Project Title: A Su Salud

Abstract:

A broad program of community health promotion was implemented in the low-income community of Eagle Pass, Texas, on the Mexican-American border. The community intervention program was part of a larger study, known collectively as Programa A Su Salud (To Your Health). Programa A Su Salud was designed to demonstrate and study the effectiveness of mass media health messages using culturally relevant role models selected from the local community. Attention to the media messages and imitation of the role models of positive behavior, such as quitting smoking, were reinforced when printed materials were distributed by a cadre of volunteers recruited from the community. Randomly selected members of the communities were also offered one-to-one counseling and support to deal with specific health risks. The Eagle Pass A Su Salud program was organized as a supporting unit for local public health services, which did not have staff for significant efforts beyond their primary mandates to serve clients in need of clinic-based services. The Texas Department of Health provided an authorizing and administrative oversight, viewing the program as an opportunity to test new approaches to community outreach and as a way to help deliver needed education to the study community.

Co-PI:

  • Amelie G. Ramirez, MPH, Assistant Professor, Baylor College of Medicine, Center for Health Promotion Research and Development, The University of Texas Health Science Center at Houston, TX

Funding Institution:

National Cancer Institute

Funding Period:

1984-1994 (including 5-year extension)

Location/Service Area:

Eagle Pass, TX and surrounding areas

Collaborators/Co-sponsors:

Texas Department of Health

Goals:

Promote health behavior and reduce risks among low-income persons in southwest Texas.

Results:

A broad program of community health promotion was implemented in a low-income community on the U.S.-Mexico border to test the feasibility and community acceptance of a theory-based model of change. The efforts included an intensive media campaign featuring role models of positive behavior (i.e., smoking cessation), recruitment of several hundred volunteers to promote imitation of the role models, and community organization to stimulate changes in policies that could influence health behavior (i.e., a city ordinance to restrict smoking). The long-term, partly randomized study assessed effects on behavior through survey instruments and, in the case of smoking cessation, biochemical validation of self-reports. Results showed that, in the study community exposed to the mass media and peer network, an 18 percent smoking cessation (one year without smoking) rate was seen, as compared to 7.5 percent in a control community with no organized campaign. Surprisingly, the group that had received the media, peer network and personal counseling campaign had a 16 percent quit rate – 2 percentage points lower than those exposed to mass media and interpersonal communications alone. The results from these case studies illustrate the kind of results that can be obtained by applying combined media and interpersonal communications. And, importantly, the necessary behavioral journalism and community networking skills require relatively little training.

Potential Impact:

The study shows that much can be done to improve Hispanic/Latino health by implementing health promotion and disease prevention interventions by applying combined media and interpersonal communications using a theory-based model of change.

Publications:

  • Aguirre-Molina M, Ramirez AG and Ramirez M. Health Promotion and Disease Prevention Strategies. Public Health Reports, 1993, 108(5): p. 559-564.
  • Amezcua D, McAlister A, Ramirez AG, Espinoza R. A Su Salud: Health Promotion in a Mexican-American Border Community, in Health Promotion at the Community Level, N.F. Bracht, Editor. 1990, Sage Publications: Newbury Park.
  • McAlister A, Ramirez AG, Amezcua C, Pulley L, Stern M, Gallion K, et al. Smoking Cessation in Texas-Mexico Border Communities: A Quasi-experimental Panel Study. American Journal of Health Promotion, 6(4): 274-279, 1992.
  • Cousins, J.H., et al. Family Versus iIdividually Oriented Intervention for Weight Loss in Mexican American Women. Public Health Reports, 1992. 107(5): p. 549-555.
  • Foreyt, J, Ramirez AG, and Cousins J. Cuidando El Corazon — A Weight-reduction iItervention for Mexican Americans. The American Journal of Clinical Nutrition, 1991. 53(6 Suppl): p. 1639S-1641S.
  • Gonzales R, McAlister A, Ramirez A, Amezcua C, Cardenas C. Volunteer Health Promoters in Eagle Pass, Texas, Border Health Journal, 10(4), 1994.