Promotoras: A Culturally Sensitive Intervention for Hispanic Breastfeeding Women

Purpose for the program: Hispanic women have high rates of breastfeeding; however, they fall short of meeting the Healthy People 2010 goals.  Culturally sensitive interventions are needed to help increase breastfeeding exclusivity.  Promotoras are community health care workers who are primarily used for chronic disease management.  They have been shown to be a successful intervention for the Hispanic population.  A performance improvement project was developed using promotoras for a culturally sensitive breastfeeding intervention program for Hispanic women in order to help increase breastfeeding exclusivity in a community health center on the U.S.-Mexico border.  

Proposed change: The expected outcomes will reveal a positive trend for women who use the promotora model to have an increase in breastfeeding exclusivity by two weeks postpartum. 

Implementation, outcomes and evaluation:

Objectives for the performance improvement project include: 1) increasing promotoras’ knowledge of breastfeeding by a providing breastfeeding course, 2) using promotoras to teach a breastfeeding course, 3) increasing breastfeeding exclusivity, 4) evaluating patient satisfaction of the program methods.

The Texas Department of State Health Services provided breastfeeding management education for the promotoras.  Once the course was complete, promotoras led a breastfeeding program for Hispanic postpartum women in order to increase breastfeeding exclusivity.  An evaluation form was used to measure maternal satisfaction of the breastfeeding course provided by the promotoras.  

Results:  Breastfeeding initiation increased for women who attended the program.  There was no difference in breastfeeding exclusivity among the groups of participants.  The participants overwhelmingly rated the program as a program they enjoyed; in addition, they reported learning about breastfeeding.

Implications for nursing practice: Using promotoras as a culturally and linguistically sensitive intervention can enhance healthcare for the Hispanic population.  Promotoras are trusted and credible to the Hispanic population.  

Keywords: Breastfeeding, promotoras