The Journal of Extension -

April 2009 // Volume 47 // Number 2 // Ideas at Work // v47-2iw3

Health and Safety Events for Latino Families: Collaborating to Create El Día de los Niños Celebración

Latino immigrants to rural counties within North Carolina are at an increased risk for experiencing injury, health complications, and chronic illness. This is due largely to the fact that many new immigrants arrive with limited knowledge of the health and safety risks that are present in their communities. To reduce the incidence of injury and health complications, programs must be developed to increase local awareness of these risks. This article outlines the collaborative efforts of one rural North Carolina community to develop and implement a community-based health and safety event for Latino families.

Andrew O. Behnke
Assistant Professor
North Carolina State University
Raleigh, North Carolina

Christine Falk
Graduate Student
University of North Carolina at Greensboro
Greensboro, North Carolina

Julia F. Storm
Extension Agromedicine Information Specialist
North Carolina State University
Raleigh, North Carolina


Between 1980 and 2000, the Latino population in rural and small-town America nearly doubled, from 1.4 to 2.7 million, and is now the most rapidly growing segment of the population in rural counties (U.S. Census Bureau, 2007). One state to see a significant increase in the rural Latino population is North Carolina. Between the years 1990 and 2000, North Carolina experienced an influx of Latino immigrants, ranking first in regard to change in a state's overall Latino population (Kochhar, Suro, & Tafoya, 2005). Immigrant Latinos in North Carolina often arrive in rural communities with little knowledge of the health and safety risks that exist. Unfortunately, this lack of knowledge can lead to undesirable outcomes, including injury, health complications, and death (Kandel, 2005).

Overall, Latinos are at an increased risk for unintentional injuries (Mallonee, 2003) and an increased risk for health complications and chronic illnesses, including obesity, diabetes, asthma, and dental caries (Flores, Olson, & Tomany-Korman, 2005). In North Carolina this issue is complicated by the fact that a majority of Spanish-speaking Latinos lack access to health care, in part because more than two-thirds (69%) are uninsured and the majority cannot communicate in English (Herrick & Gizlice, 2004).

Many injuries, chronic illnesses, and deaths could be prevented through integrated programming to inform this population of the health and safety issues present within their community. This article outlines the efforts of one rural North Carolina community to educate the Latino population about how to recognize hazards and prevent negative health and safety outcomes.

Program Planning and Development

Due to the significant need for health and safety information among rural Latino immigrant families (Kandel, 2005), 32 community partners were brought together to develop and evaluate a community-based rural health and safety program in northwestern North Carolina. The intention of the program was to address many of the health and safety risks that rural Latino immigrants face and to educate families on preventive measures that can be taken to reduce or eliminate these risks.

Members of the local Latino community were recruited to carry out a significant amount of the program planning and development. Eleven Hispanic women participating in a weekly English as a Second Language (ESL) class hosted by the Watauga County Cooperative Extension Center were heavily involved in the planning and implementation of the program. These women proposed most of the health and safety topics, promoted the event in the community, were featured in radio public service announcements and newspaper articles, participated in fund-raising, engaged additional community volunteers, contributed to and reviewed educational content, and served as co-presenters during educational workshop sessions. ESL class members were also integral in the program evaluation, providing several suggestions at the completion of the program as to how the event could be improved.

Local youth were also involved in the planning process, working with support from the Watauga County Cooperative Extension 4-H agent to develop a Latino family health and safety calendar, as well as to adapt a bilingual safety-related script for a puppet show performed outdoors during the event.

Program Description

The culminating event, El Día de los Niños Celebración, was created with the specific goals of increasing families' knowledge of rural health and safety issues, increasing the use of health and safety practices, and preventing injury and illness. The 1-day event was the first of its kind in North Carolina and included six, 20-minute rotating concurrent sessions presented in Spanish on the following topics: community safety; safety at home; food safety; fire safety; vehicle and bicycle safety; and workplace safety. Each concurrent session was co-presented by a Hispanic community member and a subject-matter educator (Extension agent, fire-fighter, etc.).

In addition to participating in these educational sessions, families were invited to participate in various games and to enjoy dinner and live music. Numerous health and safety items were raffled off to families, including flashlights, sunscreen, fire extinguishers, and fire and carbon monoxide alarms. In addition, the Watauga County Health Department provided free tetanus shots, the American Red Cross provided first aid kits, and the Town of Boone provided families with properly fitted car booster seats and bicycle helmets.

