Health promoters resilience in acquiring knowledge about western healthcare systems: Embracing a holistic approach to maintaining a healthy community

Background: Health Promoters (HPs) are critical stake holders in diseases prevention and health promotion among US immigrant populations. Many immigrants experience challenges in navigating complex US healthcare and social systems. They would benefit from other immigrant entities serving as a bridge to the western healthcare delivery process. Cultural differences, language barriers and other social practices create challenges. Purpose: The study was to increase skill sets used by African immigrant HPs and enhance health professionals' understanding the convergence and divergence of cultural roles in health and wellness impacting adaptation to Western healthcare consumption practices. Methods: Community Participatory Action Research was employed with in-depth narrative approach gathering stories from the HPs; capturing development, implementation and evaluation processes of “Building Healthy Refugee/Immigrant Communities” project. Results: HPs were trusted to be competent by their communities to deliver information and resources; improving knowledge base of how culture influences immigrant/refugee health behaviors. They were seen as major sources of information; providing referrals and cultural brokerage directing community members to needed resources. HPs were resilient, enthusiastic and motivated learning and building skills in basic disease prevention. Conclusion: HPs have been contributing to public health for decades in their communities. Though invisible in the healthcare system, recently, HPs have gained prominence. The current federal healthcare reform in will offer new opportunity for HPs' role to be more appreciated. Their cultural and language navigation skills in immigrants/refugee communities are critical assets in healthcare navigation and implementation.