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Josie Mejia

  • Author: Josie Mejia
  • Date Submitted: Dec 30, 2019
  • Category: Cancer Care

Josie Mejia spent most of her life working in the Department of Motor Vehicles in Tulare. She knew her job and she liked helping people, but she never imagined that one day, she would become a teacher.

But in 2013, four years after breast cancer forced Josie into early retirement to focus on treatment and healing, she became a teacher of sorts thanks to a collaborative project between Kaweah Health and the University of California, San Francisco (UCSF).

"I was able to help others, but at the same time I was learning, too," said Josie, who as a cancer survivor, was hired as a compañera or a companion by Kaweah Health’s Community Outreach Department to teach Spanish-speaking women with breast cancer stress management and provide them with healthy lifestyle and survivorship information. “Some of the things in the program would have helped me out a lot when I was sitting there getting my chemo.”

The three-year UCSF study called Nuevo Amanacer II, “new dawn” in English, sought to improve the quality of life among Spanish-speaking women with breast cancer in rural communities. Kaweah Health was one of three research sites chosen for the study and compañeras such as Josie played a vital part in the study as they met with 54 women in Tulare and Kings counties with non-metastatic breast cancer. More than half of all the participants in the study had Medi-Cal or no insurance. The study was first published in October.

“We visited participants once a week and every week was a different subject. We started with understanding cancer, then we went on to talk about how to communicate with our medical team with our medical family,” said Josie, noting that deep breathing exercises for relaxation were taught along with techniques on how to reframe negative thoughts. “A lot of times when you are going through something like this, that’s all you have is negative thoughts, but there are ways to change our thinking so we can be more positive, accept what we are going through, and move on.”

Anna María Nápoles, Ph.D., M.P.H., now Scientific Director of the National Institute on Minority Health and Health Disparities (NIMHD), who led the study while she was Director of the UCSF Center for Aging in Diverse Communities, said this was about teaching people skills to manage stress in their daily lives, which are ultimately skills that can benefit anyone. One of them was how to be open and honest with physicians.

“One of the things we found was Latina women are less likely to report their symptoms to their physicians and also are less likely to receive the services to maintain their health,” Anna said. “It’s important to know how to communicate with your medical team. Don’t be afraid to ask questions, don’t be afraid to report the symptoms, pick up the phone and call about getting in to see a physician if you feel like you need one.”

As a compañera, Josie bonded with the women as a breast cancer survivor, but quickly came to appreciate how different each woman’s support system was and how that played into their journey with cancer.

“We don’t all have the same level of support within our families and in our circle of our friends. Some of us are blessed to have a lot of support, while some of these women had no support at all,” Josie said. “This program was a chance to provide resources for women. There are so many resources that are available and we don’t all know about them. Many of these women don’t have computers. They don’t have the means to research, so for them having the resources there and being able to access them was a great help.”

Eldamira Ramirez, one of the study’s Visalia participants, said the program and Josie, her compañera, helped her in more ways than one. The two, who also knew each other through their daughters, have since forged a friendship from meeting weekly.

“It was very helpful for me because when you are told you have cancer, it’s like your life is ending and you don’t know how to talk to your family,” she said. “It was very helpful to help us understand there are people who can help us and we can relate with them and talk to them about cancer and how to treat it.”

What This Program Offered:

  • Cancer information in Spanish
  • Stress management techniques
  • Communciation skills
  • Emotional support from a breast cancer survivor
  • Techniques for managing negative thoughts and emotions
  • Goal-setting for taking care of oneself

What Were The Results:

  • Less anxiety
  • Less bodily symptoms of stress
  • Improved ability to relax
  • Improved awareness of tension
  • Improved ability to seek support
  • Improved coping confidence

Kaweah Health Community Outreach

For more information on Kaweah Health’s Community Outreach Program and free workshops it offers our community on balance, chronic pain self-management, along with diabetes support groups, visit