Migrant Health Promotion Promoviendo Vidas Saludables

Annual Report 2003-2004 2003 and 2004 were eventful years at Migrant Health Promotion. I n 2003, we celebrated twenty years of service to migrant and seasonal farmworkers, their families and their rural communities. Across the country, communities, health professionals and scholars increasingly value and recognize

Promotores and Promotoras for their contributions. In 2004 funding challenges continued. Promotores(as), staff members and Board members worked together to adapt to the changed environment and to maintain as many critical programs and services as possible. Migrant

Migrant Health Health Promotion deeply appreciates the dedication, Promotion Promoviendo Vidas Saludables persistence and good will of staff, Promotores(as), Promotores(as) de Salud or Camp Health Aides are community members who participate in health farmworker communities, funders and collaborators as training. They use their skills to educate and advocate for their peers, helping them find and use we continue to meet these challenges and face the health information and care, despite poverty, frequent mobility and language and cultural differences. future together. We thank you! Promotores(as) improve health by increasing access to existing services and by working to change the systems and conditions that make healthy living difficult. Mission MICHIGAN 224 West Michigan Avenue Migrant and seasonal farmworkers provide affordable Saline, MI 48176 (734) 944-0244 food to the nation, often at the expense of their own [email protected] TEXAS P.O. Box 337 health. Migrant Health Promotion is committed to Progreso, TX 78579 (956) 565-0002 strengthening the capacity of farmworker families and [email protected] Visit us online at their communities to improve their health through www.migranthealth.org!

PHOTOGRAPHY collaborative peer education and advocacy. Thanks to the Migrant Health Promotion staff, and to Charlotte Raymond and the Bristol-Myers Squibb company for donating Charlotte's talents. “Abro mi corazon y ayudo a la gente buscar una solución, asi como hicieron conmigo. I open my heart and help people find solutions, just like they did with me” Miriam Perez, Promotora “I feel like a community leader. No one can defeat me.

I feel very strong,“It’ muchs a good more thing thatthan someone before is Iin was the role a of PromotoraCamp. Health Through Aide becausethe experience that way the of camp being residents a Promotora, I’ve realized how muchcan we ask can someone achieve.” they trust.” Marisol Luevano,Zulema CrPromotorauz, Promotora Highlights

Health Centers embraced the Promotor(a) model In honor of our 20th Anniversary, Migrant Health and initiated new programs in 2003 and 2004, Promotion received two national awards. One thanks to the resources available through the was presented by the National Association of Capacity-Building Assistance Program. New Community Health Centers and recognized programs included a Promotor(a) dental health “Outstanding Service in Migrant Health.” A program in Oregon, a teen program in second award, collectively sponsored by the California, a mental health and substance abuse National Center for Farmworker Health, the program in Missouri, and general health Migrant Clinicians Network, Farmworker Health Promotor(a) programs in Washington and Kansas. Services and the Farmworker Justice Fund acknowledged “20 Years in the Advancement of The REACH Promotora Community Coalition, Lay Health Outreach.” focused on diabetes prevention and management, continued to improve the health Migrant Health Promotion was honored by the of its community. Walking group participants United States-Mexico Border Health Commission who met the target of 150 minutes per week of with the “Border Models of Excellence” 2003 physical activity increased from 19.5% to 33.1%. award for its work with partner organizations, Cooking class participants increased their fruit Promotores(as) and community members in the and vegetable intake, consumed less whole milk REACH Promotora Community Coalition. In and more 2%, 1% and skim milk. Participating addition, Migrant Health Promotion was a finalist Health Centers increased the number of HbA1c for the National Occupational Research Agenda tests, microalbuminuria tests, foot examinations, Partnering Award for Worker Health and Safety. and referrals for dilated eye examinations. School Health Advisory Councils improved the nutritional quality of school lunches and worked to limit availability of sugary snacks and beverages in schools. Camp Health Aide Programs Improving health from within labor camps and communities

he Camp Health Aide Program is a winner of the national “Models that T Work” Campaign. Developed in 1983, the program trains farmworkers as Camp Health Aides, or Promotoras and Promotores, within migrant labor camps and communities. Camp Health Aides offer their peers education, support and direct links to Migrant and Community Health Centers and other community-based services. The program forms a solid foundation for all of our work with farmworkers and their rural communities.

