© 2006 Latino Health Access
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Santa Ana, CA 92706
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©2006 Latino Health Access
Families and Schools Together (FAST)>
The goal of the Family Medicine Rotation project is to increase cultural competency of medical residents in the context of public health and community medicine. The residents also complete a clinical rotation at Latino Health Access. Promotores locate homebound, extremely low-income, medically uninsured community members who are living with untreated chronic diseases. They arrange appointments with the Family Medicine Residents, who accompany the Promotores to the patients' homes. Basic medical care is administered directly in the home, using supplies and equipment the resident carries in a suitcase. Arrangements are made to provide lab work, needed medications, and any necessary follow up. The Residents, who are primarily from Kaiser Permanente, are medically supervised by physicians from their sponsoring organizations.
The Madres a Madres Program: Combining the knowledge of the community and best evidence in parent training to strengthen Latino families
A community-campus collaboration between Latino Health Access, L.A. Net and the Southern California Center of Academic Excellence
What is Madres? The Madres a Madres program is a four session parent training and support program developed by community promotoras, the Latino Health Access (LHA) leadership and staff, parents, and Drs. Lyndee Knox (LA Net), Nancy Guerra (Southern California Center of Excellence on Youth Violence Prevention, UC Riverside), and Cristina Jose-Kampfner (LHA & AltaMed).
The program combines findings from parenting research and a recent meta analysis of parent training programs completed by the CDC, and the local knowledge and experience of LHA staff, promotores and mothers from the target communities.
The parenting intervention is delivered through four 2 hour visits between a Madres Promotora (a local mother who has completed training as a promotora), and a mother with children between the ages of 6 and 12.
The home visit intervention uses a combination of direct instruction, experiential learning and social support to help immigrant mothers in the community to strengthen their relationship with their young children, learn positive discipline strategies, and connect with other mothers in the area for emotional support, and the opportunity to share ideas and resources. The overarching goal of the program is to build an engaged network of mothers and families able to support development of essential competencies in their children to improve the emotional well-being of the child, provide support in elementary school and during the high risk transition to middle school, and reduce risk for future involvement in health risk behaviors such as substance abuse and violence.
During the highly interactive home visit sessions, Madres promotors and mothers discuss concepts of child development, brain development, essential competencies needed by children to succeed in school, and essential competencies needed by parents to support their children; practice skills based on concepts from Parent Child Interaction Therapy (PCIT) for creating positive experiences with their child; and practice positive discipline skills.
Madres Promotoras use a combination of one to one sharing, didactic instruction using visuals to increase accessibility of the materials for mothers with limited formal schooling or reading skills, video clips, social modeling and role playing to engage mothers in the learning process.
The program is designed to support introduction of additional modules based on the local needs of the community including ones that address important public health concerns such as maternal health and well-being, childhood obesity, immunizations, injury prevention, etc.
What evidence is there to support its effectiveness? A pilot study is currently underway of the Madres program in collaboration with the Southern California Center of Academic Excellence on Youth Violence Prevention with 200 families in Santa Ana California. The program incorporates many evidence-based activities such as components from Parent Child Interaction Therapy.
What are next steps? Future plans include addition of new modules to address PTSD and depression in immigrant mothers to respond to feedback from the LHA promotores and mothers, introduction of monthly group support and collaboration events led by the mothers, and introduction of Madres volunteer program for mothers interested in becoming more involved in their neighborhoods or buildings.
How do I learn more about the program? You can contact Lyndee Knox at the Southern California Youth Violence Prevention Center at lyndee.knox@gmail.com for more information or to arrange a training in your own community.
Bill Moyers recently aired a show which profiles Latino Health Access and one segment highlighted the work of our Madres Promotores: http://www.pbs.org/moyers/journal/10162009/brachoexcl_flash.html
Families and Schools Together (FAST) for immigrant families in Santa Ana: Strengthening families, building communities
A community-campus collaboration between Latino Health Access, L.A. Net and the Southern California Center of Academic Excellence
Families and Schools Together (FAST) is a multifamily group intervention designed for children and their families. Families meet weekly for 10 weeks and participate in 2-3 hour sessions that involve a series of carefully prescribed family, parent, and child activities designed to strengthen the parents’ authority in the family, improve parent-child interaction and communication, provide social support for the parents, and build relationships among families from the same school or community. The intervention is designed to engage parents with their children by reinforcing their role as leaders of their family, increasing social support available to them both from within their family and from the community, and providing new ways for them to communicate and interact with their children that interrupt coercive and negative patterns of interaction.
LHA implemented FAST in collaboration with Dr. Lyndee Knox, Dr. Nancy Guerra and the Southern California Center of Academic Excellence on Youth Violence Prevention in 2 communities in Santa Ana California. A total of 140 families participated in the program for this partnership.
Results of a randomized trial of the intervention with 200 families in the community showed impact on social support, overall parental sense of well-being and child problem-solving. These outcomes are particularly notable given the tremendous social changes and pressures many of our families experienced during intervention period (aggressive immigration enforcement and economic recession that had a heavy impact on the working poor in our communities).
Community response to the intervention has been very positive and parents shared that the program affected their relationship with all of their children, not just those in the target age range of 7 to 12. This was an unexpected outcome for us, and an encouraging one. LHA is currently looking for funding with the Southern California YVP Center to extend the program to several interested schools.