Nuestra Comunidad Sana (NCS) has a long and proud history of collaboration with community groups in the Mid Columbia, throughout the State, and across the nation. Some of these collaborations are characterized below.
Among many collaborations with La Clinica del Cariño, perhaps the first stands out: the well-child project called El Niño Sano. Using NCS Community Health Promoters for outreach to the farm-working community, El Niño Sano increased the ratio of primary care vs. acute care clinic visits for 0-18 year old patients from 1 in every 13 visits to 1 in every 2.75 visits over a four year period. Over the same period, the ratio of actual WIC visits to recommended WIC visits rose from 38% to 64%.
NCS is known for helping to build the capacity of other Promotor de Salud programs. In the late '80's and early '90's, NCS helped develop and train La Familia Sana programs in Ontario, Woodburn, and Medford. NCS Promotores/as were prominently featured at a number of national conferences in the 1990's, and participated in the "National Community Health Advisor Study" funded by the Annie E. Casey Foundation. NCS presented workshops at both the National Migrant Health Conference and the Midwest Migrant Stream Conference in 2000. Most recently, St. Mary's Hospital in Grande Junction, CO requested our help in establishing a lay health promoter program.
For many years, NCS has conducted workshops around the state for public and private agencies on issues of care for the Hispanic community. In the past, these workshops were provided free-of-charge to recipients through a contract with the Health Education Training Center at OHSU. Currently, we charge a fee to cover the cost of preparation and presentation of the workshops.
Since 1998, NCS has been building capacity in community organizations statewide to address the issue of tobacco in the Hispanic community. In 2000, NCS had 25 community partners in 8 counties with whom it worked to reduce the use of tobacco, and especially to protect family members from the effects of secondhand smoke. In 2001, both the number of partners and the number of counties will be increased.
All of our partners have a large Hispanic service base, but most do not deal with tobacco, or even with health issues as a part of their mission. With training, our partners are able to convey messages on the dangers of tobacco at their regular points of contact with their clients. This approach not only multiplies the number of such messages a family will receive in their community, but also reinforces the messages, as they come from such a diverse group of sources. This program is funded by the Oregon Health Division.
In the past, under a grant from the Kellogg Foundation, NCS collaborated heavily with other community groups on the issue of domestic violence in the Hispanic community. For several years, one or more Promotores were assigned to attend weekly interagency and resource development teams which discussed particular individuals, and cooperated to develop and/or allocate resources as appropriate. NCS provided home visiting services for Washington State Child Protective Services, and participated in a number of cross-referral agreements, notably with The Next Door, Inc. and Helping Hands Against Violence in Hood River.
NCS continues to facilitate a DV perpetrators intervention group called Hombres Autoresponsables para Parar el Abuso (HAPA). HAPA provides 24 weeks of group therapy in Spanish focused especially on the particular cultural nuances which promote violence in Hispanic families. For Washington residents, the program continues with an additional half-year of monthly sessions.
HAPA is conducted in cooperation with the Circuit Courts and local District Attorney's diversion programs, and is highly supported by the defense bar. It is funded by the United Way organizations of Hood River and Wasco Counties in Oregon and Klickitat/Skamania Counties in Washington, along with the Hood River Lions Club Foundation and fees for service.
For many years, NCS has cooperated with OHSU and other educational institutions to provide cultural competency workshops for the State's medical, nursing, and pharmacological students. These workshops have been well-received, and we believe they are contributing to more effective care for the State's Hispanic population. Similar workshops are presented periodically to health professionals such as hospital, clinic, and hospice staffs on issues of special interest to them. We charge a fee for these workshops based upon the cost of preparation and presentation.
Diabetes
Begun in 1999, our diabetes education and screening project is a collaboration between many organizations and private businesses in the Mid-Columbia. We take educational skits and visuals into the field, to churches, farm labor camps, packing houses, apartment complexes and other gathering places. After the educational presentation, we do finger-stick blood sugar tests. Those who screen in the range of concern are referred for further testing and care. Where appropriate, we follow-up with home visits. Over 1000 local residents and migrant farmworkers were screened in the first year of the project, 2000.
The project is overseen by a volunteer Medical Advisory Group consisting of 15 medical professionals and 2 Hispanic diabetic patients. Diagnosis and care is provided through agreements with providers in Hood River, Wasco and Klickitat Counties. Exercise classes will make use of local health clubs and pools at highly discounted rates. Generous funding has been provided by the Meyer Memorial Trust.
Breast Cancer Outreach
Begun in 2000, our Breast Cancer Outreach program educates women in Wasco and Hood River Counties on the need and availability for periodic clinical breast exams and mammograms. For women who qualify based on age and income, the exams and mammograms are provided free of charge through La Clinica del Cariño in Hood River, the Hood River County Health Department, and the Wasco-Sherman Public Health Department in The Dalles. In the first year of the project, the number of Latinas who received free exams in the Mid-Columbia increased by 50%. This project is funded by the Susan G. Komen Foundation.