Selected Outcomes – 2003 and 2004

In the State of Michigan Prenatal Care Outreach trained and mentored eight Camp Health Aides and Advocacy Camp Health Aide Program, in eye health and community-based research. 45 Camp Health Aides from five migrant Health Camp Heath Aides reached 300 farmworkers Centers completed 6,256 one-on-one health with information on eye health and protective interventions among their peers. The Promotoras eyewear. Preliminary results indicate use of ensured that: 83% of newborns were breastfed; protective eyewear increased among observed 97% of pregnant women received prenatal care; farmworkers from less than 1% to between 81% of children five and under were fully 29% and 77% for most task-specific risks they immunized; and that 65% of women served by encountered while working. the Program either had had a Pap smear within the past year or received one during the season. Farmworker Doula training and health By comparison, only 63% of Michigan women in education materials were promoted nationally all racial groups and occupations breastfed their at Migrant Stream Forums, with the goal of babies. Statewide, only 61.5% of Michigan establishing the Farmworker Doula Program Hispanic women received timely prenatal care. as a replicable model.

The Southeast Michigan Camp Health Aide Program completed a four-year collaboration with the Great Lakes Center for Occupational and Environmental Safety and Health at the University of Illinois at Chicago. The Program “With corn, the leaves will slice you just like a paper cut. I know it causes eye injuries – I’ve been to the emergency room twice myself. Our workers wear safety glasses every time they go into the cornfield. They’re all covered up – they’ve got their hats, bandannas, and their safety glasses peeking out.” Chris Burnor, Legacy Brand Hybrids “I thought I was not going to be able to get the message across about early detection and prevention. Thanks to all the training I received, I was prepared to take the much needed information to the community, my community.” Marisol Luevano, Promotora Colonia Health Worker Programs

Advancing community health in the border region

he Colonia Health Worker Programs offer seasonal and year-round T programming to experienced Promotoras and Promotores in the Rio Grande Valley of South Texas. They provide a wealth of community-based health promotion services in isolated colonias – rural, unregulated neighborhoods common in the border region. The longer season allows for more intense training and outreach, yet permits farmworkers who migrate to participate.

Selected Outcomes – 2003 and 2004

Eight seasonal Promotoras in the the Nuestra and, in 2004, 75 Promotores(as) from other Salud (Our Health) Breast and Cervical Cancer programs participated in a full-day child abuse Early Detection and Prevention Program prevention seminar, thanks to the Familias Fuertes provided individualized education and facilitated Program. access to cancer screening and treatment in South Texas. The Promotoras completed over Eight Promotores(as) in the Protégete (Protect 2,970 individual encounters in 2003-2004, Yourself) Border HIV Prevention Program included 1,618 participants in small gro-up reached a total of 2,465 at-risk community presentations and completed 2,200 women’s members with information about HIV/AIDS, risk health assessments. In 2003 alone, as a result factors and prevention in 2003-2004. Pre- and of the Promotoras’ work, over 400 women post-questionnaires demonstrated a 25% increase received free or low-cost gynecological exams, in knowledge of HIV transmission and prevention mammograms or other services. among select participants in Promotor(a)-led education sessions. Promotores(as) also provided Within the Familias Fuertes y Saludables in-home HIV testing and counseling to community (Strong and Healthy Families) Program, initiated members unable to access testing facilities and in 2002, three Promotoras bring parenting reached 99% of those tested with post-test information and resources door-to-door. This counseling. In 2004, in a new initiative, program is unique in that migrating Promotores(as) Protégete Promotores(as) collaborated with the serve families year-round, both in colonias in Valley AIDS Council to offer outreach at high-risk Texas and in farm labor camps in Michigan and locations and at the bridges between the US and Ohio during the migrant season. In addition, Mexico. Promotores(as) led parenting discussion groups in each of the seven migrant labor camps served; continues on next page Colonia Health Worker Programs continued

