Maia Ingram

The University of Arizona, Mel and Enid Zuckerman College of Public Health, Alumna

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Papers

The Impact of Integrating Community Advocacy Into Community Health Worker Roles on Health-Focused Organizations and Community Health Workers in Southern Arizona

by Samantha Sabo and Maia Ingram

Journal of Ambulatory Care Management, 2015

Organizational environments may encourage community health workers (CHWs) to engage community mem... more Organizational environments may encourage community health workers (CHWs) to engage community members in improving their communities. We conducted open-ended interviews and focus groups to explore how participation in the Acción intervention, which trained CHWs in community advocacy, affected organizational capacity to support their CHWs. Supervisors described improved organizational recognition and trust of CHWs. Organizational leaders reported organizational benefits and increased appreciation of CHW leadership. Both expressed increased interest in future advocacy trainings. Limiting factors included organizational mission, CHW position descriptions, and funding. Findings indicate that, with training and funding, CHW community advocacy can be integrated into organizations with congruent missions.

Community Health Worker Professional Advocacy: Voices of Action from the 2014 National Community Health Worker Advocacy Survey

by Samantha Sabo, Melanie L Bell, and Maia Ingram

The Journal of ambulatory care management

This mixed-methods study explores community health worker (CHW) engagement in professional advoca... more This mixed-methods study explores community health worker (CHW) engagement in professional advocacy. Data from the National Community Health Worker Advocacy Survey (n = 1661) assessed the relationship between CHW professional advocacy and CHW demographics, and work characteristics. Qualitative data articulated the quality of professional advocacy efforts. Approximately, 30% of CHW respondents advocated for professional advancement or collaborated with other CHWs to advance the workforce. Advocacy was more prevalent among CHWs affiliated with a professional network. CHW advocacy targeted recognition of the field, appropriate training and compensation, and sustainable funding. CHW professional advocacy is imperative to advancement of the field.

Everyday violence of immigration related ethno-racial profiling and mistreatment: A mixed methods approach to understanding immigration policy as a structural determinants of health

by Cecilia Rosales, Samantha Sabo, and Maia Ingram

Public health scholars have called for research into the impact of state level immigration polici... more Public health scholars have called for research into the impact of state level immigration policies on the public's health and have recognized these policies may exacerbate existing racial and ethnic disparities among immigrant populations and their co-ethnics. Objective: The purpose of this study was to apply the theory of everyday violence to explore immigration policy and militarization of the US-Mexico border as a structural determinant of health. Methods: Through qualitative and quantitative data, the prevalence and type of direct and indirect experiences of immigration related ethno- racial profiling, mistreatment and resistance to institutionalized victimization were explored among 499 Mexican border farmworkers during the years 2005-2007. Results: Farmworkers were predominately US citizens and permanent residents with more than two decades working in US agriculture. Approximately 25% described a personally experienced and/ or witnessed immigration related mistreatment en...

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Arizona Community Health Worker Workforce Coalition: History, Process, and Outcomes

by Samantha Sabo and Maia Ingram

The community health worker (CHW) movement has deep roots in Arizona, beginning in the 1960s with... more The community health worker (CHW) movement has deep roots in Arizona, beginning in the 1960s with Community Health Representatives in tribal communities and the Promotora movement beginning in the 1980s. In 1998, the University of Arizona conducted the first national study of CHWs and provided a national description of the workforce including core roles and competencies and subsequent research from 1999 forward has provided a strong evidence base for the effectiveness of CHWs in chronic disease and community advocacy to reduce health disparities. While for over a decade the Arizona Community Health Outreach Workers Network (AZCHOW), the Red de Promotoras and the HOPE and HEART Networks have connected CHWs throughout the state. Despite this long history, no one person, agency or network seems to have found “the magic pill” to ensure continuity of programs or long-term sustainability of this vital workforce in our state. In April 2013 in direct response to these issues and emerging po...

Developing an Action Learning Community Advocacy/Leadership Training Program for Community Health Workers and Their Agencies to Reduce Health Disparities in Arizona Border Communities

by Maia Ingram and Kenneth Schachter

Community health workers (CHWs) make unique and important contributions to society. They serve as... more Community health workers (CHWs) make unique and important contributions to society. They serve as patient advocates, educators, and navigators in our health care system and a growing body of research indicates that they play an important role in the effective delivery of prevention and treatment services in underserved communities. CHWs also serve as informal community leaders and advocates for organizational and community change, providing valuable insiders' insights about health promotion and the interrelatedness of individuals, their community, its institutions, and the surrounding environment. Accion Para La Salud or Action for Health (Accion) is a CDC-funded community based participatory research (CBPR) project addressing the social determinants of health affecting health-related behaviors with the ultimate goal of creating a mode in which community advocacy to address the systems and environmental factors influencing health is integrated into the role of CHWs working in ch...

Building CHW leadership skills: The Women's Health Leadership Institute

by Maia Ingram and Susan Kunz

The Women's Health Leadership Institute (WHLI) is a new national initiative sponsored by the ... more The Women's Health Leadership Institute (WHLI) is a new national initiative sponsored by the DHHS Office on Women's Health. The purpose of the WHLI is to build the leadership skills of Community Health Workers (CHWs) as community change agents to reduce health disparities among women. Although CHWs are a recognized workforce for outreach, education, patient navigation and referral, the leadership potential of CHWs to address the root causes of health disparities and build health equity is yet underdeveloped. The WHLI Curriculum consists of five modules that build CHW leadership capacity in terms of systemic thinking, group facilitation, needs assessment and planning in order to promote collective action at a community level. Under the guidance of a national Stakeholder Group of CHW experts, the Institute is developing a team of Master Trainees from the ten Public Health Regions. In turn, these Master Trainees will train up to 200 CHWs across the country. The WHLI is highly i...

