Online Program

Engaging the Mexican American farmworker community in improving the delivery of mental health services

Monday, November 2, 2015 : 11:10 a.m. - 11:30 a.m.

Maia Ingram, MPH, Deputy Director, Arizona Prevention Research Center, University of Arizona, Tucson, AZ

Lucy Murrieta, B.A., Sunset Community Health Center, Yuma, AZ
Jill de Zapien, BA, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
Patricia Herman, PhD, Rand Corporation, Santa Monica, CA
Scott Carvajal, PhD, MPH, Health Behavior Health Promotion, Division of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ
Mexican American farmworkers experience high rates of mental health conditions; however it is difficult for them to access care.  Patient-centered care is a systems-wide approach to improving healthcare delivery for diverse populations in the primary care setting.  We describe the application of community-based participatory research methods to assess and address gaps in mental health care as perceived by both providers and migrant worker patients living in a US-Mexico Border community. Academic partners worked with a federally qualified migrant/health center which serves the approximately 60,000 agricultural workers. Community Health Workers (CHWs) facilitated the engagement of patients in the study.  Focus groups with patients (n=64) and FQHC staff interviews (n=16) explored attributes and dimensions of patient-centered mental health care.  Patients and staff both prioritized increased access to mental health care and patient-centered care.  Patients were more concerned with interpersonal care and providers with coordination of care.  All participants stressed the relationship between life events and mental health and the centrality of family in care. Patients also emphasized the importance of a good attitude, the ability to solve problems, positive family relationships and reliance on faith. Patients suggested that the clinic inform patients on mental health resources, provide community informational talks to address stigma and offer support groups.  Results will allow the FQHC to tailor patient-centered mental health care through the use of specific protocols and targeted staff training. The process of using CHWs to engage patients could be utilized by other FQHCs to improve the delivery of health care services.

Learning Areas:

Chronic disease management and prevention
Provision of health care to the public
Public health or related research

Learning Objectives:
Define aspects of patient-centered care in a primary care environment. Describe a model of participatory research designed to elicit patient perspectives on patient centered mental health care using the community health worker model. Identify perspectives on mental health care from both providers and patients in a federally qualified health care clinic in a U.S.-Mexico Border community.

Keyword(s): Mental Health, Community-Based Research (CBPR)

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been co-investigator on numerous participatory research projects utilizing community health workers and was responsible for coordinating the research being presented.
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.