Melanie R. Wasserman, MPA, School of Public Health, Department of Health Policy and Administration, University of North Carolina at Chapel Hill, McGavran Greenberg Hall, CB#7411, Chapel Hill, NC 27599-7411, 919-960-8521, wasserma@email.unc.edu, Deborah Bender, PhD MPH, Health Policy and Administration, The University of North Carolina, C.B. 7411, Chapel Hill, NC 27599, Shoou-Yih Daniel Lee, PhD, Department of Health Policy and Administration, University of North Carolina at Chapel Hill, 1101 McGavran-Greenberg Hall, CB# 7411, Chapel Hill, NC 27599-7411, Joseph Morrissey, PhD, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 101 Conner Drive, SUite 302, Campus Box 3386, Chapel Hill, NC 27599-3386, Ted Mouw, PhD, Department of Sociology, UNC-Chapel Hill, CB# 3210, Hamilton Hall, Chapel Hill, NC 27599-2310, and Edward Norton, PhD, School of PUblic Health, University of North Carolina-Chapel Hill, McGavran-Greenberg Hall, Chapel Hill, NC 27599.

In the 1990s, North Carolina experienced a 394% increase in its Latino population. To help new immigrants access various services, several programs in North Carolina sought to connect immigrants with bridge persons (bilingual persons, promotoras, or advocates). This study presents results related to the prevalence of bridge persons in four counties and their effect on utilization of preventive health services (immunizations, cervical cancer screening). DATA: Because NC Latino immigrant populations are “hidden” and geographically dispersed, we used a church-based sampling strategy to collect cross-sectional data (N=229). Complementary photo-narrative qualitative data were collected from a 10% subsample. METHODS: Chi-square tests adjusted for sampling weights were used to test binary associations between bridge persons and use of preventive health services. Survey logistic regressions were used to control for confounding variables. A content analysis approach was applied to qualitative data. RESULTS: 46% of respondents knew bridge persons. Several bridge person profiles are associated with increased probabilities of up-to-date utilization (p<.10). Promotoras are more effective than other bridge persons, but only 14% of all respondents know one. In multivariate models, bridge persons account for 8-15% increases in the likelihood of up-to-date immunizations and pap screening (p<.10). Qualitative data describing women’s migration transitions suggest more ways which bridge persons can promote access healthcare. CONCLUSION: Bridge persons help immigrants to access healthcare; however persons who are specifically trained (promotoras) appear to be more effective. Providing healthcare training to a broader range of bridge person profiles could improve the use of recommended preventive health services.

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