Synergy between community-based participatory research and community health worker community advocacy as a force for policy change

by Samantha Sabo and Maia Ingram

Public health advocacy is by necessity responsive to shifting political climates and thus a chall... more Public health advocacy is by necessity responsive to shifting political climates and thus a challenge of advocacy research is that the intervention must by definition be flexible. Moving beyond the classification of advocacy efforts to measurable indicators of policy change and outcomes therefore requires a dynamic research approach. In this presentation, we will engage in a critical reflection on the use of the community based participatory research approach (CBPR) to develop and measure the impact of Accin, a community advocacy intervention in which community health workers (CHWs) engage community members in making positive changes to their communities. The Kingdon 3-streams model of policy change provided a theoretical framework for the Accin intervention. Research and community partners collaboratively developed research methods to identify and collect Accin intervention data. Over the course of the intervention, the flexible nature of CBPR led to the integration of additional d...

Smoking Behavior in a Smoking Workplace

The US/Mexico border: a binational approach to framing challenges and constructing solutions for improving farmworkers' lives

by Cecilia Rosales and Maia Ingram

International journal of environmental research and public health, 2012

Mexican migrant and seasonal farmworkers in the US-Mexico border region face health hazards and o... more Mexican migrant and seasonal farmworkers in the US-Mexico border region face health hazards and occupational risks and are becoming commonly known in the public health literature. According to several studies, farmworkers have high levels of chronic diseases such as diabetes and respiratory problems, are at risk for infectious diseases, and experience among the highest incidences of work-related injuries of any profession. The findings from two studies are considered and presented with the objective of contributing to an overall understanding of migrant farmworkers as a workforce moving across national boundaries and affected by the work environments and health stressors both shared and unique to each context. We propose a binational approach to comprehensively address the health problems and socioeconomic challenges faced by migrant and seasonal farmworkers. In this paper we present the results of two distinct but complementary studies of farmworker health on the Arizona-Sonora bor...

Everyday violence, structural racism and mistreatment at the US-Mexico border

Social science & medicine (1982), 2014

Immigration laws that militarize communities may exacerbate ethno-racial health disparities. We a... more Immigration laws that militarize communities may exacerbate ethno-racial health disparities. We aimed to document the prevalence of and ways in which immigration enforcement policy and militarization of the US-Mexico border is experienced as everyday violence. Militarization is defined as the saturation of and pervasive encounters with immigration officials including local police enacting immigration and border enforcement policy with military style tactics and weapons. Data were drawn from a random household sample of US citizen and permanent residents of Mexican descent in the Arizona border region (2006-2008). Qualitative and quantitative data documented the frequency and nature of immigration related profiling, mistreatment and resistance to institutionalized victimization. Participants described living and working in a highly militarized environment, wherein immigration-related profiling and mistreatment were common immigration law enforcement practices. Approximately 25% of re...

Using participatory methods to enhance patient-centred mental health care in a federally qualified community health center serving a Mexican American farmworker community

by Maia Ingram and Kenneth Schachter

Health Expectations, 2014

State Medicaid Expansion, Community Interventions, and Health Care Disparities in a United States–Mexico Border Community

by Cecilia Rosales and Maia Ingram

American Journal of Public Health, 2014

Psychotherapists' role in the medical response to male-partner violence

Psychotherapy: Theory, Research, Practice, Training, 1997

Male-partner abuse, although it is prevalent among medical patients in emergency rooms, primary c... more Male-partner abuse, although it is prevalent among medical patients in emergency rooms, primary care, and obstetric clinics, is infrequently screened for and therefore inadequately treated by the majority of physicians. Research studies to support these conclusions are reviewed. On the basis of information presented, it is recommended that psychotherapists: (1) recognize that absence of partner-violence injury in medical records often

A Community Health Worker Intervention to Address the Social Determinants of Health Through Policy Change

by Samantha Sabo and Maia Ingram

The Journal of Primary Prevention, 2014

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Stress and Sociocultural Factors Related to Health Status Among US–Mexico Border Farmworkers

Journal of Immigrant and Minority Health, 2013

Community Health Workers and Community Advocacy: Addressing Health Disparities

by Janet Rothers, Samantha Sabo, and Maia Ingram

Journal of Community Health, 2008

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Salud Sí

by Maia Ingram and Susan Kunz

Family & Community Health, 2012

Predictors and a Framework for Fostering Community Advocacy as a Community Health Worker Core Function to Eliminate Health Disparities

by Samantha Sabo and Maia Ingram

American Journal of Public Health, 2013

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The Border Community and Immigration Stress Scale: A Preliminary Examination of a Community Responsive Measure in Two Southwest Samples

by Maia Ingram, Debra McClelland, Samantha Sabo, Cecilia Rosales, and Zoila Sanchez

Journal of immigrant and minority health / Center for Minority Public Health, 2012

Understanding contemporary socio-cultural stressors may assist educational, clinical and policy-l... more Understanding contemporary socio-cultural stressors may assist educational, clinical and policy-level health promotion efforts. This study presents descriptive findings on a new measure, the border community and immigration stress scale. The data were from two community surveys as part of community based participatory projects conducted in the Southwestern US border region. This scale includes stressful experiences reflected in extant measures, with new items reflecting heightened local migration pressures and health care barriers. Stressors representing each main domain, including novel ones, were reported with frequency and at high intensity in the predominantly Mexican-descent samples. Total stress was also significantly associated with mental and physical health indicators. The study suggests particularly high health burdens tied to the experience of stressors in the US border region. Further, many of the stressors are also likely relevant for other communities within developed ...

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