Several local organizations and community volunteers took part in the execution of the daylong event, including Farm Safety Just 4 Kids, Safe Kids of North Carolina (Watauga chapter), Watauga County Children's Council, Appalachian Regional Healthcare System, the American Red Cross, the Town of Boone, the Blowing Rock Fire Department, and Cooperative Extension staff from local and neighboring counties.

Program Outcomes

El Día de los Niños Celebración was successful in reaching over 125 local families and providing them with information and safety materials. Twenty-three participants were interviewed and surveyed on their experiences at the event. Most reported that they enjoyed learning through the experiential learning activities (e.g., safety Bingo, household chemical display, child safety mobile exhibit). Participants also commented on how nice it was to have so many Spanish-speaking volunteers (over 30) to learn from and interact with and appreciated the Spanish language posters that were placed all around the event. Other participants commented on the fact that the event "rallied the Latino community together" and created an awareness of other groups working in the community to serve Latino families.

The event also had a tremendous impact on the group of 11 Latina women involved in the planning and development process. The women reported that participating in the event changed their lives in many ways, allowing them to learn how to be leaders and providing them with the opportunity to make a difference in their community.

In addition to these achievements, unexpected successes came out of the implementation of the event. For example, local participating agencies (e.g., NC Farm Bureau) realized after participation that there was a need within their agency to develop certain materials in Spanish and have since created these products. Connections were also made with local organizations for continued workshops, such as CPR training.

Program Replication

To facilitate the implementation of similar programs, the event was videotaped. DVDs of the recorded event and "lessons learned" handouts developed from the qualitative data collected at the conclusion of the event were made available to interested partners. A set of eight large Spanish-language posters was created and formed into a health and safety starter kit to address issues including safety on the job, safety in the community, and safety around the home.

The feedback from the focus groups also resulted in the creation of a free DVD for new immigrant Latino families entitled "Living in the United States: A guide to the educational, health, residence, and Law Enforcement Systems" (Viviendo en los Estados Unidos: Una guía a los sistemas de educación, salud, vivienda, y seguridad publica). Since Ninety-three percent of participants reported having DVD players and televisions, and this Spanish-language DVD offers six short video presentations on basic information and resources for safety and health in the United States. Due to the success of the initial program, Watauga County Cooperative Extension plans to continue to implement this event on a biannual basis incorporating the key lessons learned.


It is critical that programs are developed and implemented that help to educate rural Latinos about how they can protect their families from the health and safety risks present in their community. Informing this hard-to-reach audience about preventive measures regarding these issues has the potential to reduce the number of negative health outcomes and unintentional injuries experienced by rural Latinos and to prevent significant health and wellness related cost burdens for North Carolina. Taking an approach such as that used by El Día de los Niños Celebración that involves the entire community can be very successful in conveying these health and safety messages.


Flores, G., Olson, S. C., & Tomany-Korman, L. (2005). Racial and ethnic disparities in early childhood health and healthcare. Pediatrics, 115, 183-193.

Herrick, H., & Gizlice, Z. (2004). Spanish-speaking Hispanics in North Carolina: Health status, access to health care, and quality of life (Results from the 2002 and 2003 NC BRFSS surveys). NC Public Health Special Report Series by the State Center for Health Statistics. Report No. 143. NC Department of Health and Human Services. Retrieved May 14, 2008 from:

Kandel, W. (2005, December). Rural Hispanics at a glance. (Economic Research Service Information Bulletin Number 8). Washington, DC: U.S. Department of Agriculture. Retrieved May 14, 2008 from:

Kochhar, R., Suro, R., & Tofoya, S. (2005). The new Latino south: The context and consequences of rapid population growth. Pew Hispanic Center: Washington, D.C. Retrieved May 14, 2008 from:

Mallonee, S. (2003). Injuries among Hispanics in the United States: Implications for research. Journal of Transcultural Nursing, 14, 217-226.

U.S. Census Bureau. (2007). U.S. Hispanic Population: 2006. Washington, DC: U.S. Department of Commerce, Economics and Statistics Administration.