On Wednesday morning, Vision y Compromiso held an all-day workshop to amplify the work that promotoras do in Tulare County.
Established in 2001, the first and only Network of Promotoras and Community Health Workers in California is run by Vision y Compromiso to provide education, advocacy, and resources. The network also offers leadership development and training for promotoras.
A few of the main issues that plague the Tulare community are the continuous deaths and lack of access to care for their largely Spanish-Speaking population, according to Jose Ruiz Salas, Administrative Specialist for Tulare County. He added that there is also a need for more effective outreach methods.
“So, it’s not for one person to do, it is not something from 9-5 in the office with your four walls,” said Salas. “We brought together some public health funding with Vision y Compromiso and their network. A lot of them had already started becoming vital and have been instructors.”
In rural communities like Tulare, access to healthcare can be difficult due to language and insurance barriers. As a result, many residents go without seeing a doctor, which can ultimately affect their health. However, with the training provided to promotoras, they can deliver basic medical care and connect residents with resources.
“They can do different things, for example, they can inject, they can do that kind of work through clinics. They can talk with people about family planning, but they can also be the person that’s administering that family planning with the supervision of a physician,” said Melinda Cordero Barzaga, Associate Director of Vision y Compromiso.
In Salas’ presentation, where he introduced the history of the Promotora model in Tulare, he noted a previous instance in which promotoras went throughout the community to inform residents about their first major initiative—a bridge program aimed at increasing awareness of Medi-Cal. They visited homes and worksites; in one instance, an individual said they could not talk because they needed to bring in the grapes. To ensure the message was still delivered, a promotora helped bring in the grapes while explaining the available resources.
In their next projects, labeled as Projects 2–3, efforts focused on chronic disease management and diabetes prevention. Promotoras were able to become certified as lifestyle coaches in order to provide services throughout rural Tulare.
“They became certified lifestyle coaches to be able to deliver the program to their communities. So, they were leading the classes, they recruited for themselves, whether it was their own church groups or other groups that they were involved with,” said Salas.
In their fourth project, which took place in 2020 during the COVID-19 pandemic, promotoras participated in testing outreach, vaccination campaigns, and outreach in hard-to-access areas to ensure communities received accurate and timely information.
“It was an opportunity for us to address some of that information that was out there because these were people’s neighbors and they knew that these individuals had a little more money and knowledge,” said Salas.
In the early years of implementing the promotora model, volunteers were often unpaid or received only a small stipend for their work in the community. While some progress has been made, significant challenges still remain.
“Promotoras really were volunteers and were paid a stipend in some cases, not in all. And there has been that change, but there is still a long way to go for some of our groups,” said Cordero Barzaga.
As the workshop highlighted, promotoras continue to play a critical role in underserved communities like Tulare County. From expanding access to healthcare and education to responding during public health crises, their work extends beyond traditional roles. Strengthening the promotora model not only uplifts the workers themselves but also ensures that communities receive culturally competent care and vital resources where they are needed most.
