The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #68314

Miguel A. Zuniga, MD, DrPH, Martha Conkling Tromp, MSPH, and Craig H. Blakely, PhD, MPH. Health Policy and Management, Texas A&M University School of Rural Public Health, 3000 Briarcrest Drive, Suite 300, Bryan, TX 77802, 979.862.4142, mzuniga@srph.tamushsc.edu

PURPOSE: Major goals of this intervention project are to improve the ability of the lay health workers (promotoras) to impact the health behaviors of the residents and to integrate their activities with the actions of the health providers in the area to change access and utilization rates. Analysis of administrative data from health services facilities in the Colonias are being used to assess project impact

METHODS: Health provider records at the participating health clinics and hospitals are being analyzed, throughout the project period, to assess changing patterns of services potentially influenced by the promotora outreach efforts and the project partners altered inter-organizational relationships. The facility data includes anonymous records from clinic and hospital records of any or all patients of all ages and both genders. An effort is underway to continually gather information on individuals identified through a longitudinal household survey and an ethnographic study to assess health care utilization. This subset of the data is allowing project evaluators to track the system access by identified members of the household survey effort.

RESULTS: Success is measured by the relative increase of Colonia resident referrals by the Promotoras, the conversion of all Colonia residents seen in study facilities to one or more of the public insurance programs available (i.e. Medicaid, CHIP, State funded care program), and by repeated visits of individual Colonia residents to health care facilities in the study. Rates of referrals, insurance conversions and continuity of care are presented.

Learning Objectives:

• At the conclusion of the session, the participant (learner) in this session will be able to:
• 1. Evaluate health facility data from hospital and clinic records.
• 2. Discuss health access issues among residents in the colonias.
• 3. Assess whether hospitals and clinics are fulfilling the needs of this population and what role the promotora is playing in regards to health access.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.