Comunidades Latinas Unidas en Servicio (CLUES) and the Diverse Racial Ethnic Group and Nations (DREGAN) Project are working with Health Promoters from the Latino communities in reducing the burden of health problems that result from tobacco use and second-hand smoke in the Latino communities in Minnesota. CLUES/DREGAN Project and the Health Promoters are educating rural and urban communities about the dangers of second-hand smoke and providing smokers with cultural and linguistically competent resources to help them quit and remain abstinent.  
The DREGAN Project was conceived as a community-based participatory research (CBPR) and action project, which is defined as a “collaborative approach to research that equitably involves community members, organizational representatives, and researchers in all aspects of the research process.  The CBPR premise is that the community members participate in the design and conduct of the research. In this way, the process generates meaningful results for the community.

CBPR principles include:

• recognizing communities as units of identity,
• building upon the strengths of communities, encouraging collaboration,
• maintaining equitable working relationships through every step of the research process,
• disseminating findings to all partners, and
• creating a long-term commitment among all partners.

Members of the Latino community served as project advisors and research team members. They actively participated in every phase of the research process, from development of the interview protocol to data analysis, to the preparation and dissemination of reports. This collaboration enabled the DREGAN team to gain community access, secure commitment to this project, and develop strong working relationships.

Community Health Worker (Promotores de Salud) Model

One of the models of working with Latino communities has been that of lay health workers, or promotores.  The promotora model started in Mexico in the 1940’s with the “Brigadas de Salud,” the goal of which was to bring health promotion, disease prevention, and primary health care services to isolated populations, particularly, in the rural areas of the country.  The promotora model has been adopted and validated across the world, especially in Latin America, Africa and Asia.  It has been used in communities to educate about tobacco harms and other health-related topics. A promotora model is currently being used in both urban and rural pilot programs for health promotion. The promotora model uses the following methods:

• Health fairs with individual feedback
• Tobacco education campaign through churches, local Latino papers and culturally appropriate community events (i.e. Cinco de Mayo, Mexican Independence Day and holiday celebrations)
• Pastoral sermons on smoking with day by day scripturally guided stop-smoking booklet
• Educating Latino communities about tobacco related diseases and the benefits of quitting
• Developing messages that support the vision of Latinos moving to the USA to improve the quality of life of their family, in this case using the example of preventing your family from tobacco and secondhand smoke
• Environmental interventions, which could include campaigns to protect families and children by having Chicano Latino homes go smoke-free (taking smoking outside), encouraging Latino restaurants to go smoke-free, or developing church or agency policies that declare buildings and grounds smoke-free
• Individual and group cessation programs (Some churches have support groups with experience working with people in recovery which may be willing to start a similar programs for smokers)

The DREGAN Project interventions work with four pilot interventions, one rural and three urban, that each work with multiple communities. In total, twelve organizations and churches are involved in the work of the DREGAN Project.

For more information, contact: Jose Williams Castellanos, M.D.
Phone: 612-746-3505
Email: jcastellanos@clues.org

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Rev 01-28-08