1. Community Project Reaching the Underserved RAEJEANNE GUIZAR DIXIE STATE UNIVERSITY

2. Community Assessment  Latinos are a minority group that experiences socioeconomic disparities  According to 2009 U.S. Census data, Hispanics had the lowest rate of insurance coverage of any other U.S. racial or ethnic group  only 39.6% of Mexicans had private insurance coverage (Ennis, Rios- Vargas, & Albert, 2011)  Hispanics had more preventable hospitalizations than the minority group (CDC, 2012).  Hispanic teens had higher rates of obesity than white and black teens (CDC, 2012)

3. Identification of Needs  Provide teaching about ways to obtain health care  Offer information about ways to improve health that can be accomplished as a complement to, or even in the lack of, health insurance and access to primary care  Specific needs: access to healthcare  Specific disorders: cardiovascular disease and obesity  Cardiovascular disease is the leading cause of death for Latino women, and the second leading cause of death for Latinos overall (CDC, 2012).

4. Plan of Action  Latino Health Access, a successful informatory and action-based community health program in California, suggests that has been successful in improving outcomes based on interventions that target people anywhere from garages to churches  Community based intervention designed to reach people where they are  I went out into the community to talk with people and offer them resources they can use  Goal: improve access to healthcare and knowledge to improve lifestyle choices

5. Healthy People 2020  Topic from Healthy People 2020: Access to Health Service  Objective: As stated by Healthy People 2020 (2013), an objective is to “Reduce the proportion of persons who are unable to obtain or delay in obtaining necessary medical care, dental care, or prescription medicines” (web).  As previously stated, Latinos had a disproportionate rate of preventable hospitalizations. This data, paired with low insurance rates, shows a need for better education and access to care.

6. Impact According to Perez, a professor of Public Health at Nova Southeastern University (n.d.), “Lack of access to primary and preventative care results in higher use of unnecessary emergency room services, higher health care costs and poor quality of care” (web).

7. Research on Healthcare Options  Identified key sources of care and alternatives for Latinos without health insurance  Examples:  Dr.’s Volunteer Clinic: Offers medical, dental, and general services to families without health insurance who are 150% below the poverty line.  InstaCare: Even when families don’t have insurance, this option is significantly cheaper than an E.R. visit.

8. Educational Material  Pamphlet developed to provide informational material on addressing healthcare concerns:  Cardiovascular disease: Statistics and lifestyle recommendations  Information on symptoms of a cardiac emergency presented  Encouraged to change modifiable risk factors, such as blood pressure and weight  This, in turn, also decreases risks for diabetes and obesity as readers taught to maintain a healthy weight, follow a healthy diet, exercise regularly, and participate in health screenings

9. Access to Care  Information on when to attend which healthcare providers was provided:  i.e. when to choose an InstaCare as opposed to E.R.  Contact information provided to improve access to care providers  Resources identified: Information websites, provided in Spanish, were listed to offer further healthcare information

10. Brochure: Tri-fold side a Spanish

11. Brochure: Tri-fold side a English

12. Brochure: Tri-fold side b Spanish

13. Brochure: Tri-fold side b English

14. Distribution  Information was presented on a personal level  Conversational approach used  Each person or family given a brochure  Spanish was primarily used in conversation; brochures offered in Spanish  Similarly to Latino Health Access (2012), local venues such as the Three Amigos Market, were used as platforms (with establishment consent)  Many venues allowed extra brochures to be put on display for continued public access

15. Communication Considerations  Because a focus was placed on communication and sincerity, most conversations were not photographed  The focus was kept on the individual and the distraction of photography was avoided  Concern: asking local residents for multiple photographs may result in mistrust regarding motives, or impair communication

16. Implementation Distributing brochures at a local park

17. Local Laundromat Latino Health Access (2012) suggested using Laundromats for an access point. Brochures were distributed at the above location.

18. Increase Reach  Although many brochures were distributed to people directly, several were put on display at various public locations so that people could continue to access them.

19. Educational materials at a local establishment: Networking promoted education and communication.

20. More ways this community was reached: Local Market Three Amigos Market: Caters to Latino population. Business consented to distributing further brochures in addition to providing a platform for conversation. Reach Out Person-to-person contact. Local Hangouts Families approached while in a leisure environment (local park, Vernon Worthen).

21. Local Families Families had a positive reception to the information. This individual requested four additional brochures to give to family members not present that day.

22. Key Points  Community needs addressed through education and communication  Brochures distributed to community members  Person-to-person contact  Communication with local businesses  Families requested extras to give to friends/extended family  Will continue to provide educational material to community members, and discuss community concerns  Focus: education.  Goal of educating community to improve community access to healthcare and address health concerns met through communication and community interaction

23. References  Centers for Disease Control and Prevention [CDC]. (2012). Observances ~ September 15 th - October 15 th : Hispanic/Latino heritage month. Retrieved from http://www.cdc.gov/mmwr/PDF/wk/mm5340.pdf  Ennis, S.R., Rios-Vargas, M., and Albert, N.G. (2011). The Hispanic population: 2010. Retrieved from http://www.census.gov/prod/cen2010/briefs/c2010br-04.pdf  Healthy People 2020. (2013). Access to healthcare. Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=1#56  Intermountain Healthcare. (2013). InstaCare: Urgent care clinics. Retrieved from http://intermountainhealthcare.org/services/medicalgroup/clinics/instacare/  Latino Health Access. (2012). Latino health access. Retrieved from http://www.latinohealthaccess.net/  The Office of Minority Health. (2012). Hispanic/Latino profile. Retrieved from http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=54  Perez, A.M. (n.d.). Providing primary and preventative care to undocumented immigrants: Issues of access, quality and cost [PowerPoint Slides]. Retrieved from http://www.oucom.ohiou.edu/hpf/pdf/PPT/A%20Perez%20Undocumented%20immigrants%20presentation%20rev. pdf