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

Abstract #69819

Mira Levinson, MPH¹, Rodolfo R. Vega, PhD¹, Michael S. Levy, PhD², Charles R. Carnahan, MDiv, MBA², Miranda H. Turner¹, and Dora Levinson¹. (1) JSI Research and Training Institute, Inc., 44 Farnsworth Street, Boston, MA 02210, 617-482-9485, mlevinson@jsi.com, (2) CAB Health & Recovery Services, Inc., 111 Middleton Road, Danvers, MA 01923

Proyecto Encuentros is a SAMHSA/CSAT-funded program in Lynn, Massachusetts, designed to provide outreach, case management, and substance abuse services to high-risk Latinos and African Americans at risk for HIV. In two years the project has made 2571 outreach contacts; approximately 836 are unduplicated. Of these, only 56 are receiving case management services, despite the unique, culturally tailored program-design. For every 15 individuals contacted, one enters Proyecto Encuentros, and for every 46 outreach encounters, one eventually leads to program enrollment. Meanwhile, the outreach team has been working for two years or more with some individuals who still have not accepted services.

Our study asks: Are there any structural, cultural, or social differences between those enrolled to receive case management services and those not enrolled? What are the characteristics of individuals that have not accepted services? How are they different from individuals that have accepted case management and even treatment services? Are those refusing to enter accessing services elsewhere? Is the outreach interaction more comfortable to these individuals than the idea of case management and treatment? Do these individuals want to enter treatment?

In order to explore these questions, we employed methodologies including geographic information system mapping (GIS) and quantitative and qualitative surveys. GIS was used to compare locations of outreach contacts, community resources and arrest locations. Quantitative analysis included surveys of enrolled and non-enrolled individuals, demographic and risk information of outreach contacts, and area population data. Qualitative tools included open-ended conversations with outreach staff and in-depth interviews with non-enrolled outreach contacts.

Learning Objectives:

• At the conclusion of the session, the participant in this session will be able to:
• 1. List three approaches to identifying barriers to access to care among outreach contacts.
• 2. Identify and use existing data and community resources in order to respond to resource gaps.
• 3. Recognize the utility of employing diverse methodological approaches toward effective service delivery for hard-to-reach populations.

Keywords: Service Integration, Out-of-Treatment Drug Users

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: The principal author is a contracted program evaluator for CAB Health and Recovery Services, Inc.