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

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.