title: Implementation of a training program for low-literacy promotoras in oral rehydration therapy.
abstract: OBJECTIVE
  The purpose of this study was to ascertain the effectiveness of a culturally appropriate promotora training program related to oral rehydration therapy and diarrheal management. Factors that influenced the development, implementation, and evaluation of the program provided to low-literacy women in Guatemala are explored.
  
  
  METHODS
  Promotora training was conducted with 15 Mayan women from a rural community in the highlands of Guatemala. Women were selected by leaders of the community to participate in the program.
  
  
  METHODS
  Quantitative data were collected and analyzed to determine descriptive statistics and reliability coefficients for the pretests and posttests. A nonparametric Wilcoxon test for paired-samples was conducted. The qualitative data from the program evaluations were analyzed for themes.
  
  
  RESULTS
  Mean scores increased from 41.73 (SD = 9.65) to 70.33 (SD = 21.29) on the pretest and posttest. The Cronbach's alpha was 0.54 on the pretest with 0.65 on the posttest. The Wilcoxon test demonstrated a significant difference between the pretest and posttest scores (Z = 3.040, p < .05).
  
  
  CONCLUSIONS
  Extremely low-literacy levels played a major role in the ability of the women to successfully complete the requirements of the training program. The curriculum demonstrated effectiveness, but will benefit from replication with a larger sample.
authors.affiliation: School of Nursing, Clemson University, Greenville, South Carolina.
authors.forename: Roxanne
authors.initials: R
authors.lastname: Amerson
authors.forename: Rachel
authors.initials: R
authors.lastname: Hall-Clifford
authors.forename: Beti
authors.initials: B
authors.lastname: Thompson
authors.forename: Nicholas
authors.initials: N
authors.lastname: Comninellas
mesh_terms: D000293:Adolescent; D000328:Adult; D003150:Community Health Workers / Q000193:education* / Q000706:statistics & numerical data; D054521:Cultural Competency; D003479:Curriculum; D003967:Diarrhea / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy; D006166:Guatemala; D057220:Health Literacy / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D016730:Program Development; D015397:Program Evaluation; D015203:Reproducibility of Results; D012423:Rural Health; D055815:Young Adult
keywords: Guatemala; Latinos; child health; family health; health disparities; health literacy; promotora; underserved populations