224885 Policy Barriers to Healthcare Access Fuel Discriminatory Treatment: The Role of Promotoras in Overcoming Malos Tratos

Tuesday, November 9, 2010 : 8:30 AM - 8:50 AM

Tania Pacheco , California State University, Fresno, Central Valley Health Policy Institute, Fresno, CA
Mariana Ramirez , Central California Regional Obesity Prevention Program, Fresno, CA
John A. Capitman, PhD , California State University-Fresno, Central Valley Health Policy Institute, Fresno, CA
This presentation will demonstrate how policy barriers result in access inequities and how a Promotora intervention can significantly increase access to care for Latino immigrants. Broader discriminatory policy in healthcare leads to systemic barriers to access and poor treatment for Latino immigrants. Two Promotora intervention studies assessed how Promotoras can empower patients to increase their healthcare access. The studies included 416 legal and undocumented Latino immigrants in the California Central Valley. The Promotora model implementation included 1) Promotora training, 2) community outreach and participant recruitment, 3) a baseline survey (pre-test), 4) participant follow-up calls or visits, referrals, and 5) a three-month follow-up survey (post-test). Both studies found significant differences in access indicators of access from baseline to follow-up. Only 60% of documented participants had a medical home at baseline compared to 90% at follow-up, while among undocumented participants rates rose from 13% to 59% at follow-up. Findings demonstrated how systemic barriers to healthcare access such as poor service and language reflected on participant personal barriers such as lack of trust and reluctance to follow-up. Results also showed how a unique resource manual and Promotora manual aided in overcoming barriers. One of the participating Promotoras will be presenting the findings, including her own experience with the system barriers to care. She will speak on how Promotoras outreached to participants enduring social injustices based on their immigration and socioeconomic status. This Promotora has worked with researchers to ensure the accuracy of the data and that the results reflect the Promotora experience.

Learning Areas:
Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Demonstrate how policy discrimination can lead to personal barriers that limit access to healthcare. Explain how a Promotora intervention can help individuals overcome these barriers.

Keywords: Access Immigration, Hispanic

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am on of the Community Health Workers for this project and I have been involved in the data analysis process to ensure accuracy.
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.