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"We were spending a lot of money all over the world and the results weren't that great," Sexton said. "But as we looked around this area and saw the unemployment rate was high but education levels low, we realized that there are people in our own community who want to be productive individuals who can fill these jobs."

Minorities comprise about 30 percent of the total U.S. population, but represent just 12 percent of the nursing workforce, according to the American Nurses Association.

Sexton said there's no reason that collaborative efforts such as VIDA can't work nationwide to help bridge that gap, "as long as they have an elevated level of energy and focus."

McAllen city officials committed $350,000 to the VIDA program in a partnership with the Houston Endowment and Texas Workforce Commission. The Levi Strauss Foundation and other organizations also have stepped forward.

Other approaches

A few thousand miles away to the northeast in Cleveland, Hispanics comprise the city's fastest-growing population segment-a demographic that has helped spur a new nursing-education program for high school students and older adults called Creando Posibilidades, or Creating Possibilities.

Launched in July by social service provider El Barrio, Creando Posibilidades is based in part on a Phoenix program at Maryvale High School Student Nursing Academy.

The Cleveland program is designed to increase the number of bilingual health care workers locally and help Hispanic youth stay in school while ultimately preparing for high-demand nursing jobs. Its main offshoot, the nursing academy at Lincoln-West High School in inner-city Cleveland, is set to open in the fall of 2004.

There, students will take advanced courses in science, math, medical terminology, time management, communications and life skills, and attend a series of counseling workshops and lectures, plus have the opportunity to shadow local nurses. El Barrio and its partners also are working with elementary and middle schools to provide additional early exposure to health care education, said Jaren Wilson, project coordinator for Creando Posibilidades.

"At the end of their junior year in high school, they can start taking class work to be a [licensed practical nurse]," Wilson said. "It's an immensely upwardly mobile and innovative program that can help solve so many problems. By the time these students graduate, many will have earned their LPN and be making about $13 per hour."

For adults, Creando Posibilidades will offer the Patient Care Nursing Assistant training program to bilingual people older than 18 with a high school degree or equivalency. Its students will enroll in an intensive five-week training program and upon completion, be offered patient care nursing assistants' jobs at the Cleveland Clinic, receiving full health insurance and tuition reimbursement.

The projects are funded by a combined $1.3 million from the local Cleveland Clinic Foundation, area hospitals and the nation's largest health care philanthropic organization, the Robert Wood Johnson Foundation.

Hurdles to clear

Minorities face more barriers to nursing careers than a simple lack of resources, a study by the Center for the Health Professions at the University of California, San Francisco, found. These include poor high school career counseling and career path tracking, gaps between professional and culturally familiar worlds and lack of information about nursing and nursing education, according to the 2001 report, "Diversifying the Nursing Workforce: A California Imperative."

Those findings, plus the ever-growing nurse shortage, imply a need for major systemic changes in nursing curriculums, said Ed O'Neil, a professor of medicine and director of the Center for the Health Professions and principal report researcher. Needed are more programs that foster partnerships between education, employers and health care, more minority faculty role models and more recruitment funding, he said.

O'Neil said there is confusion about the multiple entry levels of nursing that will lead to an RN designation. A career pathway that accepts a broader set of practices building to an RN designation is essential to attract more minorities, he said. Hospitals, for example, could expand their volunteer programs to expose people to options in health care, and area colleges, in turn, could apply that credit to nurse training programs, O'Neil said.

Although making up more than 30 percent of California's population, Hispanics constitute only 4 percent of practicing nurses in the state, the study said. African Americans also are underrepresented, making up about 7 percent of the state's population yet only 4 percent of its nurses.