores model and explored how community health advisors can model and teach health literacy skills in underserved communities. ABOUT THE PRESENTERS Maria Barker, Multicultural Programs Manager at PPWI, is a bilingual (Spanish/English) community educator of Mexican origin. She has facilitated reproductive health education programming including hundreds of home health parties for the Latino community since 2003. She is well recognized for training and using lay community workers known as Promotores de Salud to reach the Latino community. Maria is a graduate of the Latino Nonprofit Leadership Program through UW-Milwaukee and Cardinal Stritch University, and is a Certified Sexuality Educator by Planned Parenthood of Western Washington and Centralia College. Al Castro, MS BSSW, Program Director at the United Community Center of Milwaukee, manages the UCC Health Research Department, which collaborates with universities to conduct community-engaged research to develop programs and services that address health issues and inequities in the Latino community. Castro holds a BS in Social Work from Carroll University and an MS in Business Management from Cardinal Stritch University. Castro is a licensed social worker in Wisconsin and is fluent in Spanish. Angeles Soria Rodriguez, a Mexican immigrant, started her community service by helping co-workers and neighbors access health care, hospitals, courts, DMVs, and other resources. When Angeles moved to Milwaukee, she volunteered at community organizations and attended comprehensive trainings about cardiovascular and mental health, financial management, and nutrition. Angeles now concentrates her volunteer efforts on creating leadership among Latina women and reducing Latino obesity. As a health promoter at PPWI, she uses the Cuidandonos Creceremos mas Sanos curriculum she helped develop to facilitate home health parties that help Latino families get comfortable talking about healthy

1. AL CASTRO, ANGELES SORIA,
MARIA BARKER
JUNE, 2015
Reaching Out to the Latino
Community with Health
Literate Messaging

2. Introductions
Facilitators
Audience

3. Agenda
Learn how two Milwaukee agencies reach
Latinos with health literate messages.
Hear one health promoters experience
delivering these efforts
Discuss how your agency can replicate these
efforts

4. Who is Your Audience and Community?

5.  Hispanics/Latinos are the second largest and fastest growing
minority racial and ethnic population in Wisconsin.
 Wisconsin has 336,056 Latinos (US Census, 2010)-(74%
increase from 2000).
 Represents about 6% of State’s population.
 Milwaukee County is home to 126,000 Latinos, comprising
33% of Wisconsin's Latino population.
 33% of Hispanics are foreign born
 40% are not comfortable speaking in English
Wisconsin’s Latino Population

6. Surveys / Data Review:
• Bruce Guadalupe Community School (n=1,100):
• 50% of students (K3-8th) – overweight/obese
• Elder Programs (n=156):
• 40% diabetes Type II
• Survey of Parents (n = 413)
• Perceived risk of diabetes not showing correlation
to odds of screenings
UCC Internal Scan

7. Community members identified a need for accessible
information
• Medical jargon
• Spanish/ cultural translation
• Literacy levels vary
• Interesting
• Telenovela
• Fotonovela
• Pisando Fuerte
Focus Groups/ Community Advisory Board:

8. Television in many ways has always been a social
phenomenon. It has been the fixture that anchors
family life; a cultural phenomenon whose impact
is felt across generations and across geographies.
According to Nielsen Media Research…
•Latinos watch more television than the general US population.9
•Latinos are more likely to report acting on information they
learned on television than their white counterparts.10
•55% to 62% of Latinos in all age groups watch an average of 2.5
telenovela episodes per week.11
- The New Power of TV, Initiative 2013

9. Theoretical Framework
Bandura’s Social Cognitive Theory12
• We learn vicariously from the successes and
failures of other people through a process called
social modeling
• Modeling is more likely to occur when you
identify closely and empathize with the other person

10. Our Hypothesis
Viewers who identify with the characters in
our telenovela will demonstrate
1. Increased comprehension of “oral”
diabetes-related health messages.
2. Positive changes in knowledge,
information retention, information-
seeking behaviors and self-reported
changes in eating and exercise
habits.
3. Expressed satisfaction with the
“telenovela” as an educational tool
to use to communicate information
to family members and friends

11. Methods
Viewers who identify with the characters in
our telenovela will demonstrate
•First, our study team conducted interviews with diabetic Latinos in
Milwaukee to help us identify key diabetes-related health messages.
•Second, we developed the storyline and script and met with our
Community Advisory Board numerous times to discuss key cultural and
linguistic elements.
•We cast volunteers from the community to portray the characters and
worked over several months to produce the telenovela.
•Developed a diabetes knowledge, attitudes and behaviors assessment
tool in Spanish and English to administer pre- and post- exposure to
the telenovela.
•Pilot tested the telenovela with 125 Latino adults

12. Knowledge items
20 items
• 11 items show significant positive change in knowledge
• 8 items on health attitudes.
• 2 items on behavioral intentions.

