Perceptions and use of community-based programs in Socorro County, New Mexico

Socorro County, one of the poorest and most rural counties in the Southwest, faces incredible health disparities—including twice the national diabetes mortality rate. Barriers to accessing care at the hospital and clinics include inadequate transportation to cover the vast distances, lack of quality childcare and language differences. Promotoras help the communities overcome these barriers by bringing preventive, lifelong wellness care directly to families through the local hospital's Community Based Programs (CBP). To improve CBP growth and sustainability, a countywide needs assessment was conducted in 2011. Promotoras played a critical role in the success of the assessment not only by administering surveys but also by being liaisons to the needs assessment coordinator with local tribal, migrant and isolated rural communities. The survey evaluated community-member perception of and willingness to use CBP to address diabetes, smoking and maternal-child health disparities. The presenter will describe how results differed among the diverse socioeconomic, geographic and cultural subgroups within the community and how this may impact CBP development. To better understand how to promote wellness and CBP utilization, the authors evaluated which health-related outreach sources were most trusted by respondents. Based on these findings, the presenter will encourage a discussion with CHWs from other parts of the country regarding creative strategies to improve awareness about CBPs, particularly in rural settings. Survey descriptive results (n=835) were conducted in SUDAAN after post-stratification weighting. Sampling methods focused on incorporating input from rural families, a remote Navajo reservation and a migrant dairy-worker community.