The Benefits of an Academic Affiliation with a Nonprofit Promotores Program

Strengthening families in their core capacities to be productive and contributing citizens, raising healthy and academically prepared children is an important societal goal. During the early 1990s, because child abuse was recognized and often being spoken of as a “national epidemic,” the United States was experiencing an explosion of programs introduced to impact and hopefully reduce the incidence of this devastating occurrence. Organizations working with children in the context of their family environment were all seeking remedies. Research was demonstrating that approaches—one of which is embodied in the promotores model—that address the precursor issues to poor life outcomes and pair at-risk families with a family mentor result in significant social, academic, health, and economic benefits and improvements.

The Child Abuse Prevention Network in Houston, Texas, was among those organizations across the country to undertake such a primary prevention model, and chose the Healthy Families program, under the initial auspices of Prevent Child Abuse America. The Network effort initially encompassed a seven-agency, collaborative, three-year pilot of the program and support workers were trained in that delivery model. Upon evaluation, though there remained questions about the program’s specific abuse prevention capacity, Houston’s implementation demonstrated significant improvements in parenting skills knowledge, health of child and parent, and school readiness. The program’s success prompted a change of the organization’s name to Healthy Family Initiatives, as the organization’s intent focused specifically on moving this approach to a more universal offering.

Some years into the Houston implementation, and because of its leadership in primary prevention, we were invited to serve on a state taskforce regarding the expansion of the promotores program in Texas. This was an enlightening exposure to the interesting, comprehensive community-based approach and we knew that at some point, we should explore this further.

Congress was beginning to express a greater interest in the emerging successes, now documented through various evaluations, of the growing array of programs that focused on a more holistic, and particularly longer-term, relationship with those being served. A commitment of several years to a client was now the accepted norm and federal funding was more forthcoming. However, because of the need to “prove” the efficacy of individual program approaches, the restrictions of delivery in each of the program curricula required strict adherence to each program model’s curriculum essentials. This meant that there was little flexibility to tailor the fundamental family support approach concepts to the actual community being served. There also was no leeway for either exposure to, or use of, elements from all good programs to be consolidated into one “best practices” approach that actually met the identified needs of a local environment. Costs for implementing such programs were barriers unless an organization had staff it could redirect to such activities, and could compete for and garner federal, state, and/or local philanthropic funding.

One response to these challenges came in the form of a grant that enabled a collaboration with and ability to cross-train several of our maternal/child health staff in the local Houston Community College’s Promotor(a)/ Community Health Worker Training and Certification Program curriculum, sponsored under the Texas Department of State Health Services. Texas has had highly developed credentialing activity, and a strong commitment to the promotores approach. Promotores programs have been successful in Texas, particularly in the Rio Grande Valley, where there is fertile ground for the relationship of promotores to the local citizenship.

Houston’s population represents a tremendous cross-section of ethnic, economic, and social diversity. In the coming 20 years, it is predicted that the nation’s overall demographics will look very much like those of Harris County, the larger region in which Houston is situated.^[1]  We understood that it was imperative to have a flexible, client-centered, and community-relevant response to this diversity and all the challenges it would evoke. Challenges identified would include an expanding number of school-age children who did not have basic reading and social skills for their age, lack of adequate transportation, food deserts, and ambivalence regarding how best to serve an ever-growing population’s health needs—as well as how to position our community, the fourth largest city in the country, as a positive and embracing environment in which there is ample opportunity for all. The significant differences in the promotores curriculum that set it apart from the others we used were its community-based focus, its application across the age trajectory, and its particular latitude to address presenting issues. The fortuitous opportunity for staff in our maternal/child health program to become enrolled in the College’s Community Health Worker course enabled them to access and incorporate the richness and depth of the promotores skills set; to gain a certificate from an accredited academic institution, which significantly increased their own economic and eventual employment opportunities, adding extreme competence to the workforce; and to have at their command the diverse tools in addition to other curricula basics that will contribute to positive outcomes for all they serve.

¹ Kinder Houston Area Survey 2017