13. Conclusions
•Telenovela promises to be an effective educational medium
with Latinos for diabetes (maybe other diseases?)
•Majority of participants exhibited significant increased
knowledge of the disease
•Significant change in behavior intent to follow up with
screening
•Actors are becoming “messengers” to others after their
experience

14. Dulce Tentacion Trailer
Telenovela: Dulce Tentacion

15. Assessment of Your Community
Community Based Participatory Research
Surveys
Interviews with experts in the field
Focus groups

16. Commonalities Challenges
Values!
Latino Values are often
guided by 5 principals
Family
Respect
Male role
Female role
Religion
 Income and health equity
challenges to using
health care
 Language and cultural
literacy of health
resources
 Severe barriers for
immigrants to health
information, screening
and care.
The Findings

17. The Development of Informed, Culturally
Relevant Material

18. The Messanger The Venue
The Messenger and the Venue

19. Meet a PPWI Messenger
Ángeles Soria
PPWI Health Promoter

20. Questions?
How can we be of service for your
agency to reach Latinos with
health literate messages?

21. Reference
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diabetes and impaired fasting glucose in adults in the US population: NHANES 1999–2002. Diabetes Care. 29(6):1263–1268.
2. Harris MI, Klein R, Cowie CC, Rowland M, Byrd-Holt DD. (1998) Is the risk of diabetic retinopathy greater in non-Latino blacks and Mexican
Americans than in non-Latino whites with type 2 diabetes? A US population study. Diabetes Care. 21(8):1230-1235.
3. Engelgau MM, Geiss LS, Saaddine JB, Boyle JP, Benjamin SM, Gregg EW, et al. (2004) The evolving diabetes burden in the United States. Ann
Intern Med. 140(11):945-950.
4. Eberhardt, M.S., Ingram, D.D., & Makus, D.M., et al. (2001) Urban and rural health chartbook. Health, United States, 2001. Hyattsville, MD:
National Center for Health Statistics.
5. Council on Scientific Affairs (1991) Hispanic health in the United States. Journal of the American Medical Association. 265:248-252.
6. Harris MI, Eastman RC, Cowie CC, Flegal KM, & Eberhardt MS (1999) Racial and ethnic differences in glycemic control of adults with type 2
diabetes. Diabetes Care, 22, 403-408.
7. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (2002) Diabetes Care 25, S5–S20.
8. Institute of Medicine (IOM). 2004. Health Literacy: A Prescription to End Confusion. Washington, DC: The National Academies Press.
9. Nielsen Media Research. (2000). National Hispanic people meter sample, September 1999–May 2000. Retrieved, from
Nielsenmediaresearch.com.
10. Beck, V., Huang, G. C., Pollard, W. E., & Johnson, T. J. (2003). TV drama viewers and health information. Paper presented atthe American
Public Health Association 131st Annual Meeting and Exposition, San Francisco, CA.
11. Carrasquillo, M., Pearson, M., Valente, T., Wilkin, H., Slan, L., Beck, V., & Huang, G. (2003, November). Spanish language TV viewers and
health information: Partnering with public health to educate about breast cancer. Presentation at the 131st American Public Health
Association Annual Meeting and Exposition, San Francisco, CA.
12. Bandura, A. (2004). Social cognitive theory for personal and social change by enabling media. In A. Singhal, M. J. Cody, E. M. Rogers, & M.
Sabido (Eds.), Entertainment-education and social change: History, research, and practice (pp. 75–97). Mahwah, NJ: Lawrence Erlbaum
Associates.
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with Financial Education. The Journal of Consumer Affairs 43(1):56-79.
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States? Identification and the Effects of a Telenovela Breast Cancer Storyline. Journal of Health Communication, 12:455-469.
15. Jibaja ML, Kingery P, Neff NE et al. (2000) Tailored, interactive soap operas for breast cancer education of high risk Hispanic women. Journal
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