LATINO FAMILIES ORAL HEALTH JOURNEYS:

Transcription

1 LATINO FAMILIES ORAL HEALTH JOURNEYS: AN OPPORTUNITY TO LISTEN, LEARN LEAD

2 OVERVIEW Ø THE NEED Ø THE COLLABORATIVE Ø KEY FINDINGS Ø START WITH EMPATHY Ø CULTURAL CONTEXT Ø COLLECTIVE ACTION Ø A CALL TO ACTION

3 THE NEED Latino children are one of the fastest growing demographics in our state and continue to bear a disproportionate burden of oral disease in Washington. Ø Compared with white, non-hispanic children in second and third grades combined, Latino children had a higher rate of decay experience (71 percent versus 45 percent), Ø Were nearly twice as likely to have permanent teeth affected (16 percent versus 9 percent), Ø Had twice the rate of rampant decay (29 percent versus 15 percent), Ø And higher rate of treatment need (13 percent versus 9 percent). Washington State Department of Health, Smile Survey

4 THE NEED 250 K-12 Latino Student Population Growth White African American Latino Asian/Pacific Is.

5 COLLABORATIVE OBJECTIVES Ø Ø Ø Learn about Latino families needs and experiences accessing oral health care services for their children and family; Discover and share best practices to increase access to dental care for Latino children through the ABCD program; and Design and pilot tools, resources, and strategies for implementation of best practices at the local level.

6 HUMAN CENTER DESIGN P U T T I N G P E O P L E A T T H E Means listening, building relationships & partnering with the community you want to serve. C E N T E R

7 HCD IN PRACTICE START HERE LISTEN FIRST (THE STORY) WHAT ARE THEIR EXPERIENCES, NEEDS, DREAMS, and HOPES? BUILD RELATIONSHIPS SHARED VALUES/ INTERESTS. WHAT CAN WE ACCOMPLISH TOGETHER? DEVELOP SOLUTIONS HOW MIGHT WE ADDRESS A CHALLENGE? HOW DO WE LEARN TOGETHER? LEARNING & ACTION

8 HCD PROCESS

9 TESTIMONIOS I can t read or write. It s difficult to say that out loud. I have four children. All I think about is how I can make sure they do better in life and it s frustrating looking at a piece of paper in a clinic that you know can help you help your kids, but you don t know what it says. Latino Parent, Mattawa, WA PLA Convening

10 TESTIMONIOS I feel I have no barriers, but for families that only speak one language (Spanish) it would be hard for translating purposes. For example my mom that speaks limited English, my daughter or I have to go to the appointments with her or make them for her to translate. What has helped my mom in the past was when there s a Spanish-speaking provider so neither myself nor my daughter have to go with her to the appointment. So it s great when providers or someone in their office is able to schedule appointments for those families that don t speak English as well as set up transportation for them when needed. Latino Parent, Aberdeen, WA PLA Convening

11 TESTIMONIOS It was a different experience for us. We were lucky because my sister already lived here. So she helped me to go to the clinic and told me where to sign up my kids for school. My sister had a tough time. She moved here and had no family or friends here. They had to sleep in their car until they were able to find housing. I think we need to think about how we can reach families that are new to the community or who are disconnected from these services. Latino Parent, Wenatchee, WA PLA Convening

12 TESTIMONIOS You get a call the day before to confirm your appointment and you do because you want to go to the dentist. But then, the next day your boss realizes they haven t met their quota so we need to pick more fruit. This is the reality of harvest season. So I can t go to the appointment and now they won t take me back for one year. I have to work to feed my children and they need healthy food. Of course I care about my children s health. This is why I work: to care for my children. Latino Parent, Prescott, WA PLA Convening

13 TESTIMONIOS My wish is that everyone in our community could access health care regardless of whether they have coupon or not. I want my parents, my children, and my community to be able to live healthy lives, but we also live di cult lives. We care a lot about oral health, but we haven t been cared for enough so we get used to dealing with things like a toothache in a different way. I don t want my children to have to do that. I m happy they are in school and learning and can see a dentist. Now, I wish more children and families could have access to all of that. Latino Parent, Sumas, WA PLA Convening

