(From left) Monica Lara holds her son Jordan as she works with promotora Maranda Hernandez.
(From left) Monica Lara holds her son Jordan as she works with promotora Maranda Hernandez. Credit: Bonnie Arbittier / San Antonio Report

Toys litter the floor throughout a teal-colored one-bedroom home on the city’s near West Side where Beverly Chavez lives and works as a “promotora.” Her challenge? To teach struggling parents, often facing overwhelming stress, how best to nurture – and not abuse – their children.

Chavez’s home serves as an epicenter for change in an area where inequality and lack of opportunity have persisted for decades – and where nearly one-third of San Antonio’s confirmed child abuse cases occur.

“I am reaching out to all my neighbors because I think that everyone should be informed … we don’t all naturally become mothers and know what to do,” Chavez said. “Helping parents means a lot to me, because my children are growing up in this neighborhood” where a teen recently committed suicide and people are struggling with the stress of high crime and limited job opportunities.

Chavez is one of 10 promotoras – community health workers – both living and serving the area just west of Interstate 10 downtown, south of Culebra Road and north of Highway 90. She works to teach parents how best to guide and nurture their children, and how to keep them healthy and safe. She does so in an area where 41 percent of residents live in poverty, according to the U.S. Census Bureau.

Of the 5,588 confirmed cases of child abuse in San Antonio in 2017, the Texas Department of Family and Protective Services reported that more than 30 percent occurred in West San Antonio, in particular within 78207 and the zip code immediately to the northwest, 78228.

Promotora Beverly Chavez (right) plays with (clockwise, from top left) Sofia, Julian, Leilah, and Jordan.
Promotora Beverly Chavez (right) plays with (clockwise, from top left) Sofia, Julian, Leilah, and Jordan. Credit: Bonnie Arbittier / San Antonio Report

When Councilwoman Shirley Gonzales (D5) learned that her district was home to the highest incidence of child abuse in the San Antonio metropolitan area last year, she teamed up with the Family Service Association to launch a pilot program to train promotoras on how to educate the community and equip them to intervene.

Promotoras connect hard-to-reach residents, including those with cultural or language barriers, to health care agencies and organizations, Gonzales said. Because promotoras share the cultural, economic, and social characteristics of those they help, they can work better than outsiders to educate, intervene, and stop child abuse in those neighborhoods, she said.

Promotoras are a growing portion of the health service industry, driven by efforts to improve health outcomes and reduce healthcare costs by teaching people healthy behaviors and explaining how to use available healthcare services. The number of community health workers such as promotoras is expected to grow 16 percent nationwide between 2016 and 2026, according to the Bureau of Labor Statistics.

Organizations throughout the city deploy promotoras to work with residents who suffer from breast cancer, obesity, diabetes, and other chronic health issues. Getting more promotoras on the ground is the focus of one program at Northwest Vista College, which emphasizes health education, health promotion, and community outreach on a wide range of health topics, including environmental health and psychology.

With the support of City Council, Gonzales secured a two-year grant allowing 10 residents in Chavez’s zip code, 78207, to complete the required certification course to become a promotora at the Westside Education Training Center. The University of Texas at San Antonio will complete an evaluation of the program by 2020.

When the Rivard Report visited promotora training sessions on child abuse in late March, trainees – both men and women – covered topics including how to teach parents to take care of their own physical and mental health, how to spot risk factors for abuse, and how to communicate with aggressive teenagers.

Trainees focused particularly on how to raise sensitive issues so that people needing help do not fear judgment or repercussions.

Some families working with promotoras will have been referred by schools, Child Protective Services (CPS), or community centers in the area, said Veronica Salgado, parenting and youth education manager for the Family Service Association. For those families without CPS involvement, Salgado said, the easy part is getting them to agree to participate in the program – but the hard part is getting them to stay.

“We try to [pitch] the program as a learning experience instead of it being about what [parents] are doing wrong,” Salgado said. People are often guarded when it comes to sharing what happens in the home out of fear of losing custody of their children, she said, which is why promotoras who live within the community serve that same area.

