Clinical Impacts Test of Promoto

This project is working to develop and test a methodology for assessing the impact of environmental health education, and the integral role of training and deployment of promotoras for community-environmental health education, on clinical outcomes for children who might be subject to pesticide exposure. The project addresses limitations of earlier studies through the development of a multi-stage, multi-population intervention and associated evaluation design. In particular, the project is 1) examining the selection and training effectiveness (pre-post tested) on environmental health knowledge, behavior, educational effectiveness of promotoras, 2) evaluating, prior to and after educational interventions, community adults knowledge and behaviors regarding pesticides, in-home conditions and family practices that affect pesticide exposure, and clinical indicators (at several points in time) for children exposure to pesticides. To more fully isolate the impacts of promotora-led environmental health education on clinical outcomes, the project includes both intervention and control communities.

The initial intervention design and evaluation component of the project benefits from its ability to draw from project staff’s earlier research on clinical outcomes associated with environmental health education and on role of promotoras-led health education in affecting knowledge of community families regarding environmental threats in the Texas border region. The project’s ability to further refine and test the intervention and associated evaluation methodology benefits significantly from its ability to build directly on several ongoing projects in a rural and an urban setting on Texas border region. First, the ability to advance understanding of clinical impacts of pesticide-focused health education (complete with control communities) is advanced by the project’s building on two EPA-funded projects that will be in process on the border communities targeted by the proposed project. Second, additional emphasis on promotora training and evaluation in the role of environmental health education will be possible through coordination with an ongoing RWJF-funded promotoras-development project in the same border communities. Each of the aforementioned ongoing projects is associated with components of the Texas A&M School of Rural Public Health.