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A Su Salud

Grant: 1R01CA38347


A Su Salud, part of a larger program called Programa A Su Salud (To Your Health), sought to study and demonstrate the effectiveness of mass media health messages using culturally relevant role models from the local community. Attention to media messages and imitation of role models of positive behavior, such as quitting smoking, were reinforced with printed materials distributed by community volunteers. Randomly selected community members also were offered one-on-one counseling to deal with specific health risks. The Eagle Pass A Su Salud program was organized as a supporting unit for local public health services, which did not have staff for significant efforts beyond their primary mandates to serve clients with clinic-based services. The Texas Department of Health provided an authorizing and administrative oversight, viewing the program as an opportunity to test new approaches to community outreach and as a way to help deliver needed education to the study community.


  • Amelie G. Ramirez, DrPH
    IHPR, The University of Texas Health Science Center at San Antonio (at Baylor College of Medicine and The University of Texas Health Science Center at Houston for this project)


Texas Department of Health


Eagle Pass, Texas, and surrounding areas


A broad program of community health promotion was implemented in Eagle Pass, including an intensive media campaign featuring role models of positive behavior, recruitment of more than 100 volunteers to promote role-model imitation, and community organization to stimulate policy changes that could influence health behavior (i.e., a city ordinance to restrict smoking). The long-term, partly randomized study assessed effects on behavior through survey instruments and, in the case of smoking cessation, biochemical validation of self-reports. Results showed that, in the community exposed to the mass media and peer network, an 18-percent smoking cessation (one year without smoking) rate was seen, compared to 7.5 percent in a control community with no organized campaign. Surprisingly, the group that had received the media, peer network and personal counseling campaign had a 16 percent quit rate – 2 percentage points lower than those exposed to mass media and interpersonal communications alone. The results from these case studies illustrate the kind of results that can be obtained by applying combined media and interpersonal communications, and that the necessary behavioral journalism and community networking skills require relatively little training. It also shows that much can be done to improve Hispanic/Latino health by implementing health promotion and disease prevention interventions by applying combined media and interpersonal communications using a theory-based model of change.


  • Gonzales R, McAlister A, Ramirez A, Amezcua C, Cardenas C. 1994. Volunteer Health Promoters in Eagle Pass, Texas. Border Health Journal, 10(4).
  • Aguirre-Molina M, Ramirez AG and Ramirez M. 1993. Health Promotion and Disease Prevention Strategies. Public Health Reports, 108(5): p. 559-564.
  • McAlister A, Ramirez AG, Amezcua C, Pulley L, Stern M, Gallion K, et al. 1992. Smoking Cessation in Texas-Mexico Border Communities: A Quasi-experimental Panel Study. American Journal of Health Promotion, 6(4): 274-279.
  • Cousins, JH, et al. 1992. Family Versus Individually Oriented Intervention for Weight Loss in Mexican American Women. Public Health Reports, 107(5): p. 549-555.
  • Foreyt, J, Ramirez AG, and Cousins J. 1991. Cuidando El Corazon – A Weight-reduction Intervention for Mexican Americans. The American Journal of Clinical Nutrition, 53(6 Suppl): p. 1639S-1641S.
  • Amezcua D, McAlister A, Ramirez AG, Espinoza R. 1990. A Su Salud: Health Promotion in a Mexican-American Border Community, in Health Promotion at the Community Level, N.F. Bracht, Editor. Sage Publications: Newbury Park.
  • Ramirez, AG, & McAlister, AL. 1988. Mass media campaign – A Su Salud. American Journal of Preventive Medicine, 17, 5, 608-621.