To address this problem, we developed a health education program based on a promotores de salud (lay health educators) model with theoretical underpinnings in the Ecological Validity Framework (EVF) for cultural program adaptation, as well as Self-Efficacy Theory. The purpose of our study is to address the following research questions: 1) Did participants increase self-efficacy between pre and post test?; 2) Are higher levels of self-efficacy related to more healthy behaviors at post- test?; 3) Did participants improve their health behavior between pre and post test?; and 4) Did participants reduce their levels of psychological distress as measured by depressive symptoms between pre and post test?
Methods: A curriculum was developed that includes content on the following topics: taking care of yourself, healthcare, well-being, nutrition, exercise, stress and depression, including others and sustaining growth. The program employs a home-visiting model in which promotoras deliver information through eight one-on-one sessions with mothers. The sample consisted of 27 participants.
Mixed-methods were employed in this one-group study design. Quantitative pre and post-tests were administered to measure changes in health behaviors and maternal well-being. These tests included the following measures: 1) Self-Efficacy Scale for Health Behaviors; 2) Center for Epidemiology Studies Depression Scale (CES-D); and 3) Adaptation of the Family Habits Scale. Qualitative interviews were also conducted after the intervention to explore the relevance of the program to participants' lives and the successes and challenges they encountered in implementing healthy habits.
Results: Results from our pilot study suggest a promising health education intervention for Latina mothers who care for their child with IDD. To answer our research questions, paired sample t-tests were employed. Findings show that 1) participants significantly improved their self-efficacy; 2) there is a significant relationship between overall healthy habits and self-efficacy; 3) participants significantly improved nutrition habits and self-care habits; and 4) levels of depressive symptoms were significantly reduced. Qualitative findings revealed successes and challenges that the promotoras encountered in implementing the program and mapped onto the concept of self-efficacy.
Conclusions & Implications: This study offers new information about the utility of a culturally sensitive health education program for Latina mothers caring for children with IDDs. To build on these findings, a study is underway using randomized-control trials in which participants are assigned to an intervention group or a wait list group. The goal is to recruit 50 participants to the intervention group and 50 to the wait list group. The randomized study will help to address threats to validity and determine whether changes between pre and post-test can be contributed to the intervention.
