Connexiones Por Salud; A Collaborative Care Intervention to Improve Pediatric Preventive Care Utilization Among Mexican Immigrant Families in New Latino Diaspora Communities

We propose to carry out an intervention development project, using a Community Based Participatory Research approach, to create a multi-faceted intervention to reduce obstacles to care for these infants of immigrant families. Through exploratory work we have carried out in Norristown Pennsylvania over the last several years we have identified a number of broad and specific obstacles to care utilization by this immigrant population. A review of the family and health system based obstacles to pediatric care for this community have led us to the “promotora” health navigator model. Our planned intervention will directly link pediatric health care providers with social service agencies through a pediatric care navigation approach which adapts the culturally congruent promotora approach using lay health promoters from the target community.

The specific aims of our proposed developmental study, to be carried out over a period of two years are to:

  1. Transform an existing advisory group to a robust community collaborative board which includes pediatric health providers, social service agencies, and the target Latino community and is focused on the development of the proposed intervention;
  2. Adapt existing promotora training programs for the specific aspects of the proposed intervention;
  3. Pilot the promotora navigator intervention with 40 women beginning at pregnancy and following them through the first year of life of the infant; and
  4. Carry out an analysis of Medicaid billing data to determine the rate of insurance enrollment/continuation as well as guideline consistent care utilization through 2 years of life for Latino infants born in the target community.

Each of the steps of the proposed development project are aimed at developing a sustainable and effective approach to enhancing the delivery of pediatric services to Latino immigrant families within existing health delivery systems. Through a participatory research approach we aim to identify avenues for realigning existing services and more effectively delivering services to infants of Mexican immigrants. Over the course of the two years of this planned developmental project we hope to develop a sustainable collaborative model linking these disparate parts of the services available for support of the healthy development of these Latino infants.