The Covering Kids and Families Program services. In 2004, the four Covering Kids gathers information on barriers to accessing care Promotoras assessed a total of 1,420 children for through Medicaid and the State Child Health health insurance. Eligible uninsured children were Insurance Program (CHIP). The program also referred to CHIP or Children’s Medicaid, and provides application assistance and information their parents were given application assistance about the proper utilization of benefits, and helps with new or renewal forms. families to overcome obstacles in accessing

La Voz Latina Program

La Voz Latina (the Voice of Latinas in Government) representatives to discuss women’s health and Program is an adaptation of the Promotor(a) related policy. In March 2003, two of the model designed to respond to Promotoras’ Promotoras visited a total of four congressional readiness to participate in policy work and to offices and three national advocacy groups in build fundamental change through education, Washington, DC to promote health policy advocacy, leadership and community organizing. changes for underserved women and their Promotoras work with underserved Latinas and families. In 2004, Promotoras helped form their communities to increase access to health leadership committees in target communities to information and health care and to actively participate in policy training and promote La Voz participate in creating equitable health care events in their neighborhoods, holding 36 systems and health policy. community meetings. The Promotoras and community leaders met with Texas legislators to Selected Outcomes — 2003 and 2004 discuss women’s health policy and to advocate Three La Voz Promotoras learned about the for future funding for women’s health. legislative process, discussed reproductive health with their peers and met with state and national “Migrant Health Promotion was the most beneficial and informative source of support for us while we were developing our first Promotora [not italic] training program.” Cathy Bless, Farmworker Health Center, Cobden, Illinois

“I gained new ideas, new friendships and above all, lots of positive information to be“W ae betterhave Promotorahelped families de Salud who. Myhave batteries lost coverage are charged!” for their children for reasons that are not acceptable.Participant, I have a feeling of accomplishmentNuestras Líderes: when Promotores I hear thatde Salud, children are back on2002 Medicaid East Coast immediately Migrant Streamafter a Forum brief investigation. We understand the [Medicaid policy] changes so we can inform others. It is really GREAT…” Graciela Camarena, Program Specialist

Capacity-Building Assistance

Creating and fortifying Promotor(a) programs nationwide!

national leader in program development and innovation, Migrant Health A Promotion is committed to sharing its expertise to improve the health of farmworkers and their rural communities. Capacity-building assistance is provided to Migrant and Community Health Centers and related organizations to establish and strengthen Promotor(a) programs using Migrant Health Promotion’s experience and resources.

Selected Outcomes – 2003 and 2004 Through the Capacity-Building Assistance MATERIALS AND RESOURCES Program, Migrant Health Promotion maintained New in 2003 and 2004 a strong presence at regional and national migrant health conferences and provided timely • Over 139 sets of the Infórmate for information on funding opportunities, in-depth Farmworker Teen Health Toolkit, including a consultation, training materials, sample grants manual, teaching notes and an implementation and other resources. The CBA Team provided guide were distributed free of charge to clinics successful, intensive regional trainings for Health and other agencies interested in adolescent Centers at both the East Coast and Western peer health education programs. Migrant Stream Forums.

• The Salud Para Todos Implementation Guide With support from Migrant Health Promotion, and the revised Salud Para Todos Manual La Clínica del Cariño (OR) began a dental and “Teaching Notes” are now available. Promotor(a) program as part of an expansion grant from the Bureau of Primary Health Care; • The draft Farmworker Doula Manual has Community Health Centers of the Central Coast been completed and pilot-tested in English (CA) began a teen Promotor(a) program; Moses and Spanish. A draft “Teaching Notes” to Lake Community Health Center in Quincy, WA accompany the Farmworker Doula Manual began a new Promotor(a) program serving has also been completed. migrant farmworkers, and the Kansas Department of Health and Environment began a Promotor(a) Most capacity-building materials and resources program as part of an expansion grant from the are now readily available online at Bureau of Primary Health Care, serving Low www.migranthealth.org! German-speaking, Mexican-American migrant farmworkers.

