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Aquí Para Tí/Here for You Clinic Based Program

A collaborative, multidisciplinary, bicultural/bilingual healthy youth development program in a primary health care setting. Aquí Para Tí/Here for You Clinic Based Program. Bibiana Garzón, MS, Mónica Hurtado, Cherylee Sherry, MPH, CHES, Verónica Svetaz, MD, MPH.

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Aquí Para Tí/Here for You Clinic Based Program

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  1. A collaborative, multidisciplinary, bicultural/bilingual healthy youth development program in a primary health care setting Aquí Para Tí/Here for You Clinic Based Program Bibiana Garzón, MS, Mónica Hurtado, Cherylee Sherry, MPH, CHES, Verónica Svetaz, MD, MPH

  2. a collaborative, multidisciplinary, bicultural/bilingual youth program created in 2002 housedat the East Lake Clinic, one of Hennepin County Medical Center’s community clinics targeted to Latino youth (ages 11-24) and their families funded by the Eliminating Health Disparities Initiative of the Minnesota Department of Health Program Description Poster ID# 2083

  3. To provide comprehensivecare in a safe and confidential environment for Latino youth (11 to 24 years old) and their families Program Philosophy Poster ID# 2083

  4. Program Elements • Culturally appropriate • Confidential family-centered approach • Resilience oriented-Youth Development Approach • Comprehensive • Community based • Patient support and coordination of services Poster ID# 2083

  5. Youth Development/Resilience Approach Poster ID# 2083

  6. Aqui Para Ti Team • APT team consists of physician, health educator, social worker/therapist and coordinator of services • serves as a bridge between the Latino cultures and the majority culture in which they live Poster ID# 2083

  7. Services Provided • Medical Services • Health Education • Mental health assessments and referrals to therapy • Education for parents • Referrals to community resources as needed Poster ID# 2083

  8. Service Area • 80% from Hennepin County • Other counties served: • Ramsey • Dakota • Anoka • 16% from zip code 55406 (southeast MPLS) Poster ID# 2083

  9. Patients Served • From July 2002 to July 2008 • Aqui Para Ti has served: • 735 youth • -482 Teenagers (11-18 yrs) • -253 Young adults (19-24 yrs) • 307 parents Poster ID# 2083

  10. Demographics of Patients Served • 66.7% Female • 65.6% teens (11-18) • 34% young adults (19-24) • 76.7% Spanish-speaking • 60% of patients aged 11-18 came with a parent Poster ID# 2083

  11. APT patients needs & assets Poster ID# 2083

  12. APT Program Changes Over Time • Initially majority were considered low risk/needs patients • By 2004 the number of patients with high risk/needs was greater than low risk/needs patients • Today, over 70% of APT patients are high risk/needs patients Poster ID# 2083

  13. APT patients’ risks & assets • APT has become a referral center, receiving mainly high needs teens and families • The data that you are going to see represents only our patient population but does not represent the Latino population in Minneapolis Poster ID# 2083

  14. Socio-Economic Status • Among APT patients: • One out of two youth born outside of the US stated they did not have enough money for food and bills. • One out of three youths born in the US reported the same. This means most of our Latino youth remain in severe poverty regardless they are US born citizens. Poster ID# 2083

  15. Family and Friends APT Data Family and Friends From July 2002-2007 • Among APT patients: • An equal number of younger and older youth feel that parents listen to them • Significantly more females felt parents were NOT listening to them (35 % females vs. 20 % males) • Only half of all APT patients could identify a role model Poster ID# 2083

  16. Among APT patients: 66.6% (regardless of sex) reported having friends and adults to talk to. US born youth have more friends and adults to talk with compared to those born outside US. Younger youth have significantly more friends to talk with vs. older youth Family and Friends Poster ID# 2083

  17. School Achievement • Among APT patients: • Almost all our younger and older youth found school is a positive place (94 vs. 95 %). • Almost 20% reported that they would NOT continue further studies because they needed to work. • 60% of non US born and 70% of US born youth plan to study after High School • Desire to study after high school was independent of gender Poster ID# 2083

  18. Reproductive Health APT Data Reproductive Health From July 2002-2007 • Among APT patients: • US born youth’s most frequent age for first sexual encounter was 14 years, while 15 years of age was the most frequent age for first sexual encounter in the non-US born youth • Significantly more non US born youth had sexual contact when they did not want it (14 % compared to 5% for US born youth) Poster ID# 2083

  19. Mental/Behavioral Health • Among APT patients: • Almost 40 % of younger and older youth felt sad in the previous 2 weeks. • Regardless of age almost 20 % have had suicidal thoughts. • Both groups have significant incidence of having been abused (12% younger vs. 20% older). Poster ID# 2083

  20. Risk Levels Among APT patients: • Risk levels were not dependent on age • Females (42%) were significantly more categorized in a high- risk category that males (30%) • Youth born in US (52%) were proportionally significantly more categorized in a high-risk category vs. those youth born outside US (35%) Poster ID# 2083

  21. Lessons learned • Use a systemic approach that involves parents and family and takes intoaccount school, neighborhood and all factors surrounding a teen’s life • Conduct mental health screenings in the primary care setting. Most patients value highly their relationship with their providers and may be more likely to disclose their feelings, and engage in treatment • Be aware that acculturation is dynamic and acculturation levels are not the same for all the members of a family • Know your population, speaking their language is not enough. There are differences in values and beliefs within the same culture Poster ID# 2083

  22. Lessons learned • Doing secondary pregnancy prevention among Latino teens is equally important as doing primary pregnancy prevention. Research indicates that without intervention, Latino teen mothers are at a high risk of having a new child in less than 3 years • Integrated health care systems such as HCMC are essential to provideaccess, quality, and affordable care to underserved populations. In addition, providers have a network of support and do not have to work in isolation • A paradigm shift has to occur in the US health care system if we are serious about eliminating health disparities. Poster ID# 2083

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