The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #60326

Laura R. Murray, Intrah/PRIME II, Federico Henriquez y Carvajal #11, Segundo Piso-Gazcue, Santo Domingo, Dominican Republic, James McCaffery, PhD, Training Resources Group, 909 N. Washington St., Suite 305, Alexandria, VA 22314, and Margaret Rabb, IntraHealth International/The PRIME II Project, 1700 Airport Road, Suite 300, CB # 8100, Chapel Hill, NC 2599-8100, 919-966-5636, rrichter@intrahealth.org.

In an activity originally aimed at comparing two learning approaches for community family planning and reproductive health promoters, the PRIME II Project discovered that non-training factors related to providers’ behavior played a critical role in improving their knowledge and skills. The health promoters, who work in cane cutter communities populated by Dominicans and Haitian immigrants, were initially divided into two groups. One group received a five-day classroom training; the other a two-day orientation on self-directed learning techniques. Theoretically, the first group would learn primarily in training and the second largely through peer-group sessions. Both groups, however, benefited more from applied learning through their daily practices of conducting home visits, selling pills and condoms, and facilitating community talks, and through an interactive radio program on reproductive health topics broadcast weekly. For the group that received classroom training (on family planning methods, STIs, HIV/AIDS, cervical cancer prevention and maternal health), post-training knowledge test scores only increased to 59% from 52% pre-training. Seven months later, however, these promoters had improved to 72%, a score they matched in a subsequent follow-up. Promoters in the second group saw a 50% increase in knowledge test scores seven months after orientation, demonstrating significant learning despite the fact that peer-group sessions did not happen as planned. PRIME has concluded that practice, a comprehensive and easy-to-understand manual, a radio program consistent with local culture, and a variety of other incentives were key components to increasing the promoters’ learning and sustaining it over time.

Learning Objectives:

• • Identify the roles and responsibilities of community health promoters in cane cutting communities in the Dominican Republic.
  • Discuss the challenges in working with volunteer health promoters in hard-to-reach, low resource areas.
  • Describe the ways in which non-training factors proved most effective in increasing and sustaining promoters’ knowledge.

Keywords: Community-Based Health Promotion, Sustainability

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.