continues on next page “Being a Teen Health Aide means being more responsible for my actions and learning about what can happen in the real world.” Aaron Avalos, Teen Health Aide Salud Para Todos Programs Prioritizing mental health and substance abuse issues.

he Salud Para Todos (Health for All) Farmworker Family and Community T Health Program trains and supports Promotoras and Promotores addressing mental health, substance abuse, stress and violence in their farmworker labor camps and communities.

Selected Outcomes – 2003 and 2004 New programs began in California, Maine and Promotores(as) accomplished a 55% increase Missouri. In 2003, three Salud Para Todos in farmworkers’ knowledge of substance abuse. Program sites, with a total of 23 Promotores(as), Promotores(as) at the Maine site documented performed 1,574 individual health encounters, a 38% reduction in the stress level of the 47 group education sessions, and made over farmworkers with whom they worked, and the 225 referrals. Through education, peer support North Carolina group accomplished a 45% and increased access to existing services, the reduction in reported depression levels.

Capacity-Building Assistance continued

TRAINING Providing stellar support to Promotoras, Promotores and their advocates. Migrant Health Promotion supports a full-time The ground-breaking Texas Diabetes Education training department in the border region of South and Care Management Project jointly trained Texas. With strong endorsements from Texas Promotores(as) and health care professionals to A&M University and the Robert Wood Johnson work together more effectively. Across Texas, Foundation, Migrant Health Promotion became trained teams of Promotores(as) and health care the regional Promotor(a) trainer for numerous local professionals educated new teams, and agencies. More than 75 Promotores(as) take part collectively responded to the challenges that in trainings annually, which include instruction in underserved Latino families face in managing their legislative activity, personal development, diabetes. leadership, mind and body wellness, human systems family support and resources and financial literacy. "I thought Protégete was a really good thing. We got to talk with people . . . I thought it was great to share information that people needed. The grown-ups would thank us for sharing this information." Chris Ortiz, age 16, former Teen Health Aide in both the Infórmate and Protégete programs Infórmate Teen Programs Building youth leadership and preventing HIV/AIDS.

he Infórmate (Inform Yourself) Teen Health Program provides peer-based T health education to adolescents using theater, games and healthy activities. Farmworker adolescents trained as Teen Health Aides play an active role in developing, implementing and evaluating activities in their labor camps and communities.

Selected Outcomes – 2003 and 2004 In Texas, the Protégete (Protect Yourself) Border October 2004, the Michigan Aides presented a HIV Prevention Program Teen Health Aides workshop at a state conference on the prevention developed a bilingual theater production, of HIV and sexually transmitted infections. engaging adolescents with HIV prevention messages and interactive discussions. Audience Teen Health Aide Cynthia Cabello was honored members completed pre- and post-questionnaires, by the U.S. Congress as a Young Leader of revealing a 21% increase in knowledge of HIV Today. Cynthia was described as a leader “both transmission and prevention as a result of the in action and example, engaging her peers and program. helping them empower themselves to enact positive change in their community. She is Infórmate Teen Health trained a total of 18 Teen respected by her family, friends, peers, employers Health Aides at three sites in Michigan. Together, and especially her community.” they reached over 2,346 of their peers with one-on-one and group education on HIV/AIDS, Other Infórmate achievements in 2004 include substance abuse and related issues. At two sites, the planning and implementation of a comparison the Teen Health Aides developed interactive the- group to strengthen program evaluation, the ater performances; they also conducted group distribution of over 135 Tool Kits free of charge health education sessions. Survey results indicate to agencies serving migrant farmworkers and that the program has a positive impact on the youth, and ongoing efforts to assist other knowledge, attitudes and health behaviors of the agencies in replicating the Infórmate model Teen Health Aides as well as the farmworker with teens in their areas. teens participating in Infórmate activities. In

Salud Para Todos Programs Prioritizing mental health and substance abuse issues.

