Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111212

Lise M. Youngblade, PhD, Donna Hope Wegener, MA, and Laura A. Curry, PhD. Institute for Child Health Policy, University of Florida, 1329 SW 16th St., Room 5130, Gainesville, FL 32608, (352) 265-7220 x 86269, lmy@ichp.ufl.edu

All children need a medical home, and this is especially so for children with special health care needs (CSHCN). Many uninsured CSHCN receive care in safety net settings such as community health centers. However, these CSHCN often face barriers to comprehensive healthcare in a medical home owing in part to lack of insurance, fear, acculturation or language issues, and lack of experience with organized health care. These issues are often especially salient in impoverished communities, very rural areas, and in migrant communities. Creative strategies are needed to overcome these barriers. Significant ethnographic research documents the importance of the matriarchal family structure in Black and Hispanic families, and underscores the importance of grandmothers as sources of knowledge, expertise, control, and approval. This presentation describes Telehealth Connections, a creative project that mobilizes this vital and untapped community resource – grandmothers – for identifying and screening CSHCN, assisting families in accessing insurance and care coordination, and supporting the child's medical home at local community health centers. As part of the medical home, grandmothers can help to ease barriers related to trust and immigration concerns, acculturation or language issues, and lack of experience with organized health care. We describe our protocol to identify and train grandmothers as community outreach workers and as vital components of the medical home. We present evaluation data which documents increases in insurance applications, access to healthcare, and satisfaction following the implementation of this model in two underserved communities – a rural, primarily Hispanic, migrant community, and an urban Black and Haitian community.

Learning Objectives: At the conclusion of this session participants will be able to

• describe a community-based strategy for reducing barriers to health care in the safety net
• understand the issues involved in training and incorporating grandmothers as lay health workers in the concept of the medical home

Keywords: Access to Health Care, Safety Net

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation