2015 APHA Annual Meeting & Expo

Home Events & Meetings Annual Meeting Schedule & Program

Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
Only $90 for presenters, $140 for registered attendees and $200 for non-attendees.

Online Program

334582
Latinos Understanding the Need for Adherence: Chronic Disease Management through Culturally Tailored Care Coordination in a Federally Qualified Community Health Center


Tuesday, November 3, 2015 : 5:30 p.m. - 5:50 p.m.

Melawhy Garcia, MPH, Graduate School of Public Health, Institute for Behavioral and Community Health, San Diego State University, Chula Vista, CA
Christina Buelna, MA, GSPH, San Diego State University Research Foundation, Chula Vista, CA
Paulina Mendoza, MPH, Institute for Behavioral and Community Health, San Diego State University, Chula Vista, CA
Sheila Castaneda, PhD, Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA
Linda Gallo, Ph.D., Department of Psychology, San Diego State University, San Diego
Gregory Talavera, MD, MPH, Graduate School of Public Health, San Diego State University, San Diego, CA
Audio (mp3) recording Recorded Presentation (mp4)
Latinos are disproportionately affected by chronic conditions, and face complex social, economic, and structural barriers to self-management.  Latinos Understanding the Need for Adherence (LUNA), a randomized controlled trial, enrolled low-income Latino adults to evaluate the efficacy of a chronic disease intervention in a large community health center.

LUNA adapted the Chronic Care Model (CCM) to provide participants with a culturally tailored intervention designed to decrease cardiovascular disease risk factors. The special intervention (SI) included: 1) proactive care coordination 2) health promotion and skill building group sessions led by community health workers (CHWs), 3) telephone follow-up and support; 4) clinical visits with trained mid-level providers (MLPs) to review clinical status, behavioral health goals, and referrals; and 5) bi-annual booster sessions for 2 years. Behavioral and clinical measures were assessed at baseline, 6-months, and 12-months. CHWs served as important links between participants, clinic staff, and MLPs to assist participants with adherence and self-management goals.   

The presentation will highlight lessons learned and the feasibility of implementing the CCM with low-income Latinos, and the multiple roles CHWs can play in Patient Centered Medical Homes. Behavioral change and health outcomes of 500 participants will also be presented.

Culturally tailored coordinated care is necessary to engage low-income Latinos at risk for or diagnosed with chronic conditions. CHWs play a valuable role in patient activation, retention, and maintenance, and should serve as part of the care team in medical facilities serving low-income and minority populations.

Learning Areas:

Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Public health or related laws, regulations, standards, or guidelines
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the design and implementation of a chronic disease management study and the benefits of employing the Chronic Care Model to accomplish system changes in a large federally qualified health center. Describe the important roles of community health workers in the delivery and management of coordinated care strategies. Discuss the feasibility and lessons learned from the implementation of a randomized controlled trial in a large federally qualified health center on the U.S./Mexico Border.

Keyword(s): Chronic Disease Management and Care, Community Health Centers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have served as project manager on numerous community based research interventions focusing on Latino health disparities including chronic disease prevention with Latino families and management of chronic conditions among low-income Latino adults.
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.

Back to: 4409.0: Interdisciplinary approaches among CHWs and public health entities (jointly organized with the Public Health Education and Health Promotion Section)