The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #68168

Miguel A. Zuniga, MD, DrPH, Craig H. Blakely, PhD, MPH, and Martha Conkling Tromp, MSPH. Health Policy and Management, Texas A&M University School of Rural Public Health, 3000 Briarcrest Drive, Suite 300, Bryan, TX 77802, 979.862.4142, mzuniga@srph.tamushsc.edu

PURPOSE: Project intervention goals are to improve the ability of lay health workers (promotoras) to impact health behaviors of the Colonia residents and to integrate their activities with the actions of health providers in the area to change access and utilization rates. A series of pre- and post-demonstration household surveys are being used to assess project impact. The evaluation is monitoring communication patterns between promotoras and residents. Residents’ ties to various health delivery systems in the county are being examined along with the effect of the outreach/case management activities on their health system use.

METHODS: A household survey has targeted 600 residents in two-intervention project Colonias and a non-intervention control colonia in Hidalgo County. Survey respondents were selected randomly through selection of block groups, then households, then residents within households. Interview subjects can be a child, the head of the household, or another adult in the household. Respondents were interviewed at the beginning of the outreach project and will be interviewed at the end of the four-year project.

RESULTS: Baseline demographic profile, insurance status, perception of health care available in the community, utilization of health care by traditional and non-traditional providers in Texas and in Mexico, and health status (SF-8) data are presented. The disease burden profile is characterized by high frequencies of self-reported behavioral problems (43%) coupled with the respondents’ perception of needed mental health services (76%) and a low utilization rate of mental health services (9%). The rate of uninsured is greater than 40 percent for all respondents.

Learning Objectives:

• At the conclusion of the session, the participant (learner) in this session will be able to:
• 1. Describe the role of a promotora and the impact they can have among Colonia residents in border communities.
• 2. List health concerns of Colonia residents in Hildalgo County.
• 3. Discuss present health services and access problems for the Colonia residents.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.