Using participatory research to build effective service integration for Hispanics: A key informant and focus group study

BACKGROUND: The Hanover Juntos / Hanover Together (herewith, Juntos) project is a community-based participative research (CBPR) collaborative focused on needs, social capital, and service integration for the Hispanic population. It was conceptualized and designed by a team of health services researchers and community health workers. The Juntos project is an example of health-focused advocacy with Hispanic agricultural and manufacturing workers in Southcentral Pennsylvania. OBJECTIVES: To describe participant's perceptions of unmet service needs, to identify barriers to service integration, and to evaluate specific options for improved inclusion in the care system. METHODS: To date, ten qualitative key informant interviews and two focus groups have been conducted with leaders and members of the Hispanic community. Audio-taped interviews and focus groups were transcribed verbatim in Spanish and forward translated into English. Data analysis was performed using qualitative analytic methods resulting in representational themes. RESULTS: Twenty-eight participants represented a range of countries of origin. Distinct themes emerged for which recommendations were crafted. These themes included segregation from social, public, medical, mental health and physical abuse services, overt and covert discrimination, social isolation, and youth risk behaviors. Barriers identified included language, culture, poverty, lack of health insurance, documentation status and poor living conditions. Based on these findings Juntos has implemented actions leading to significant change in overcoming barriers and improving service integration. CONCLUSION: A long-term commitment to using the CBPR approach with the Hispanic community is an effective way to engage in health research and to establish a meaningful dialogue and grassroots advocacy.