“Neighbors always know what’s happening next door,” Salgado said.

Chavez agrees that she and her neighbors are wary of outsiders, and says it is easier to trust someone who lives in your community and has shared similar experiences rather than someone who works for an agency saying they want to help.

“When I am the one helping, because I am coming from the same history [and] the same background as them, they feel less judged,” she said.

Before becoming a promotora, Chavez received the support she needed to leave a dangerous relationship in which she was a victim of domestic violence. Promotoras connected her to resources in the community and made her feel like she was not alone.

They “helped [me] change [my] whole life,” she said. “If I hadn’t trusted people in the community and accepted their help and let them support me, I would still be in that same situation.”

While most promotoras do in-home visits, Chavez invites people into her home to review the curriculum, which she says can help ease the discomfort of those who feel uneasy,  afraid, or fear judgment when inviting someone into their residence.

Among the mothers Chavez meets in her home is Monica Lara, a 23-year-old single mother of four who lives next door. All four children joined Lara for her session, and throughout her conversations with the promotoras she paused throughout to hug and kiss them, and give them glasses of milk. “They are my whole world,” Lara said.

Lara denies ever becoming overly frustrated with her children or needing assistance with caring for them. Rather, she says, she participates in the program to “do more things for myself and learn more so that I can be a better mom to my kids.”

During a scheduled home visit on May 22, both Chavez and promotora Maranda Hernandez worked with Lara on the first lesson of the child abuse prevention curriculum, which explored “change, growth, and letting go.”

Monica Lara lifts her son Jordan into her lap.
Monica Lara lifts her son Jordan into her lap. Credit: Bonnie Arbittier / San Antonio Report

Discussing change, Lara spoke about her desire to get a job to provide opportunities for herself and her children, and how it would raise her sense of self-worth. “I really just want to be comfortable with myself,” she said.

When discussing letting go of unhelpful thoughts and being open to new possibilities, Lara cited moments when being a stay-at-home mother of four was difficult, including frustrations with her 1-year-old twins who are teething, constant messes throughout the house, and rarely having a quiet moment. “Sometimes it can be challenging,” she said.

From the outside looking in, Lara appears to be a loving mother to her children and understanding of their needs. She encourages them and expresses love and support.

While it may not seem as though Lara would immediately benefit from child abuse prevention education, Hernandez said that the conversations that come about as parents work through the 12-week program help them become both better parents and better people.

“When you are the nurturer, the mother, the stay-at-home parent, you are constantly thinking about the kids and never about yourself,” Hernandez said. “You usually don’t have the free time to think about anything else.”

The child abuse prevention curriculum also addresses risk factors for abuse, which can include social isolation, parenting stress, poor parent-child relationships, poverty, mental health issues such as depression, and a history of family violence, Hernandez said.

As the sole care provider for her children, Lara said she does not have friends or reach out for support. Having a promotora available to help her explore her feelings and experiences may help her avoid abusive behavior in the future, Hernandez said. In addition, teaching Lara about child abuse risk factors and how to intervene can help an entire neighborhood where shotgun houses are separated by only a few feet of space.

“Working in this community I [overhear] my neighbors saying they don’t trust a lot of people, but because I am a neighbor, I am someone who gets that trust,” Chavez said. One of the greatest needs in 78207 is for parents to create a support system so that people can get the help they need, she said. “If parents don’t get involved there is not going to be a change.”

“It’s okay for us to be [at] the poverty level, but there are so many things that will help us all that [people] can utilize,” Chavez said. “When we don’t try to learn more or use programs or ask for help, not just you [suffer], your children suffer, [too].”

(From left) Monica Lara and her sons Jordan and Julian play in their neighbor and promotora's front yard.
(from left) Monica Lara and her sons Jordan and Julian play in their neighbor and promotora’s front yard. Credit: Bonnie Arbittier / San Antonio Report
Roseanna Garza

Roseanna Garza

Roseanna Garza reports on health and bioscience for the San Antonio Report.