Capacity-Building Assistance continued TRAINING Providing stellar support to Promotoras, Promotores and their advocates. Migrant Health Promotion supports a full-time The ground-breaking Texas Diabetes Education training department in the border region of South and Care Management Project jointly trained Texas. With strong endorsements from Texas Promotores(as) and health care professionals to A&M University and the Robert Wood Johnson work together more effectively. Across Texas, Foundation, Migrant Health Promotion became trained teams of Promotores(as) and health care the regional Promotor(a) trainer for numerous local professionals educated new teams, and agencies. More than 75 Promotores(as) take part collectively responded to the challenges that in trainings annually, which include instruction in underserved Latino families face in managing their legislative activity, personal development, diabetes. leadership, mind and body wellness, human systems family support and resources and financial literacy. Community Coalitions

Working together to create healthy systems, policies and individuals

As a part of the Texas statewide Covering Kids Data from participant surveys and clinical and Families Program, Migrant Health chart reviews indicate improvements in clinical Promotion led the Children’s Health Coalition management of patients as well as healthy in the Rio Grande Valley. The Coalition provides behavioral change among community members. Texas families with information and assistance on Walking group participants meeting the 150 utilizing public health insurance programs for minutes per week of physical activity target low-income children, such as CHIP and increased from 19.5% to 33.1%. Evaluators Medicaid. documented increases in the consumption of green vegetables and other vegetables and fruits The REACH Promotora Community Coalition among cooking class participants, as well as a creates individual and systems changes around decline in whole milk consumption and increases diabetes through community organizing and in 2%, 1% and skim milk consumption. coalition building in South Texas. The Coalition Participating Health Centers were found to integrates and evaluates Promotor(a) interventions have increased the number of HbA1c tests, within schools, clinics and the community to microalbuminuria tests, foot examinations and reduce and eliminate racial and ethnic disparities referrals for dilated eye examinations, and for in health. With Promotor(a) leadership, the the first time tracked the completion of eye Coalition organizes regional events promoting examinations. School Health Advisory Councils physical activity and water consumption. Their are working to improve the nutritional quality activities include educational classes, healthy of school lunches and to make sugary snacks cooking demonstrations, physical activity sessions and beverages less available in schools. and other accessible interventions designed to prevent and control diabetes. Major Funding Source

Catholic Consortium for Migrant Health

Bristol-Myers Squibb Foundation

Department of Health and Human Services (DHHS), Centers for Disease Control and Prevention (CDC), HIV Projects for Community-Based Organizations

DHHS, Administration for Children and Families

DHHS, CDC, National Center for Chronic Disease Prevention and Health Promotion, Racial and Ethnic Approaches to Community Health (REACH) 2010

DHHS, CDC, Agency for Toxic Substances and Disease Registry

DHHS, Health Resources and Services Administration (HRSA), Bureau of Primary Health Care (BPHC), Migrant Health Program

DHHS, HRSA, Office of Minority Health, Bilingual/Bicultural Demonstration Program

DHHS, Substance Abuse and Mental Health Services Administration (SAMHSA), Substance Abuse and HIV Prevention Youth Services

Michigan Department of Community Health, Division of Family and Community Health

Ms. Foundation for Women

Nokomis Foundation

Robert Wood Johnson Foundation

University of Illinois at Chicago, Great Lakes Center for Occupational and Environmental Safety and Health and the National Institute for Occupational Safety and Health, Community Partners for Healthy Farming Intervention

Texas A & M University System, Health Science Center Research Foundation and the Robert Wood Johnson Foundation

Texas Department of Health, Texas Diabetes Program – Community Diabetes Services Projects

