Response to Goebel et al.,Re: Empowering the Latino Community Related to Palliative Care and Chronic Disease Management through Promotoras de Salud (Community Health Workers) (DOI:10.1089/jpm.2020.0332)

Dear Editor:

The Journal of Palliative Medicine published an article titled “Empowering the Latino Community Related to Palliative Care and Chronic Disease Management through Promotoras de Salud (Community Health Workers)” written by Dr Joy R. Goebel, RN, PhD, Dr Mara N. Bird, PhD, and Dr Iveris L. Martinez, PhD. ¹ We commend the authors of this study for the innovative and culturally sensitive use of promotoras to educate Hispanic patients on health care information.

In this study, >2000 community members were educated on palliative care. We want to understand the setting in which the content was delivered to the community. Group settings have been demonstrated to be an effective method used by promotoras in the past to reach the community regarding health matters. ² Clarifying the method of content delivery can be beneficial in replicating and enhancing the methodology of this study.

Second, we seek to further understand the demographics of the 76 promotoras participating in the study. Although it was noted that the methodology was a limitation, we wanted to further understand the intent of not including the following two variables: years of promotora experience and assessment of palliative care knowledge post-training. Were there any barriers in obtaining this information or would this information derail the overall purpose of the study? Years of promotora experience can provide insight into the level of personal connection to the community and their profession. ³ A post-training assessment can provide insight on areas of improvement for future training and facilitate replication of intervention in future studies. ⁴ In addition, including the Senderos booklet provided to the community members in the appendix would be beneficial to readers who may want to replicate the study.

In conclusion, promotoras have been instrumental in the past. They are the ideal individuals to deliver culturally competent and relevant health care information to the communities in which they live.^2,3 We find this study to be an important contribution to the literature by introducing an existing strategy (education by promotoras) into the discipline of palliative care. We are eager to hear from the author to continue this necessary dialogue to promote the understanding of palliative care in the Hispanic community.