title: "The Promotora Explained Everything": Participant Experiences During a Household-Level Diabetes Education Program.
abstract: The purpose of this study is to describe participant experiences of a household-level, community health worker-led intervention to improve diabetes-related health behaviors and outcomes.
  
  
  
  The Home Health Parties (HHP) aimed to improve diabetes self-management among Hispanics living in a rural, agricultural area in eastern Washington State. Trained promotores (community health workers) delivered a series of education sessions and distributed incentives to support diabetes-related behavior change. Open-ended, semi-structured questionnaires were administered to a random sample of 40 HHP participants. Qualitative methods were used to code and analyze the interview transcripts.
  
  
  
  Four primary themes emerged from interviews: (1) participants' desire for improving knowledge about diabetes; (2) experiences of building skills for diabetes management; (3) developing social support; and (4) embracing household-level change.
  
  
  
  This study shows that involving family members and increasing social support are effective strategies for improving health behaviors and chronic health outcomes among vulnerable Hispanics living with diabetes. Our findings demonstrate several important considerations regarding the design of diabetes management interventions for rural Hispanic populations including the following: (1) promotores are critical as they provide social support and encourage behavior change by building relationships based on trust and cultural understanding; (2) well-designed tools that provide step-by-step examples of healthy behaviors, such as cookbooks, and tools that aid participants to monitor behavior change, such as pedometers and glucose monitors, serve to build skills and improve confidence to achieve goals; and (3) targeting households is a promising strategy for individual and family lifestyle changes that benefit the entire family unit.
authors.affiliation: Health Services Department, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA (Ms Shepherd-Banigan, Ms Vaughan, Dr Thompson).
authors.forename: Megan
authors.initials: M
authors.lastname: Shepherd-Banigan
authors.affiliation: Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (Ms Hohl, Ms Vaughan, Ms Ibarra, Ms Carosso, Dr Thompson).
authors.forename: Sarah D
authors.initials: SD
authors.lastname: Hohl
authors.affiliation: Health Services Department, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA (Ms Shepherd-Banigan, Ms Vaughan, Dr Thompson).|Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (Ms Hohl, Ms Vaughan, Ms Ibarra, Ms Carosso, Dr Thompson).
authors.forename: Catalina
authors.initials: C
authors.lastname: Vaughan
authors.affiliation: Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (Ms Hohl, Ms Vaughan, Ms Ibarra, Ms Carosso, Dr Thompson).
authors.forename: Genoveva
authors.initials: G
authors.lastname: Ibarra
authors.affiliation: Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (Ms Hohl, Ms Vaughan, Ms Ibarra, Ms Carosso, Dr Thompson).
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Carosso
authors.affiliation: Health Services Department, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA (Ms Shepherd-Banigan, Ms Vaughan, Dr Thompson).|Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (Ms Hohl, Ms Vaughan, Ms Ibarra, Ms Carosso, Dr Thompson).
authors.forename: Beti
authors.initials: B
authors.lastname: Thompson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000208:ethnology / Q000523:psychology*; D005190:Family / Q000208:ethnology / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006630:Hispanic or Latino / Q000523:psychology*; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D015397:Program Evaluation; D036301:Qualitative Research; D000073278:Self-Management / Q000379:methods / Q000523:psychology*; D012944:Social Support; D014861:Washington