Funded Projects

Identifying priorities of NC Latinx communities

Project Year

2023

City & State

Chapel Hill, North Carolina

Program Name

CATCH Planning

Topic

Immigrant/Migrant/Refugee/Undocumented

Program Description

"Background: Latinx children make up a quarter of the US pediatric population and are more likely to be uninsured and experience unmet medical needs and unique care barriers, such as limited English proficiency, compared to non-Latinx white children.(1, 2) Anti-immigrant rhetoric and policies intensified after the 2016 presidential election with over 400 immigration-related executive actions.(3) This resulted in decreased healthcare utilization and public benefit enrollment by immigrant families, with worsened birth outcomes among immigrant mothers, fewer prenatal care visits, and increased cancelled visits and decreased primary care visits among undocumented adults and children.(4-8) In our area, 28,000 Latinx residents <20 years live in Orange, Durham and Chatham counties, a quarter of whom are <5 years-of-age.(9, 10) Within these three counties, 24-34% of Latinx children live in poverty and they are 4-8 times more likely to be uninsured compared to non-Latinx white children.(10) Proposed intervention: We propose a partnership with Latinx community leaders and families to identify priorities and potential solutions to decrease inequities in wellbeing among Latinx families in Durham, Orange, and Chatham counties. Specifically, we plan to: (1) By August 31, 2023 (month 3), establish a Community Advisory Board (CAB) of leaders among local Latinx families and Latinx-serving community organizations and providers committed to improving the health of Latinx families. (2) By November 30, 2023 (month 6), conduct 15 semi-structured interviews with key stakeholders including Latinx families and Latinx-serving community members to identify which barriers are most important to them and potential solutions. (3) By May 31, 2024 (month 12), analyze qualitative data with iterative feedback from the CAB on priorities and potential solutions, and disseminate results. Furthermore, will begin plans for applying for a future implementation phase. Methods: Community leaders will be identified from discussions with potential leaders/families and form the CAB. We will conduct 15 semi-structured interviews to discover priorities/potential solutions with the leaders/families identified from our first objective. We will use snowball sampling to find and recruit additional participants. We will conduct rapid qualitative analysis immediately following each interview using a matrix of domains.(11) Individual matrices will be combined into a key matrix to identify potential themes. We will discuss results on a weekly basis during team meetings, monthly at Advocacy Subcommittee meetings, and bi-monthly at CAB meetings to obtain iterative feedback on priorities and potential solutions. We will also conduct directed content analysis of transcripts, organizing results into themes. We will apply a priori codes to transcripts in Atlas.ti and add emergent codes to the codebook, organizing codes into themes. We will disseminate and discuss results with the CAB team. A main outcome of the interviews and discussions is to identify priorities and next steps with the CAB, using structured decision-making tools such as a criteria-based decision matrix, like a Pugh Matrix, to implement solutions with future grant. A report detailing the project, key findings, and recommendations for the implementation phase will be disseminated throughout the community. Anticipated Outcomes: Short-term outcomes include establishment of new relationships and strengthening of prior ones among community leaders and families; exchange of ideas to better understand the experiences and processes with healthcare utilization, benefit enrollment, and other unmet social needs in the Latinx population; and identifying community priorities and best perceived solutions. We will seek publication of our findings in a peer-reviewed journal for broader dissemination. Mid-term outcomes include increasing community and policymaker awareness of these experiences and needs and enacting an implementation phase from the priorities and proposed solutions identified in the planning grant. Long-term outcomes include implementing interventions at a broader systems level after being informed by the planning grant and a future implementation grant. "

Project Goal

Short-term goal: To understand barriers to healthcare utilization, public benefit enrollment and other adverse social drivers of health, and to identify priorities and potential solutions from the perspective of the Latinx community in Durham, Orange, and Chatham counties. Long-term goal: To decrease inequities in healthcare utilization, public benefit enrollment and other adverse social drivers of health among Latinx families in Durham, Orange and Chatham counties.

Project Objective 1

By month 3 of the project, we will have established a Community Advisory Board (CAB) of leaders among local Latinx families and Latinx-serving community organizations and providers committed to improving the health of Latinx families.

Project Objective 2

By month 6 of the project, we will have conducted 15 semi-structured interviews with key stakeholders including Latinx families and Latinx-serving community members to identify which barriers are most important to them and potential solutions.

Project Objective 3

By month 12 of the project, we will have analyzed qualitative data with iterative feedback from the CAB on priorities and potential solutions for a future implementation phase.

AAP District

District IV

Institutional Name

UNC Chapel Hill

Contact 1

Brittany Raffa