Increasing access to clinical preventive services for hard-to-reach Asian communities through faith-based organization networks

Background:Socioeconomic constraints, language barriers, and cultural beliefs have been known to limit the Asian community’s access to and utilization of high quality medical care. To better provide clinical preventive services for hard-to-reach Asian communities, the Los Angeles County Department of Public Health partnered with the Asian Pacific Liver Center at Saint Vincent Medical Center in 2012 to augment their hepatitis B screening program.

Methods: The program utilized a faith-based organization network to provide culturally competent care at 26 local health events. Standardized protocols for blood pressure measurements and referrals were integrated with the existing program, which is led and administered by a team of physician extenders.

Results: Over the course of six months, 2,298 individuals were offered hepatitis B screening; 1,499 of whom were also offered blood pressure assessments. Overall, 45% were Southeast Asians. Nearly half were foreign-born. One-third had normal blood pressure readings; 30% had readings in the prehypertensive range, and 26% had readings suggestive of hypertension. Over a quarter had no hepatitis B immunity; 146 tested positive for hepatitis B.

Conclusions: Results of this expansion suggest that integrating additional services to an existing screening program for hard-to-reach Asian groups was feasible. The promise shown by this enhanced program demonstrates the potential in applying team-based care approaches through leveraging clinical-community linkages. Other healthcare and public health systems can build upon these lessons as they prepare for expected changes under the Affordable Care Act which places increased attention on clinical-community linkages to improve access to clinical preventive services.