Assistant Professor, Health Services
KL2 Scholar

• Started meeting them with when I came as a postdoc
• Conducted interviews there on stress, discrimination and health
• Presented the findings at CASA Latina staff meeting
• High levels of stress
• Depressive symptoms
• Social isolation
• Staff were interested in program to help address some of the findings from the study
• I approached them with the idea of writing a grant to pilot a stress and coping curriculum

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Trained 40-45 local promotoras in Durham, Wake and Chatham counties
• 6 sessions to train groups of 12-15 Latinas
• Recruited through churches, community organizations and agencies
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• Skill building on coping strategies for isolation, anxiety, sadness
Appled relevant topics: immigration, isolation, family re-organization
• Tangible items such as a comfort basket as potential strategies
• Promotoras shared information with 2-3 other Latinas in their social network (Compañeras)
• Promotoras teach selfhelp strategies to compañeras to improve compañeras’ coping skills and reduce their stress
• Saw reductions in depressive symptoms, perceived stress and increase in coping skills

https://www.iths.org/funding/TribeCommunityPractice
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Funds can be used for small pilot research, quality improvement projects, or non-research activities that develop research capacity. All proposed research must be participatory, which means involving community, tribe and practice members in the health research processes.
Examples include but are not limited to:
Conference, seminar or course attendance (example only):
• Attend a course, seminar, training workshop or conference related to community, tribe, or practice-based participatory health research that will help increase research capacity.
Organize a gathering of your community, practice or tribe (example only):
• Organize a meeting for community or practice members to talk about research questions that are important to study
(for example, Town Hall).
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Conducting research or quality improvement work (examples only):
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• Hire a consultant to help write a research grant proposal.
Build research review or regulatory capabilities at your organization, community, or practice. Examples include creating cultural or tribal review boards, institutional review boards (IRBs), or other regulatory systems.
Collect preliminary data from a community or practice to support a future grant proposal.
Conduct chart reviews to find gaps in services, such as racial and ethnic health disparities.
Conduct an interview or focus group (qualitative study) with providers and patients to learn why a health intervention does not work as well for some groups of people.
Survey a specific racial or ethnic group of people to learn about their views on cancer and cancer prevention

• Negotiating responsibilities and budget
• Changes to the curriculum

• Project Coordinator/Trainer came out from North Carolina to spend 2 days training CASA Latina staff on the curriculum and how to facilitate meetings
• Half-day training with CASA Latina on data collection

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Session 1: Introduction to the program and to stress
Activity – Book and video about immigration story
Activity – Sponge, how much stress can you take?
Activity – How do you deal with stress?
Homework: Make a card for a loved one
Gift: Toolbox

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• Session 2: Separation
Activity –“Josefina’s Story”
Brainstorm – Healthy and Unhealthy ways of coping with stress
Activity – Writing with your bellybutton
Activity – Web of social support (with yarn)
“Mi Abuelita Dice…”
Homework: Practice a healthy way of coping – like walking

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Session 3: Adjusting to Life in Seattle
Information about social support
Activity: Share the cards they made
Activity: Social networks (here and there)
Activity: Introduction to meditation (raisin)
Gift: Frame for a photo of loved one
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Session 4: Coping with Stress
Activity: Loteria with Coping Strategies
Yoga and Meditation
Homework: Practice meditation
Gift: Relaxation CD and candle

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Session 5: Seeking Mental Health Services
Invited therapists from SeaMar and Consejo to explain the how to seek mental health services and the role of a psychologist/social worker
Activity on holistic health
Reflection in pairs over the workshop
Gift: soap

• Recruited 22 participants
• Of those 12 came to at least one session
• 9 attended all five sessions
• An additional 6 came to at least one session after we did the pre-tests
• Low-income, primarily from Mexico, Spanish dominant
Characteristics Mean/%
Years in the US
Age
9.5
37
Married/living as married 36%
Employed year round 43%

CESD Scores (range 0 - 60)
PSS (range 0 - 56)
Acculturative stress (0 - 84)
Coping (range 1 – 4)
Pre-Test (N=22) Post-Test (N=10)
23.6
14.7
26.2
21.5
1.9
22.2
19.1
2.5

Purpose : To obtain feedback on the session content and how it was offered
“I have a lot more abilities than what I believed.”
“To value ourselves, to make time for ourselves…it is very valuable for me because I give all of my time….I have 4 sons.”
“Free time is also for me…to get rid of stress and be better.”
“The other day it was raining so hard, and
I kept going without an umbrella…walking in the rain…I felt so good…not cold…and I said to myself, “yes, the ALMA sessions have done a lot for me.”
“You have the ability to transform stress…to decrease stress…by a variety of ways, like meditating.”

“I learned to practice more exercise and that helps me control my anxiety ”
“I learned to walk my dog for [lowering] stress”
“To put into practice the different tips [from actions to manage stress sheet] …I see it and I read it because I hung it up in my kitchen.”
“Related to the relaxation [activity] was what I liked most…I am less tense ”
“I think that what called most to my attention was the relaxation
[activity]…to learn how to relax because we lived so stressed”

• Working in the community always takes longer than you think it will
• Be mindful of the burden to the community
• Be mindful to the burden on you
• Be responsive to community needs
• Follow through – our next step is to find funding to test and implement as promotora or stress reduction program