204765 Increasing Access to Care among Low-Income, Uninsured Populations: Community-Suggested Strategies

Monday, November 9, 2009

Maria Rosa Watson, DDS, MS, DrPH , Center for Health Improvement, Primary Care Coalition, Silver Spring, MD
Michelle Markey, MA, MTS , Center for Health Improvement, Primary Care Coalition, Silver Spring, MD
While the barriers to health care access have been well-documented, those facing such barriers are rarely involved in developing strategies to address them. The purpose of this community-based participatory research (CBPR) project was to develop community-suggested strategies to reduce access barriers to health care among low-income, uninsured populations in Montgomery County, MD, and to test the impact of a community-suggested strategy on access to care. Methods: A delayed intervention control study was used to measure the differences in access to care. Barriers to health care access and strategies to increase access were elucidated via 15 focus groups (n=100) with local health promoters and uninsured individuals, phone interviews with “no-show” participants who had been scheduled for appointments, and discussions with a CBPR advisory panel and community partners. In the intervention year, we tested the impact of placing an on-site “facilitator” to help address common barriers to attending a scheduled follow-up appointment at safety-net clinics. Results: Attendance at follow-up increased as compared to the baseline year; for African-Americans attendance almost doubled (45% increase: OR= 1.8 (1.07 - 3.14)). Among Latinos, attendance increased 10% (OR= 1.2 (0.8-1.7)) and was four-fold better than attendance for others who did not received the intervention that same year (OR= 4.4 (1.2 - 16.35)). Conclusions: The community-suggested intervention and CBPR process had a positive impact on access to care for participating uninsured patients.

Learning Objectives:
Discuss barriers to health care access among the various uninsured racial/ethnic communities in Montgomery County, Maryland. Demonstrate a community-based participatory research process to address barriers to health care access. Describe community-suggested strategies for increasing access to care

Keywords: Access to Care, Community

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a CBPR researcher with over 10 years of experience working in the community.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.