University of Arizona / Border Vision Fronteriza and DHHS, HRSA 2003 Financials

Collaborative Program 2003 Award

General support and the Sister Donna Zetah Education Fund $ 97,500

Texas Diabetes Education and Care Management Project 75,000

Protégete Border HIV Prevention Program 224,000

Familias Fuertes y Saludables Program 109,406

REACH Promotora Community Coalition 904,990

Eye Injury Prevention in Migrant Farmworkers in Florida 25,432

Capacity-Building Assistance /Promotora Programs, Salud Para Todos and 495,000 Salud Para Su Corazon and the Texas Diabetes Education and Care Management Projects

Nuestra Salud Breast and Cervical Cancer Early Detection and Prevention Program 150,000

Infórmate for Farmworker Teen Health 2003 299,996

State of Michigan Prenatal Care Outreach and Advocacy Camp Health Aide 7,000 Program Administration

La Voz Latina Program 20,000

Farmworker Doula Program 15,000

Covering Kids and Families Access Initiative 62,497

Occupational Safety and Health Research and Southeast Michigan Camp Health 44,247 Aide Program

Promotor(a) Training: Creating an Integrated Health Outreach System, Colonia Residents in 76,131 Hidalgo County

REACH Willacy Diabetes Project 80,000

Community Health Workers for Children’s Health Project 20,000 Major Funding Source

American Express Foundation – Economic Independence Fund

Anonymous Gift

Catholic Consortium for Migrant Health

DHHS, Administration for Children and Families

DHHS, CDC, National Center for Chronic Disease Prevention and Health Promotion, Racial and Ethnic Approaches to Community Health (REACH) 2010

DHHS, Health Resources and Services Administration (HRSA), Bureau of Primary Health Care (BPHC), Migrant Health Program

DHHS, HRSA, Office of Minority Health, Bilingual/Bicultural Demonstration Program

DHHS, Substance Abuse and Mental Health Services Administration (SAMHSA), Substance Abuse and HIV Prevention Youth Services

Family Medical Center, Temperance, MI

Ms. Foundation for Women

Robert Wood Johnson Foundation

Texas A & M University System, Health Science Center Research Foundation and the Robert Wood Johnson Foundation

Texas Association of Community Health Centers (TACHC)

Texas Department of Health, Texas Diabetes Program – Community Diabetes Services Projects 2004 Financials

Collaborative Program 2004 Award

Nuestro Dinero (Our Money) Financial Literacy Project $ 15,000

Southeast Michigan Camp Health Aide Program 15,000

General support and the Sister Donna Zetah Education Fund 97,500

Familias Fuertes y Saludables Program 109,400

REACH Promotora Community Coalition 883,274

Capacity-Building Assistance for Promotora Programs and Salud Para Todos 425,000

Infórmate for Farmworker Teen Health 150,000

Infórmate for Farmworker Teen Health 363,632

Southeast Michigan Camp Health Aide Program 31,973

La Voz Latina Program 20,000

Covering Kids and Families Access Initiative 61,889

Promotora Training: Creating an Integrated Health Outreach System, Colonia Residents in Hidalgo County 50,000

Children’s Health Coalition 62,500

REACH Willacy Diabetes Project 80,000 Muchas Gracias

Migrant Health Promotion is grateful for the hard work, dedication and collective talents of our Board of Directors, our staff and the collaborators and volunteers who share our vision. We are thankful for the generous financial contributions of our federal, state, and private donors, and we are indebted to you for trusting Migrant Health Promotion and the farmworkers and rural communities we serve to solve health problems with creativity and flexibility – from within our own communities.

Catholic Consortium for Migrant Health Ascension Health, St. Louis, Missouri Catholic Health Initiatives, Denver, Colorado Catholic Healthcare Partners, Cincinnati, Ohio SC Ministry Foundation, Cincinnati, Ohio SSM Health Care, St. Louis, Missouri Trinity Health, Novi, Michigan

