Minority health program puts power in participants' hands

“Change for Life” uses an adaptation of a seven-stage program, the Prochaska model for intentional change, which psychologists often employ to help clients change unhealthy behaviors. The revised model addresses five of the stages, allowing participants to track their own progress and direct the process.

Ruiz, a native of Mexico, was not familiar with Prochaska’s model. But she didn’t need a background in psychology to understand how the course works. Nor did it take long for the Nashua resident to realize she could apply the five steps to change in other areas of her life.

“I had the tendency to go up and down with my weight,” Ruiz said in Spanish during a recent interview at an outreach office on West Hollis Street. “I wanted to learn to eat healthy.”

Ruiz, who is married and the mother of a 7-year-old son, says the weekly two-hour class taught her that change is a process. Typically, a person begins by considering an issue such as being overweight, ruminates about it, prepares to take action and finally does something - steps outlined in words and images in the course workbook.

“The program helped me to learn to eat (more healthfully), but it really helps in other things,” Ruiz said, noting she has used the model to deal with stress, to improve her outlook and increase activity in her daily life. “I was somebody who always said, ‘I can’t do it.’ Learning English, for example, is very difficult for me, but I say to myself, ‘I can do it. It costs me a lot (of effort), but I can do it.’ ”

Sonia Parra, Latino program coordinator, said the pilot for the Latino program, “!Cambia Tu Vida!” (“Change for Life”), attracted three men and 22 women seeking information and support to improve their health, and continues to draw a larger number of women. (In the black community, participation has been more evenly divided between the sexes.)

“They select a risk factor to work on - diet, weight, smoking, stress, excess salt intake,” said Parra. “Then they learn to use the model (to change).”

From the beginning, facilitators, who are also graduates of the course, emphasize that change takes time and perseverance. Change is a process, participants learn. Rarely does it proceed in a straight, uninterrupted line.

To emphasize this, Parra developed an illustration for the cover of the program manual - drawings detailing the five stages that transform a caterpillar into a butterfly.

“We had a different cover, and I told my boss, ‘We need to find something to identify the program,’ ” said Parra.

She said she went home from work one day thinking about the cover, watched a moth fly into her kitchen after her husband opened a door and realized she had the perfect image.

“It’s the five stages they (participants) go through,” Parra said.

The Latino program coordinator said “Change for Life” draws from a broad demographic that includes professionals with advanced degrees, laborers, people with limited or no literacy, the unemployed and others. What everyone learns, however, is that anyone who makes a successful, intentional behavioral change negotiates the same stages. The person also discovers that support from others is key to making and maintaining the change.

Merrimack resident Yvonne Brodie knows that. She signed up for “Change for Life” after a representative of the New Hampshire Minority Health Coalition visited her church, New Fellowship Baptist Church in Nashua, to talk about the program and take blood pressures and blood-sugar levels.

It turned out that Brodie’s blood

pressure and blood-sugar levels were both dangerously high.

“I had no symptoms or anything,” said Brodie, a native of Jamaica, who was referred to a physician and treated for her conditions.

Afterward, she signed up for the program and now helps teach it.

“The program is fantastic. It’s helped me so much,” she said.

Carolyn Oguda, African-Descendent coordinator for the New Hampshire Minority Health Coalition’s NH REACH 2010 program, said because black residents are “not as cohesive” as Latinos, outreach requires more effort. The program is critical for this population, she added.

‘“We don’t think you’d be comfortable in these groups,” Oguda said minority residents have been told when they inquired about other programs in their communities. “And they weren’t limited in English or without health insurance.”

She said black residents in Hillsborough County, the area the grant covers, represent many countries and speak a number of languages including Sudanese, Arabic, Swahili and French.

Oguda said black residents are often skeptical of health-promotion programs, and for good reason. Victims of scientific experiments such as the notorious Tuskegee Syphilis Study that began in the 1930s, blacks are not easily convinced that participation is in their best interest.

But the program is designed to put prospective participants at ease.

Classes meet in churches and living rooms. Facilitators are graduates. Success stories, like that of Ruiz, abound.

“I feel there are still a lot of things I have to work on, but I look at where I was and where I am now,” said Ruiz. “I feel I have gone far, and I am willing to keep going.”