1. This presentation will probably involve audience discussion, which will create action items. Use PowerPoint to keep track of these action items during your presentation In Slide Show, click on the right mouse button Select “Meeting Minder” Select the “Action Items” tab Type in action items as they come up Click OK to dismiss this box This will automatically create an Action Item slide at the end of your presentation with your points entered. Emergency Preparedness in the Latino Community Sonia E. Mora, MPH Latino Health Initiative Montgomery County, DHHS

2. Overview of the Latino Community in MC l There are 316,257 Latinos living in Maryland (5.7% of total MD population) l About 40% (125,354) of the Latino population in MD lives in Montgomery County. l Latinos constitute 13.7% of the county’s total population l Mostly from Central & South America (67%) * 2005 American Community Survey Data

3. Overview of the Latino Community in MC l Fastest growing population in Montgomery County with a 5% annual growth rate between 2000 and 2005 2005 American Community Survey Data

4. Characteristics of County Latinos l Young population l Close family/social networks l Lowest median income l Under educated l Limited English Proficiency l Lack information about existing resources and services

5. Background l Scarce information on emergency preparedness (EP) knowledge and attitudes in Latinos l Racial/ethnic minorities more vulnerable to disasters l Need to develop culturally and linguistically competent (EP) interventions

6. Emergency Preparedness Pilot Project for Latinos Collaborative Effort: Latino Health Initiative of Montgomery County Advance Practice Center of Montgomery County University of Maryland Funding Provided by: National Association of County and City Health Officials Centers for Disease Control and Prevention

7. Latino Health Initiative Established in 2000 under the Department of Health and Human Services by the County Executive and Council to develop, implement, and evaluate a plan of action responsive to the health needs of Latinos in Montgomery County.

8. Latino Health Initiative l Comprised of DHHS staff and a Steering Committee of 17 volunteer leaders and experts on Latino health l Programs and activities are guided by 7 priority areas outlined in the Blueprint for Latino Health l Recognized as a model to effectively reach and serve Latino populations

9. Latino Health Initiative Addresses health disparities by using a multifaceted approach to: l enhance coordination of efforts; l develop culturally and linguistically specific strategies and model programs; l provide technical assistance to entities serving Latinos; and l advocate for appropriate services, programs and policies.

10. Advance Practice Center (APC) As one of eight in the Country, the Montgomery County APC serves a a resource in emergency response by providing assistance to other entities; collecting appropriate tools developed by other local public health agencies in the National Capital area; and developing and disseminating toolkits, technologies, and other materials that have been evaluated and tested in Montgomery County.

11. Objectives of the Project 1. Compile information/assess Latino’s knowledge, perceptions of risk, and preferred and actual sources of information on EP. 2. Develop and test an EP intervention among low-income Latinos 3. Develop culturally appropriate EP materials to be replicated and used in other jurisdictions

12. Focus Groups: Methods l Discussion guide developed in Spanish based on literature review l Participants included community members (5 groups) and health promoters (1 group) over age 18 l Participants recruited via LHI staff, entities serving Latinos, and health promoters l Sessions conducted by experienced bilingual Latino facilitators

13. Focus Groups: Results l 51 individuals participated in 6 FGs: 30 women and 15 men (community FG) and 6 women (health promoter FG) l 67% of participants were from Central and South America l 65% had been in the US less than 6 years and 27% had been in the US more than 6 years

14. Focus Groups: Results l Participants had difficulty defining “emergency” l Wide range of perceived personal emergency risks l Few participants reported receiving information on EP l Concern with government’s readiness l Most participants did not have an EP plan l Immigration identified as a current emergency

15. Focus Groups: Results Reported most trusted sources of information:  Fire fighters and police  Red Cross  Someone who is well trained with charisma  Doctors  Community leaders  TV & Radio  Spanish language newspapers

16. Focus Groups: Results Reported preferences for receiving information:  Courses or seminars  TV or radio programs  Pamphlets, flyers, or manuals  Participating in simulations or practice

