Incontinence Care Needs in a US rural border region:
Perspectives of promotoras
Purpose: The purpose of this study was to explore the incontinence care needs of rural, primarily Hispanic, community dwelling adults living along the U.S.-Mexico border of southern New Mexico from the perspective of the community health workers, or promotoras, who serve this community.
Sample: Community health workers (promotoras) attending a regional meeting were invited to participate in a focus group format to discuss their experiences with urinary incontinence; 25 promotoras provided verbal and/or written feedback.
Method: A participatory action framework guided this focus group session, which followed an outreach presentation on basic concepts of urinary incontinence. Participant feedback and discussion solicited following the presentation was used to assess perceived community needs for incontinence care and bladder health promotion. Participants’ verbal feedback and written responses to open-ended questions were analyzed by methods of qualitative content analysis for themes depicting perceived needs of their community for bladder health education and behavioral strategies to alleviate incontinence.
Findings: The following themes were identified: predisposing conditions, treatments tried, home remedies, psychosocial effects, and training requested. Promotoras’ comments revealed the lack of information regarding the causes and associated factors of urinary incontinence, the lack of understanding of available behavioral treatment options and how to perform behavioral strategies to promote continence. Promotoras identified the negative effects of urinary incontinence on psychosocial health and asked for strategies to help rural adults cope with this condition.
Conclusion: Themes identified will guide the content development of future train-the-trainer sessions for community health workers or promotoras in urinary incontinence self-care strategies. Train-the-trainer sessions were identified through methods of participatory action to be the preferred strategy for bladder health promotion outreach to rural adults living in areas with limited access to medical services.
Keywords: incontinence, rural, promotoras, Hispanic, qualitative, needs assessment, participatory action, community health worker
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