Transcript Cultural Competency:

Reaching Latinas with
Information on Folic Acid:
How to Use the NCFA Hispanic
Outreach Tool Kit
Liany Elba Arroyo, MPH, CPH
Institute for Hispanic Health
National Council of La Raza
Presentation Overview
• NCLR Overview
• Snapshot of the Latino Community
– Activity 1
• Barriers Faced By Latinos
• Review Tool Kit & Marketing Plan
– Activities 2 and 3
• Strategies to Engage the Latino Community
• Questions/Comments
NCLR Overview
NCLR is the largest national Latino civil rights and advocacy organization in
the U.S. It was founded in 1968 to improve opportunities for Hispanic
Americans.
NCLR’s headquarters is in Washington, DC, and it has offices in AZ, CA, GA,
IL, NY, TX, and Puerto Rico.
Three major functions:
• Strategic, capacity-building assistance to community-based
organizations
• Applied research, policy analysis, and advocacy
• Public information efforts and other events
NCLR has nearly 300 Affiliate partners in 41 states and Puerto Rico.
the District of Columbia
IHH Overview
In 2002, Institute for Hispanic Health (IHH) was established to:
• Promote science-based, quality, culturally competent
interventions to improve access to and use of health
promotion and disease prevention programs.
• Reduce the incidence, burden, and impact of health
problems among Hispanics and promote well-being.
• Partner with NCLR Affiliates, government agencies, private
funders, and other Hispanic-serving organizations to
address disparities.
Demographics of U.S. Latino Population
• 46.9 million (not including the approximately four million
residents of Puerto Rico); Hispanics in U.S. compose roughly
15.4% of U.S. population.
• 64% of Latinos are of Mexican origin.
• 40% are foreign-born (excluding Puerto Ricans).
• Median age is 27.7, compared to 36.8 for the U.S. population
as a whole.
• 25% of children under five are Hispanic.
• 22% of children under 18 are Hispanic.
Source: U.S. Census Bureau 2008
Demographics of U.S. Latino Population
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One-third of population has no health insurance.
11% of college students are Hispanic.
24% do not speak English well.
21.5% live below poverty level.
Median household income is about $37,800.
Almost 40% have not graduated from high school.
States with the largest Latino populations:
– California, Texas, Florida, New York, Illinois, Arizona, New
Jersey, Colorado, New Mexico, and Georgia
Source: NCLR calculations using U.S. Census Bureau, 2007 American Community Survey.
Hispanic Women in the U.S.
• Hispanic women have a higher fertility rate than
non-Hispanic White women (97.7 vs. 58.5 per
1,000).
• 54% of pregnancies among Latinas are unplanned.
• 53% of Latina teens get pregnant at least once
before the age 20.
• Complications such as diabetes, obesity, and
uninsurance affect Hispanic women at higher rates
then the general population.
Latina and Prenatal Care
More than 20% of Latina immigrant women do
not begin prenatal care in the first trimester.*
Multiple barriers inhibit access to prenatal
care (e.g., uninsurance, poverty, language, low
levels of education, low socioeconomic status,
lack of information, and immigration status).
*National Latina Institute for Reproductive Health (NLIRH), Prenatal Care Access
Among Immigrant Latinas (New York: NLIRH, 2006)
Latinas and Prenatal Care (cont’d)
U.S.-born Latinas have higher rates of
pregnancy complications than foreign-born
Latinas (90.5 vs. 71.8 per 1,000 live births).*
Latinas are 1.5 to 2 times more likely to have
babies with neural tube defects than other
groups.
*David Hayes-Bautista et al., Timely Access to Prenatal Care: Prime Necessity for
Latina Mothers, (Los Angeles: Center for the Study of Latino Health and Culture,
UCLA, 2003).
Activity 1:
Your Latino Community
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In groups of three, think about the community you are attempting to reach
with information on folic acid.
List the characteristics of that community. Include the following:
– National origin (e.g., Mexican, Puerto Rican, Central American)
– Generational status (e.g., immigrant; 1st, 2nd, or 3rd gen.)
– Socioeconomic status (e.g., working poor, middle class)
– Family unit (e.g., large extended families, small family unit)
– Rural vs. urban (geographically dispersed)
If you do not have all of this information or are not familiar with the Latino
population you are trying to reach, where could you find out this information?
You have five minutes to discuss this in your group.
Save this information for an activity later on.
Barriers to Health Care Access
• Access
• Language
• Lack of insurance
• Literacy levels
• Information
• Sociocultural Factors
• Lack of knowledge about U.S. health care system
• Fear of deportation or jeopardizing future legal status
• Familial orientation
• Mixed-status families
• Generational status
• Education
Barriers to Health Care Access
• Structural Factors
• Long waits
• Inconvenient hours
• Lack of transportation
• High cost of services
• Lack of Spanish-speaking providers
• Legal permanent residents who enter after 08/1996
barred from accessing Medicaid (CHIP reauthorization
allows pregnant women and children to access
Medicaid and CHIP)
What can we do?
• We need to develop culturally and linguistically appropriate
strategies to reach Latinas most at risk and in need of
information.
• Two-pronged approach:
• Media
• Community outreach
• NCLR and NCFA developed two tools in response to this
need:
◦ Hispanic Media and Community Outreach Tool Kit
◦ Hispanic Communications and Marketing Plan
Hispanic Media &
Community Outreach Tool Kit
Purpose: To provide organizations with a tool
they can use to guide them in partnering with
the Hispanic media on folic acid promotion.