14 COMMUNITY IMMERSIONS DEFINE YOUR AUDIENCE Who are our Latino families? COMMUNITY IMMERSIONS What are their needs & experiences? JOURNEY MAPPING How might we better understand their journeys to access care? Ø Latino Children Ø Parents, siblings, grandparents, and other family members. Ø Influencers: schools, community orgs., churches, employers, other people in the community. Ø Translation & Interpretation are important, but not always enough. Ø Fear & Shame (Cultural & Social Barriers). Ø Diet Habits & Access to Healthy Food Sources. Ø Sharing information across organizations/systems. Ø Developing partnerships with local organizations. Ø Cultural competency training Ø Highlighting best practices Ø Planning tools for families

15 CHOICES KEY MOMENTS UNDERSTANDING ORAL HEALTH JOURNEYS KEY MOMENTS KEY MOMENTS Lack of Resources Language Barriers No Follow-Up Other CHALLENGES KEY MOMENTS ACCESS TO SERVICES

16 COMMUNITY IMMERSIONS MINI-PILOTS Here s an idea! What do you think? MINI-PILOTS Thanks for the feedback! How about now? SUCCESS STORY Tell me about a time you successfully accessed care. Ø How might we help more Latino children access care? Ø Rethinking how we share information/resources. Ø Partnering with community leaders/influencers. Ø Inviting families to tell us more about their needs. Ø Caring for the wholecommunity matters. Ø Partnering with people trusted in the community. Ø Employ a human-centered approach throughout the whole process. Ø Confianza/Trust is key for Latino families. Ø One positive experience makes the difference. Ø One source of support. Ø Involve families and ask them how they want to be treated. *Developed for the ABCD Latino Collaborative, Washington Dental Service Foundation

17 PARTICIPATORY LEARNING & ACTION MODEL We learned We unlearned We can address this issues. CHANGING ATTITUDES Thank you for listening (Trust, Empathy, Partnership) Latino families share their knowledge (stories). Facilitators (ABCD Coordinators) share suggestions. SHARING KNOWLEDGE CHANGING METHODS Bringing people together to assess their own needs and strengths. Journey mapping and behavior story boarding. Institutions share experiences. Relationship Building v. Resource Distribution

18 COMMUNITY IMMERSIONS REDEFINE WORK We need to redefine our work. PARTICIPATORY LEAERNING Learning along with the community KEY FINDINGS Tell me about a time you successfully accessed care. Ø What are the key questions we nee to ask? Ø How can we confirm our findings? Ø How do we build lasting trusting relationships with the community? Ø Community gatherings to present findings and hear feedback. Ø More stories, more learning. Ø Inviting key partners to listen to these stories. Ø Confianza/Trust is key Ø Empathy through listening. Ø Cultural context and awareness ma. Ø Partnership with communitybased trusted organizations and individuals.

19 ORAL HEALTH JOURNEYS MECHANISMS Supportive community environments Trusting relationships with informed resource Peer networks Access to resources Early/timely access OUTCOMES Form positive networks Develop resiliency Establish a dental home Become advocates for oral health in community Oral health ORAL HEALTH JOURNEYS MECHANISMS Negative community experiences Resource-poor families Falling through the cracks Distrust Little or non-existing peer network EMPATHY CULTURAL AWARENESS COLLECTIVE IMPACT OUTCOMES Little trust in system Skepticism in the community Oral health challenges Community challenges Forced underground Latino Children s EVERY Oral UNDOCUMENTED Health Learning Collaborative STUDENT A SUCCESS STORY

20 FINDINGS & LESSONS LEARNED Ø Start With Empathy: Ongoing opportunities to listen to the stories of Latino families within their communities can help you discover better ways to serve with this community. Ø Cultural Context Matters: Beyond translation and interpretation, it s essential to understand the cultural and geographical context of the population you are serving. Ø Collective Impact: Building a network of partners, advocates, and community influencers will help to boost your outreach efforts to connect with the most underserved populations.

