Cover Story

Teach people how to make good decisions, and good outcomes will follow, says clinical psychologist Martha Givaudan, PhD.

With that message, Givaudan has helped inspire a 300 percent increase in Mexico's cervical cancer screenings and integrated sexual education and substance abuse prevention training into Mexico public schools' curriculum.

Givaudan, executive vice president of the nonprofit Mexican Institute of Investigation of Family and Population (IMIFAP) in Mexico City, tailors research-based approaches to help people live healthier lives. IMIFAP provides health education to marginalized communities throughout Mexico and 14 other Latin American countries. Today, the organization's "Yo Quiero, Yo Puedo" ("I want to, I can") programs on substance abuse, domestic violence prevention and more have reached 17.5 million Hispanics. The programs encourage people to make self-directed but informed decisions to improve their quality of life, Givaudan says.

Success hasn't come easy. In some rural communities, she encountered people who lacked basic education about hygiene, and she had to teach them the importance of such skills as brushing their teeth before educating them about safe sex and annual Pap smears.

"We found that the people here sometimes need to start from scratch," says Givaudan.

She also had to overcome cultural barriers--avoiding, for example, a common health education exercise that asks participants to close their eyes and imagine their future, because individuals of Mayan descent associate this with death.

Givaudan is now heading an education program on a condition that affects 16 percent of people who live on the U.S.-Mexico border: diabetes. Due to the stressful living conditions, the condition's prevalence here is higher than in nonborder states in the United States and Mexico. With support from Pfizer, IMIFAP is training clinicians about proper nutrition and exercise habits for diabetes prevention, emphasizing social skill development in stress management and decision-making to reach the 5,000 at-risk adults in the region, Givaudan says.

Similarly, with funding from the Elton John AIDS Foundation and Mexico's Ministry of Education, IMIFAP has launched an interactive media campaign to increase knowledge and dispel myths about HIV/AIDS among 300,000 children and adolescents in 18 Mexican states. Programs like this teach teenagers how to communicate and serve as a "vaccine" against unhealthy actions, says Givaudan. "You can provide a lot of information about many things...but if you do not have the skills in how to make decisions and take responsibility for your actions, it's difficult to change behaviors," Givaudan says.

--A. Cynkar