It contains:
 A profile of the Latino community
 An overview of how to work with the media
 An explanation of how the Hispanic media differs from
mainstream media
 Suggested talking points
 Templates for related press materials
 Information on resources
Hispanic Media & Community
Outreach Tool Kit (cont’d)
Is it important to work with Spanish-language
media because they:
 Seek to provide information to the community that is relevant
and culturally sensitive
 Like a human angle -- personal stories, statistics, and data on
the Latino community
 Reach a segment of the population that may not be familiar
with mainstream U.S. institutions or the political system
 Enjoy cultivating relationships and will continue to seek you out
as a source of additional information
 Have bilingual staff and will work with all groups to fulfill their
mission
Activity 2:
Practicing Your Elevator Speech
• Divide into groups of three. One person in the group will be the
reporter, one will be an organizational spokesperson, and one will
be timekeeper.
• Reporter should ask spokesperson three questions:
– Why is this issue important?
– Why should it matter to Latinos?
– What can Latinos do to address the issue?
• Spokesperson answer questions in a 30 second sound bite, then a
15 second sound bite. Each person in the group should take a turn
in each role.
• Each team should pick one person to share their answers with the
group.
Hispanic Communications and
Marketing Plan
Purpose: To provide organizations with a tool
to plan targeted outreach campaigns for the
Hispanic community and increase partnerships
with local Latino organizations. It contains:
◦ A planning tool for increasing outreach, partnerships,
and contacts with Latino organizations and women
◦ A timeline of possible monthly activities organized by
key dates
◦ A budget template
Hispanic Communications and
Marketing Plan (cont’d)
Possible activities include:
 Media Outreach
◦ Radio, TV, newspapers/print, internet, emails, and greeting
cards
 Community Partnerships
◦ Get involved with Latino community organizations!
◦ Be a resource for local organizations. Know about and
attend their events.
 Community Outreach
◦ Give talks in the community, advertise in local
establishments, and attend popular local events.
Hispanic Communications and
Marketing Plan (cont’d)
Key months for activities include:
– January -- National Birth Defects Prevention
Month and Folic Acid Awareness Week
– May -- Mother’s Day; National Teen Pregnancy
Prevention Month; National Women’s Health
Week; National Women’s Check-up Day
– September -- Hispanic Heritage Month
(September 15 – October 15)
– October -- National Spina Bifida Awareness
Month
Hispanic Communications and
Marketing Plan (cont’d)
Budget Template:
 This allows organizations to plan their outreach
budget according to their activities and to think
about the various costs that may be involved.
 Always take advantage of opportunities that
might be free or low-cost but still pervasive and
effective. Building and cultivating relationships
can create these opportunities.
Marketing and Communications
Plan Template
Goals: (What do you want to accomplish? Be sure whenever possible that these
are measurable; it is best to include a target figure.)
Plan: (How specifically do you plan on reaching your goals? What are you going
to do differently this year than last year? Who are your partners?)
Timeline: (Map out your plan for the year. Include all of the “little” steps so you
don’t forget. Use this timeline as a checklist each month to see what needs to
be done.)
January
July
February
August
March
September
April
October
May
November
June
December
Activity 3:
Using What You Learned
• Divide into groups of four.
• As a group, use the template as a guide to develop a media and
community outreach activity for a specific month. Use the
information from Activity 1 to help you decide what types of
activities you are going to engage in.
• As you fill in the template, think about the following questions:
– Why did you pick this month?
– Why do you think these activities will be effective in reaching
the Latino community?
– Who are your partners and why? What benefit(s) do they get?
– How will you measure success?
How Can We Effectively Reach the
Latino Community?
• Identify and understand the needs of the community
you are serving.
• Tailor programs to address those needs.
• Work in collaboration with the community.
– They determine their needs.
– They are partners in decision making.
• Community should benefit from the collaboration.
• Knowledge and capacity should be transferred/left in
community.
Strategies for Engagement
– Employing promotores de salud
– Viewing family as the basis for intervention
– Using social marketing and grassroots approaches
simultaneously
– Working with community-based organizations
– Providing tools to act upon information received
– Maintaining ongoing interventions
Who are Promotores de Salud?
• Promotores de salud are lay health
educators trained in health topics of
interest to the community.
• The concept evolved from the
Russian feldshers in the 1600s to
China’s “barefoot doctors” in the
1950s and then to promotores de
salud in the 1960s as liberation
theology was taking hold in Latin
America.
Promotores de salud may function as:
♦ Patient navigators who assist the
community in navigating the health
care system to access health services
♦ Community representatives who
take a lead role in leading local
health advocacy efforts
Final Points
 These tools do not detail all effective methods of
reaching the Latino population – organizations still may
need to tailor messages/strategies to their community.
 Media is important BUT more successful when the
grassroots (i.e. community) activities compliment the
air media message to truly hit home on a personal
level.
 Do not limit yourself by simply translating English
materials. Develop messages for Latinos.
 Don’t forget English-speaking Hispanics!
Questions?
Liany Elba Arroyo, MPH, CPH
Director, Institute for Hispanic Health
National Council of La Raza
1126 16th Street, NW
Washington, DC 20036
[email protected]