Board of Directors Mike DuRussel Olga Gabriel Migrant Health Services Directory Linda Guillen La Guía de Servicios de Salud Para Migrantes Jose Ricardo Ibáñez Cynthia Jaimes La Guía helps farmworkers locate available health services. Migrant Bonnie Kay, PhD Health Promotion produced and distributed 30,000 copies each of the Moira Kenny, RSM 2003 and the 2004 editions to farmworkers, their advocates and their Kimberly Kratz, MSW, MPH organizations. La Guía is now available on Migrant Health Promotion’s Bertha Lopez, MSW, ACSW, CSW Web site, www.migranthealth.org. Maureen Martin Domingo Navarro, MBA Diane O’Hara, CPA Education Fund Sarah Peña During 2003-2004, the Sister Donna Zetah Education Fund awarded Arturo Pérez 57 scholarships to current and former Promotoras, Promotores, Teen Inés Pérez Health Aides and their family members who are pursuing educational Cristina Ramos and career goals. Rodolfo Sanchez, JD Jack Schneider, MD Staff Briana Adato, Program Coordinator Emily Ahonen, Program Coordinator Julie Allen, Intern Bertha Andrade, Promotora Jesus Bautista, Program Coordinator Nora Bedard, Program Coordinator Yolanda Betancourt, Promotora Tori Booker, MSW, MPH, Associate Director Mirasol Bravo, REACH Evaluation Assistant Melanie Briones, Intern Gaciela Camarena, Program Specialist Rebecca Cano, Administrative Assistant Nora Y. Cavazos, Evaluation Coordinator Lucila G. Ceballos Felix, Training Specialist Enedelia Cisneros, Promotora Mary Coalter, BSN, Capacity-Building Director, East and Midwest Erik Colegrove, Office Manager Rene Meave, Program Coordinator Paulette Davis, Bookkeeper Dora Mejia, Promotora Maria Davila, Promotora Diana C. Nieto, Administrative Assistant Rachel Diem, MA, Administrative Assistant Lizette Pacheco, Program Coordinator Joanna L. Drescher, Intern Mirian Perez, Promotora Karen Dugas, Intern Maricruz Polanco, Promotora Jennifer Filipovich, MSW, MPP, Program Director Lisa Rajt, Intern Tanya Fisher, Intern Maria Rangel, Secretary Beula Flores, Program Coordinator Susan Ringler Cerniglia, Development Director Luis Flores, Secretary Josie Rodriguez, Program Coordinator Maria Lourdes Flores, Promotora E. Lee Rosenthal, PhD, MHP, Amy Frank, Intern Capacity-Building Director, West Esli Galvan, Program Coordinator Juanita Ruiz, Program Coordinator Noemi G. Garcia, Health Education Director Rosa Ruiz Morales, Office Manager Carin Garrett, Intern Adela Salinas, Program Coordinator Rebecca Garza, PhD, Associate Director Sara Skinner, MPH, Program Director Adalinda Gaytan, Program Coordinator Derek Smith, Program Coordinator Alex Gomez, Office Manager Carmen Soto, REACH Promotora Letty Gomez, Promotora Angela Torres, Administrative Assistant Alejandra Gonzalez, Program Coordinator Alberto Treviño, Program Director Lily A. Guzmán, Intern Maria C. Treviño, Promotora Shannon Hill, Intern Virginia Valadez, Promotora Karin Hopkins, Program Coordinator Noelle Van der Tuin, MSW, Program Director Dores Jay-Pang, REACH Principal Investigator Mary Jane Velasquez, Promotora Ashley L. Koebel, Intern Fina Washowiak, Building Custodian Kimberly Kratz, MSW, MPH, Executive Director Carla Weiss, Business Manager Elvia Ledezma, Evaluation Specialist Sara Wolf, Intern Genoveva Martinez, Program Coordinator Summer Wood, Intern Jennifer Mason, Program Director Belinda Zavala, Program Coordinator Promotoras and Promotores 2003 & 2004

