Ethnicity and health knowledge gaps: Impact of the California Wellness Guide on poor African American, Hispanic, and non-Hispanic White women

This investigation, which was based on a secondary data analysis, examined the impact on poor African American, Hispanic, and non-Hispanic White women of a health promotion intervention sponsored by The California Wellness Foundation. The intervention was built around the Wellness Guide (the Guide), an extensive booklet containing a wealth of information about issues related to health and well-being at each stage of life. The Guide, or its Spanish adaptation, La Guia, was distributed to participants in the State of California's Women, Infant, and Children program at 24 clinics; 12 other sites served as control clinics. A questionnaire incorporating various measures of knowledge, knowledge confidence, information acquisition skills, and behavior was administered prior to and after distribution of the Guide. Results revealed a substantial gap in wellbeing-related knowledge and information acquisition skills between Hispanic clients, who scored very poorly on most measures, and African American and non-Hispanic clients, who seldom differed from each other. The intervention was found to be effective in increasing knowledge and information acquisition skills for all three groups. There was no strong or consistent evidence that the intervention benefited any one group more than the others. However, African Americans and non-Hispanic Whites were about twice as likely as Hispanics to report having contacted a health or human service organization as a result of their exposure to the Guide. Theoretical and practical implications of these findings are discussed, with special consideration given to the unique health circumstances of poor Hispanic women, many of whom are low in acculturation.