Increasing appropriate access to care for people of African ancestry living in America

Background: In America, current statistics indicate that 12.3% of the population is classified as African American; of which1.5 million are Afro-Caribbean, and over 600,000 as Africans. Appropriate access to care is determined by culture, values, preferences and norms. This paper will report an access to care project conducted by California's Department of Managed Care, Office of the Patient Advocate.

Methods: A mixed-methods approach was used to triangulate data from consumers, providers, and outreach centers. Target population self-identified as African American, Continental Africans, Afro-Latinos, Afro-Caribbean, and Africans other nationality living in California. Data was collected from key informant and focus group interviews and surveys matched by qualitative/quantitative data analysis. A-priori hypothesis was that material designed from the perspectives of people of African ancestry will increase utilization of healthcare resources. We investigated content, language, layout/design, and implementation methods.

Results: N=317 consumers from diverse backgrounds and geographical regions participated in 42 focus groups throughout California; 2/3 identified as African Americans and 1/3 as African people of other nationalities; 90.9% reported they did not know any health resources to help them find the right doctor, understand medical coverage choices, how to get the right care, or where to get help to solve health plan issues.

Conclusion: Designed African-centered material increases access to appropriate health/mental health services to people of African ancestry. This paper will discuss systems changes within a state department that increased engagement; report design and implementation strategies; and demonstrate culturally appropriate outreach materials designed to increase access to care.