21 START WITH EMPATHY Eliminating oral health disparities for Latino children will require a deep understanding of the experiences of Latino families. This means going beyond exploring experiences directly tied to oral health care services. The health of a population is also determined by its social circumstances. Ø Spend Time in the Community: Seek opportunities to listen and spend time with the community you want to serve outside healthcare settings. Ø Targeted Outreach: Outreach and education campaigns need to prioritize caring for the whole family s oral health and engaging the most underserved populations. Ø Social Stressors & Empathy: Discuss with colleagues why empathy is important and how social stressors impact families.

22 CULTURAL CONTEXT MATTERS Improving the oral health outcomes of Latino children will require understanding the health status of the Latino community within the larger context of society and history. Some of the factors that will affect Latino families access to health care include degree of cultural integration, language, and immigration status. However, these factors will manifest in different forms across different regions in the state. Ø Culturally Responsive Care: Be an advocate for culturally responsive care trainings for all healthcare professionals. Ø Translation & Interpretation: Be an advocate for families to always have access to quality interpreting services. Ø Understand Regional Context: Create a community map to understand pressing concerns and who are key influencers.

23 COLLECTIVE IMPACT Moving toward oral health equity will require addressing the social determinants of health, which also means the public health sector won t be able to achieve this on its own. Health departments must work in conjunction with cross-sector partners to better understand how to do this collective work. This effort must be community informed and driven to ensure. Ø Build a Coalition: Seek opportunities to partner with agencies, organizations, and providers. Ø Partner With Families: As you build relationship with families consider asking for their feedback to help you reach other families. Ø Community Health Workers: Partner with Community Health Workers and invest in their professional development.

24 KEY QUESTIONS Ø Start With Empathy: How are you listening to the stories of the communities you serve? Ø Cultural Context Matters: How are you deepening your understanding of the cultural and geographical context of the communities you serve? Ø Collective Impact: How are you building partnerships with community-based organizations and other agencies to collectively better serve the community?

25 TESTIMONIOS I think for many parents it can sometimes be di cult to go to the dentist or learn about oral health because it s scary to learn something on your own, but I think if we had more opportunities to learn alongside each other we could be more successful together. What would happen if all of us made an e ort to care for each other? I hope we have more opportunities like this one to come together and listen to each other s stories. This is the first time I have the opportunity to sit down with healthcare professionals and dentists so we can actually have a conversation and help each other out. This makes me feel really good. Latino Parent, Prescott, WA PLA Convening

26 Thank you for listening to our stories. There s really very few things that feel as empowering as knowing that my community is being heard. - Latino Parent, Wenatchee, WA

27 ACKKNOWLEDGEMENTS The was made possible thanks to the Arcora Foundation s vision and commitment to oral health equity. A special amount of gratitude is owed to our participating ABCD Coordinators, Lupita Espinoza, Carol McCormick, Maria Vargas, Christina Ortiz, Jodi Ferguson, Natalie Mills, and Julie Zambas, as well as their respective health departments and organizations. Each one of our Collaborative members worked tirelessly for and with Latino families across their respective counties. In addition, of Laura Flores, Health Equity Lead Strategist at the Arcora Foundation, and Kathy O Meara-Wyman, ABCD State Program Managing Director, played an integral role in supporting the work of the collaborative and helping us to envision how this work could positively impact the ABCD State Program. We also need to acknowledge the role of various key partners who played an important role in participating in community meetings. Key partners included Socorro Garcia, Broetje Orchards, Nooksak Valley School District, Community Choice, ESD 123, Wheatland Family Dental, Columbia Basin Health Association, Benton/Franklin Health Department, Vista Hermosa, Tri-Cities Community Health, and Grays Harbor College. An additional note of gratitude is owed to Dr. Francisco Ramos-Gomez for inspiring our Collaborative members to continue advocating for oral health equity.