Imagine how a day like this would stand your world on its head:
Your spouse walks in one evening and announces plans to take a higher-wage job in a foreign country. He's gone inside of a week. With luck, you may get to follow in a few months.
The luck holds, and six months later you're sitting in an apartment in a foreign country head buried in your hands, wondering how you're going to make it, perhaps depressed, socially isolated and overwhelmed.
Your extended family, on whom you rely so heavily, is thousands of miles away. The rules are different here. Everything you do is difficult, and your kids aren't in much better shape homesick, unsure how to act, perhaps having trouble making friends, and trying to succeed in school.
That's the reality for many Hispanic women in the Triangle. Fortunately, a new pilot research program for Durham and Chatham counties recently was launched to ease Latinas' transition and to improve their ability to cope and help one another.
Called ALMA, it is a collaboration between the Duke University School of Medicine and the University of North Carolina School of Medicine. Funding for the project, called the Duke-UNC GlaxoSmithKline Health Disparities Initiative, comes from the GlaxoSmithKline (GSK) Foundation in Research Triangle Park, North Carolina.
ALMA stands for Amigas Latinas motivando el alma Latina Friends Motivating the Soul (or Alma), a name chosen by the project's community advisory committee.
The groundwork began in the spring of 2006, when the Duke and UNC research team reached out to Latinas in Durham and Chatham counties to ask how a small research grant could help.
ALMA was launched in early February 2008 when the research team recruited 18 socially and economically diverse adult Latinas into the ALMA program for its Durham study, which will expand to Chatham later this year under the program name of Chatham Latinas.
ALMA teaches the women skills to handle emotional stress and sadness, function in their new environment, and share those skills with other Latinas. The goal is to create health, especially the capacity for mental health, within the individual and the community.
The amigas friends element is central to its success.
After 10 weekly sessions learning and testing skills, the 18 Latinas qualify as promotoras literally "promoters" but in reality, far more. They fan out after the training as lay health advisers to teach their newly learned self-help skills to family members and friends.
"We train the trainers, who go out in their community and train other people," says project director Tia Simmons of Duke's Division of Community Health. "We want to provide ways for these women to help themselves, based on their common bond coming here and using their varied backgrounds to help them understand our cultural practices, education, and health systems."
Georgina Perez of the Division of Community Health, agrees.
"The ALMA project is teaching the promotoras new, positive and creative ways to cope with stress, along with the chance to build their social network of other Durham Latinas and learn more about the Durham community," Perez says.
The ALMA curriculum focuses promotora training on skill-building to deal with anxiety and sadness, common experiences in immigration, and the challenges of adapting to a new culture.
Dr. Victor Dzau, chancellor for health affairs at Duke University and president and CEO of Duke University Health System, and Dr. Bill Roper, dean of the School of Medicine, vice chancellor for medical affairs, and CEO of the UNC Health Care, are sharing a four-part GSK grant of which ALMA is one component.
Susan Yaggy of Duke's Division of Community Health is the principal investigator for Duke; Dr. Giselle Corbie-Smith is the principal investigator for UNC-CH. "Our collaboration multiplies what each of us brings to communities," says Yaggy. "We share an approach that has the community define the problems, shape what we offer, and then guide us as we move forward."
"Our shared focus on addressing the needs of the communities we serve has been the foundation for this project," Corbie-Smith says. "Working in partnership with communities gives us the highest likelihood of doing the most good."