"No Queremos Quedar Mal": A Qualitative Analysis of a Boundary Setting Training Among Latina Community Health Workers

Community health workers (CHWs)-or promotoras de salud in Spanish-have successfully addressed the health needs of Latinx and immigrant populations. However, for promotoras, setting boundaries is particularly difficult given challenges like residing in the same communities as their participants. The purpose of this study was to describe the development and impact of a boundary setting training to support the emotional well-being of immigrant promotoras. The training (four 1-hr sessions) was informed by social cognitive theory and a Chicana feminist framework. The promotoras who participated in the training helped create Lazos Hispanos, a community-based participatory research (CBPR) study and CHW program located in the Southeastern United States. The goal of Lazos Hispanos is to increase access to health and social services among local Latinx community members. Five promotoras completed the training after 1 year of participating in the program. Thematic analysis was used to interpret findings from two semistructured group interviews. Two themes emerged: (1) the promotoras negotiated gendered and cultural expectations when setting boundaries, and (2) they felt a stronger sense of personal and professional agency. Findings suggest that this boundary setting training had a positive effect on their sense of professionalism, emotional well-being, and ability to establish boundaries. They reported having less guilt and anxiety as they navigated gendered and culturally informed expectations. Similar training could be adapted to other immigrant and minoritized groups.