Race and ethnicity
A primary care center, county health department, community organizations, and lay health advisers jointly developed and implemented various activities to reduce risk factors for cardiovascular disease and diabetes in a low-income, largely African-American population, leading to improvements in health-related behaviors and better health.
Physicians working in underserved areas use preprinted “prescription pads” to increase use of free community recreational activities and resources by overweight and obese patients, with the goal of helping them achieve a more healthy weight.
Outreach workers from two community-based organizations coordinate efforts to support Mexican farm workers in navigating the health care system and enhancing their health. The program led to more physical activity, better dietary habits, and higher satisfaction.
A care “pathway” helps pregnant substance abusers obtain health insurance, obstetrics care, substance abuse counseling, and other services, allowing the vast majority of these women to give birth to babies with viable birth weight who are free of illicit substances.
Culturally and linguistically appropriate education and emotional support to low-income monolingual Chinese immigrants leads to improved knowledge and better blood glucose control in a pilot test of diabetes patients. Based on the success of this pilot, the program has been expanded to serve those with coronary artery disease and congestive heart failure as well.
With the support of the Ministerial Alliance and local churches, a collaboration between an integrated health system and the YMCA offered a 6-month program combining exercise classes, nutrition and wellness programs, incentives, and case management support, leading to improved exercise and eating habits and lower blood pressure and body mass index among overweight and obese African-American women.
A hospital makes a telephone-based recording of discharge instructions available to non–English-speaking and low-literacy patients in their native language, leading to improved comprehension of discharge instructions and high levels of patient/family satisfaction.
CIGNA uses a multifaceted approach to facilitate culturally appropriate behavioral health care for members, including the matching of patients to providers who meet desired characteristics; the program enhanced the diversity of the behavioral health practitioner network and increased member satisfaction.
Trained, bilingual medical assistants in a capitated health center serve as health coaches to chronically ill (often diabetic) patients of similar ethnic or racial backgrounds, leading to better disease management and clinical outcomes for those with diabetes, very positive feedback from patients and center staff, and low turnover among medical assistants and coaches.
Language-concordant health coaches team with residents to improve the self-management skills of patients who have limited English proficiency and health literacy, leading to improvements in the management, documentation, treatment, and clinical outcomes of patients with diabetes.