Esmeralda Adame Maria Gonzalez Chris Ortiz Minerva Aguirre Teresa Gonzalez Rosa Perez Jesse Alfaro Juana Maria Guillen Alma Perez Margarita Altamirano Debbie Hernandez Cantu Laura Perez Priscila Ambria Gerardo Ibarra Martha Perez Rosa A. Arellano Berta Jaimes Beatriz Pitones Sandra Arellano David Lara Bianca Pitones Edith Avila Martha Lara Brenda Resendez Jessica Briceno Odilia Leal Jeannette Rocha David Caballero Martha Longoria Gerardo Rodriguez Cynthia Cabello Marisol Luevano Teresa Rodriguez Jessica Cabello Veronica Martinez Laura A. Rosales Juanita Castillo Carlos Mata Juanita Rubio Lissette Castillo Maria de Jesus Medrano Lilia Salgado Anna Ceiba Becerra Elizabeth Mena Sughey Salaiz Maria de la Rosa Lorena Mendez Fidencia Salazar Suann Dorset Maria del Rosario Mereles Sonia Salazar Francisca Estrada Maricela Meza de la Cruz Liliana Salinas Elvira Fernandez Rosa M. Montelongo Angela Sanchez Leonor Fernandez Saul Montoya Noelia Serrano Brenda Garcia Deedra Moreno Maria G. Soto Carla Garcia Jorge Moreno Eloy Sustaita Diana Garza Rosa Moreno Viviana Tamez Dianira Gaytan Evelia Mota Esmeralda Torres Bertha Gomez Norma Muñoz Ana Maria Villanueva Alejandra Gonzalez Martha Navarro Beatriz Villanueva Eduardo Gonzalez Jorge Ochoa Eliza Zolorio Jose Gonzalez Florentina Orozco

Promotoras and Promotores 2003 & 2004

Esmeralda Adame Juan Carlos Gerardo Elizabeth Mena Bianca Pitones Minerva Aguirre Thomas Glasspole Daniela Mendez Ruth Ramirez Jesse Alfaro Bertha Gomez Lorena Mendez Brenda Resendez Margarita Altamirano Alejandra Gonzalez Agustina Mendoza Jeannette Rocha Priscila Ambria Eduardo Gonzalez Maricela Meza Gerardo Rodriguez Aureliano Angulo Janeth Gonzalez de la Cruz Teresa Rodriguez Rosa A. Arellano Jose Gonzalez Maria del Rosario Laura A. Rosales Sandra Arellano Maria Gonzalez Mireles Juanita Rubio Mary Laura Augustine Teresa Gonzalez Rosa M. Montelongo Lilia Salgado Edith Avila Priscilla Gould Saul Montoya Sughey Salaiz Antelmo Aviles Juana Maria Guillen Deedra Moreno Fidencia Salazar Jessica Briceno Luis Hernandez Jorge Moreno Sonia Salazar David Caballero Maria Hernandez Rosa Moreno Liliana Salinas Cynthia Cabello Juan Hernandez Alvarado Evelia Mota Angela Sanchez Jessica Cabello Debbie Hernandez Cantu Norma Muñoz Gricelda Sanchez Diaz Juanita Castillo Gerardo Ibarra Martha Navarro David Sanchez Orozco Lissette Castillo Berta Jaimes Patricia Neptune Catalina Santiago Anna Ceiba Becerra David Lara Jorge Ochoa Noelia Serrano Arizona Clegg Martha Lara Erika Olsen Paula Somuano Maria de la Rosa Odilia Leal Florentina Orozco Maria G. Soto Suann Dorset Rose Marie Levi Laura Orozco Valencia Eloy Sustaita Juana Escobar Martha Longoria Chris Ortiz Viviana Tamez Francisca Estrada Juan Lopez Epiphanio Ortiz Esmeralda Torres Elvira Fernandez Rafael Lopez Rosa Perez Ana Maria Villanueva Leonor Fernandez Marisol Luevano Alma Perez Beatriz Villanueva Brenda Garcia Mary Noella Marshall Laura Perez Errol Watkins Carla Garcia Veronica Martinez Litzi Perez Abel Zavala Diana Garza Carlos Mata Martha Perez Eliza Zolorio Dianira Gaytan Maria de Jesus Medrano Beatriz Pitones