Skip to Main Content



Use Lay Health Navigators: Montgomery County Health Department Promotora Program

In Montgomery County, an outbreak of tuberculosis in the growing Hispanic population prompted the health department to think differently about how they deliver health care. Many in the Hispanic community did not seek health-care services because language barriers kept them from understanding how to navigate the system, and until the tipping point—TB—health-care providers didn’t address the issue.

“TB is a very contagious disease, and it does not carry a green card,” Jan Chamness, public health director, acknowledges. “That was probably the driving force that made us look at the basic health care of this population.”

Using the expertise of staff member Pastora Back, a Colombia native, the health department created the promotora program. A promotora, which literally means “promoter,” is an unpaid volunteer who commits to taking basic health courses from the health department in order to share that information with the community.

According to Chamness, the health classes emphasize teaching community members how to take responsibility for their own health. Identifying and taking care of disease early in the process is also important. Some of the topics covered are diabetes, cholesterol, blood pressure, asthma, cancer screening, and smoking.

Because of the promotoras, emergency room visits for basic medical needs have decreased, since more Hispanics now receive primary care through the health department. Additionally, regular, preventive dental care has risen. For Pastora Back, those statistics are satisfying.

“One of things I am really proud of is that they’re not dependent on us the same way they were before, and I attribute all of that to the promotoras,” she says.

Remaking Rural Health: A KET Special Report is a KET production, Laura Krueger, producer, and is funded, in part, by a grant from the Foundation for a Healthy Kentucky.