17. Focus Groups: Results Reported messages to communicate to the Latino community:  Be calm (calma)  Be alert (esten atentos)  Be united (esten unidos)  Act (actuar)  Keep important telephone numbers handy and prepare  Prepare for an emergency

18. Implications l Latinos are a key population to target regarding EP l The matter of relative risk in comparison with other priority issues faced by the community should be taken into consideration l Consistent and unified messages should be delivered through credible sources l Current immigration climate needs to be acknowledge when reaching the Latino community

19. EP Efforts in the Latino Community of MC l Developed an implementation plan using health promoters (HP) l Developed a (HP) Spanish- language training curriculum l Pilot Tested an intervention in two Latino communities

20. Health Promoter Curriculum l Basic information on public health emergencies and actions to take to prepare for an emergency l Outreach, community engagement techniques, and use of educational materials l Outlines specific knowledge and skills learning objectives, training content and methods l Includes simple record keeping tool

21. Emergency Preparedness Education for the Latino Community Conducted by Health Promoters: A Mini Pilot Project Presented by: Mercedes Moore, RN Vias de la Salud Health Promoter Program Latino Health Initiative

22. Vias de la Salud: Background Promote healthy behaviors Facilitate access to services Low-income Latinos

23. Vias de la Salud: The Promotoras Volunteer lay health educators Grassroots community members Trained

24. The Pilot Intervention October 2007 – January 2008 October: Six Vias promoters trained Draft Spanish-language curriculum

25. The Intervention: Community Educational Sessions Two sites: school & community center Three educational sessions each site About 20 participants each site Culturally competent practices to reduce barriers

26. The Intervention: Content What is an emergency: public vs personal/family Three steps to emergency preparedness –Initiate a conversation –Make a plan –Prepare emergency supply kit: 9 items

27. Step One: Have a Conversation Why prepare Contacts Where to meet Where to shelter What to do

28. Step Two: Make a Plan Personal information Local contact Out-of-state contact Nearest relative Pets Meeting places

29. Step Three: Prepare a Kit 9 essential items –Water –Food –Clothing –Medications –Flashlight & batteries –Manual can opener –Radio –Personal hygiene –First aid

30. Have a Conversation

31. Make a Plan

32. Prepare a Kit

33. 9 Essential Items

34. Assessment Methodology Effects on Participant Attitudes & Practices: Pre-post Design –7 questions: attitudes & practices –Pre-test: 1 st session –Post-test: after 2 nd session –Post-test 2: after 3 rd session Effects on Promoters’ Knowledge, Attitudes & Practices: Pre-post Qualitative Data

35. Results: Participant Feelings about Family Preparedness

36. Results: Participant Preparedness Practices

37. Results: Other Reported Items in Supply Kit ItemPrePostPost 2 Clothing0712 Medications0717 Flashlight1610 Can opener144 Radio056 Hygiene items044 First aid015 Other4815

38. Results: Participant Knowledge of School Emergency Plans

39. Results: Participant Opinions of Sessions “Excellent.” “Perfect.” “Very good.” “Very interesting. Very important.” “Very well explained and very easy to understand.” “They motivate us to prepare for an emergency.” “Everything was very clear. Moreover, we put it into practice.” “Thank you for the information in Spanish.” “Continue with these sessions because I think there are a lot of people like us who didn’t know how to react in the event of an emergency.”

40. Factors Contributing to Success Carefully designed culturally & linguistically competent intervention Limited number of key messages Collaboration with trusted agencies Incentives? Skills, talents, enthusiasm, experience of promoters Community trust in promoters

41. Conclusion Training curriculum & accompanying materials facilitate replication in other sites. Careful attention to building relationships with community & nurturing promoters

42. For More Information about the Latino Tool Kit visit www.montgomerycountymd.gov/apc or contact Kay Aaby at kay.aaby@montgomerycountymd.gov For information about the Latino Health Initiative visit www.lhiinfo.org or contact sonia.mora@montgomerycountymd.gov mercedes.moore@montgomerycountymd.gov