nized in terms of program inputs (e.g., the problem being addressed, characteristics of the client’s circumstances, resources needed, and content of the program); the activities or outputs of the program; and the outcome objectives (including increases in knowledge and skills, modified behavior). The evaluation portion of this model focuses on establishing quantitative performance standards (e.g., how many individuals will change their behavior in the required direction and over what time period). This model is currently being used in Arizona to develop, implement, and evaluate the “Tell a Friend Campaign.” This campaign, discussed later in the chapter, is designed to increase poison control center access across the state through community partnerships and the distribution of multilingual educational materials.

A third communication model entitled “A Su Salud” aims to change behavior by using positive role models and volunteers from the community to provide positive social support. This model has been implemented by the Texas Department of Health to encourage the use of screening for breast and cervical cancer in diverse communities (Suarez et al., 1993) and is currently being employed by the South Texas Poison Center in an attempt to increase awareness of poison center services in the Hispanic community.

THE CHALLENGE OF ETHNIC DIVERSITY

Current demographic trends show that the U.S. population is growing larger, older, and more ethnically diverse. Hispanics are now the largest minority and are projected to grow to 23 percent of the population by 2045. In some states, such as California, many cultures and languages are represented in the population. What are the challenges these trends pose for poison control center educators?

Penetrance data available from the American Association of Poison Control Centers (AAPCC) show different levels of poison control center use in ethnically diverse and low-income communities (American Association of Poison Control Centers, 2003b). One study that illustrates different poison control center use patterns by different population segments was conducted at a Texas medical center by Kelly et al. (1997). The purpose of the study was to characterize and compare caretakers of children who failed to contact the poison control center about unintentional poisonings prior to visiting an emergency department with those who used the center first and were then referred to the emergency department. Comparisons were made by age, gender, relationship to the child, ethnicity, language preference, education, and marital status. The results showed that whites were most likely to call a poison control center, followed by Hispanics and then blacks. Also, caretakers schooled in Mexico



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