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Abstract

This three-year project was aimed at improving access to and quality of health care for patients who are overweight or obese or are living with diabetes and/or cardiovascular disease. It targeted Hispanics/Latinos who live in Prince George's and Charles County, Maryland. Strategies included developing a competency screening tool for bilingual staff applying for Greater Baden Medical Services (GBMS) jobs that require Spanish proficiency, designing an in-house interpreter training curriculum for bilingual staff members who are used as ad-hoc interpreters, developing an official interpretation and translation policy that includes use of a sign language interpretation and telephone interpretation company, translating all GBMS documents into Spanish, and providing ongoing training to all GBMS staff. The evaluation collected data on patient safety, patient satisfaction, health outcomes, and staff cultural competency. The data was extracted from electronic medical records, tracking sheets, pre/post knowledge assessments and pre/post tests for blood pressure and blood sugar levels (hemoglobin A1c levels). The evaluation found that there was improvement among medical staff in their knowledge of culturally competent care, and marked improvements in the quality of the training being delivered to their interpreters. In addition, there was also an increase in the number of Hispanics/Latinos seeking health care at GBMS, which grew from 15 percent to 20 percent. Most importantly, the evaluation found that 33% (48 of 146) of those patients with diabetes who participated in the project had controlled hemoglobin A1c measurements at the end of the project, compared to only 15% (8 of 53) of those patients with diabetes who had controlled HbA1c measurements at the inception of the project. The indicators for hypertension were even more impressive, improving from 49% of patients with controlled blood pressure to 79% by the end of the project.

Related NPA Goals:

• Increased awareness, education and outreach to address racial/ethnic minority health and health disparities problems
• Improved access to, and appropriate utilization of, health & other community-based services and systems through user-centered design for racial/ethnic minorities (e.g., health IT, culturally/ linguistically appropriate services, service provider education/ training, workforce diversity)
• Strengthened leadership and coordination to leverage resources and enhance effectiveness and efficiency of individual and collective efforts (including, but not limited to, research and data)

Related Healthy People 2010 Objectives:

• 1-4 Increase the proportion of persons who have a specific source of ongoing care
• 1-6 Reduce the proportion of families that experience difficulties or delays in obtaining health care or do not receive needed care for one or more family member
• 5-1 Increase the proportion of people with diabetes who receive formal diabetes education
• 5-4 Increase the proportion of people with diabetes whose conditions are diagnosed
• 22-1 Reduce the proportion of adults who engage in no leisure time physical activity
• 19-7 Increase the proportion of physician office visits made by patients with a diagnosis of CVD