Table 2. Culturally Competent Elements of Seven Promotora-Training Materials.
| Program Curriculum (Total number of Strategies[0-5]per Curriculum) | ||||||||
|---|---|---|---|---|---|---|---|---|
|
|
||||||||
| Strategies to Enhance Cultural Competence (Kreuter et al., 2003) | Elements of the Training Curricula | A (3) | B (4) | C (2) | D (5) | E (5) | F (4) | G (5) |
| Evidential | Provide history of role of promotoras | ✓ | ||||||
| National statistics about health topic | ✓ | ✓ | ✓ | ✓ | ✓ | |||
| Contact information for health professionals | ✓ | ✓ | ✓ | |||||
| Linguisticb (readability levels) | Fry: mean = Grade 10.5 (for English) | 15 | 14 | 10 | 8 | 7 | 9 | |
| SMOG: mean = Grade 11.8 (For English) | 16.9 | 15.0 | 12.2 | 10.1 | 9.7 | 11.0 | ||
| SOL: Grade 17.1 (for Spanish) | 17.1 | |||||||
| Peripheral | Photographs, graphics, and illustrations | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ |
| Vibrant colors | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ||
| Spacing (white space) | ✓ | ✓ | ||||||
| Fotonovelas (photo stories) | ✓ | ✓ | ||||||
| Sociocultural | Emphasize family involvement | ✓ | ✓ | ✓ | ||||
| Hispanic food cookbook | ✓ | ✓ | ||||||
| Target diet and exercise cultural norms | ✓ | ✓ | ✓ | |||||
| Constituent involving | Role–play | ✓ | ✓ | ✓ | ✓ | ✓ | ||
| Practicing conflict resolution strategies | ✓ | ✓ | ✓ | |||||
| Leading small discussion groups | ✓ | ✓ | ✓ | ✓ | ✓ | |||
| Sending clear messages | ✓ | |||||||
| Receiving constructive criticism | ✓ | |||||||
| Active listening practices | ✓ | ✓ | ||||||
| Use of learning games (Bingo) | ✓ | ✓ | ✓ | ✓ | ||||
| Using visual aids | ✓ | |||||||
| Adapting curriculum to audience | ✓ | ✓ | ||||||
| Being open and nonjudgmental | ✓ | |||||||
| Recruiting and maintaining participants | ✓ | ✓ | ||||||
| Providing social support | ✓ | |||||||
| Encouraging participation | ✓ | ✓ | ||||||
NOTE: SMOG = Simple Measure of Gobbledygook; SOL = standards of learning.
b
For linguistic strategy, we examined text readability level of the training materials using three readability instruments. We analyzed the six English-language training materials (A-F) using the Fry method and SMOG and the Spanish-language curriculum (G) using the SOL. We also counted any material written at a 10th-grade level or below as a “linguistic strategy” for the total strategies used count.