Do Current Social Norms and Institutional Policies & Practices Promote or Hinder Self-Care of Community Health Workers, Promotores, and Other Grassroots Agents of Change Serving Highly Stressed Communities?
Despite increasing incorporation of strategies addressing social factors that influence health into community and population health efforts, current norms and practices regarding self-care of community-based workers and advocates (if they exist at all) often make it a question personal responsibility and choices; neglecting to take into account those same social and environmental factors that may be limiting those choices. On July 6, 2016, Coaction Institute brought together stakeholders representing public health, academia and frontline community health workers in dialogue about the special risks for secondary stress among grassroots agents of change working in low-income communities and communities of color. The group also discussed the development of social and institutional norms and practices congruent with current community and population health knowledge and existing models that promote the reduction of these risks.
Coaction Institute supporting Novato Youth Center and West Marin Promotores with Multi-Level Self-Care Training
This Fall, Coaction Institute has begun work with institutional partners serving low-income, Spanish-speaking residents in Marin County, California. The project replicates a model developed in El Salvador by Coaction Institute’s Director. It was initially created to support health and community workers trained to address gender violence and family violence in rural and urban communities throughout the country, as an enhancement to the Pan American Health Organization’s (PAHO) regional program being implemented in partnership with Central American public health ministries. The success of the program led to its adoption on a regional level, extending beyond El Salvador’s borders. Over a decade later, the former program manager at PAHO in El Salvador invited the Coaction Institute Director back to El Salvador to adapt the program for a private civic engagement and social service agency, called Glasswing International. A self-assessment completed by the Glasswing participants prior to and following the one-year process revealed a reduction in the group’s secondary trauma score from 21 to 12. Significantly, the group achieved this while maintaining its high score in the area of compassion.
The strategies included in the model include education, as an empowerment tool; community building among the participants to generate a sense of connectedness, learning, solidarity and mutual support; development of a shared vision of what self-care promoting institutions and communities look like; participatory action planning; and advocacy and action to generate institutional and community systems policy and practice changes to support self-care among agents of change. The 12-month program period includes partnership development, collaborative planning, engagement of participants, self-assessment, implementation, on-going monitoring and evaluation.
Novato Youth Center Promotores de Salud and institutional program staff begin process of building resiliency to reduce secondary stress risks
The Novato Youth Center is committed to supporting the well-being of their team of promotores and to increasing the sustainability of this critical volunteer corps. Not only did we begin education with the promotores and program staff about secondary trauma, risk and protective factors for community-based workers; but the institution has also taken the courageous step of asking the promotores themselves how it could better protect them from those risks. During our first session, the participants (staff included) completed a baseline self-assessment of levels of satisfaction, workplace burnout and secondary trauma associated with their health promotion duties. An open conversation about the cohort's findings resulted in valuable feedback to the Center of small changes that could be make to reduce risk factors and increase protective factors for the promotores. The staff is using the promotores' input to develop an institutional plan to support self-care. All the participants will be working on creating their own personal plans in our next work session in November. Stay tuned for information about the progress and outcomes of this fascinating project!
