Sherrill Windsor W, Crew Linda, Mayo Rachel M, Mayo William F, Rogers Brooke L, Haynes Donna F
Department of Public Health Sciences, Clemson University, Clemson, South Carolina 29634, USA.
Educ Health (Abingdon). 2005 Nov;18(3):356-67. doi: 10.1080/13576280500312850.
Access to comprehensive and quality health care services is difficult for socioeconomically disadvantaged groups in rural regions. Barriers to health care for rural Latinos include lack of insurance, language barriers and cultural differences. For the Latino immigrant population in rural areas, barriers to access are compounded.
THE CASE OF WALHALLA, SC: The town of Walhalla, South Carolina is a rural community located in Oconee County, the northwest corner of the state. Disparities exist between rural and urban residents in several health categories, and these disparities illustrate the need to provide competent, appropriate and affordable healthcare to rural populations. The Hispanic population of Oconee has dramatically increased in the past decade, and the majority of these immigrants have no health insurance and have limited access to health services. DESIGNING A PROGRAM TO FIT THE COMMUNITY--THE "WALHALLA EXPERIENCE": The purpose of the Accessible and Culturally Competent Health Care Project (ACCHCP) is to provide care for underserved populations in Oconee County, South Carolina while providing rural educational opportunities for health services students. Funded by the Health Resources and Services Administration of DHHS, the program is designed to offer culturally appropriate, sensitive, accessible, affordable and compassionate care in a mobile clinic setting. In this interdisciplinary program, nurse practitioners, health educators, bilingual interpreters, medical residents and Clemson University students and professors all played key roles. Women in the community also serve as Promotoras or lay health advisors. The program is unique in using educational initiatives and innovative strategies for bringing health care to this underserved community and offers important information for rural health care initiatives targeting minority groups. This paper reports on the challenges and successes in the development and implementation of the ACCHCP program in Walhalla, South Carolina.
农村地区社会经济弱势群体难以获得全面优质的医疗保健服务。农村拉丁裔人群获得医疗保健的障碍包括缺乏保险、语言障碍和文化差异。对于农村地区的拉丁裔移民人口而言，获得医疗服务的障碍更为复杂。
以南卡罗来纳州瓦尔哈拉为例：南卡罗来纳州的瓦尔哈拉镇是一个位于该州西北角奥科尼县的农村社区。农村和城市居民在几个健康类别上存在差异，这些差异表明有必要为农村人口提供合格、适当且负担得起的医疗保健服务。在过去十年中，奥科尼县的西班牙裔人口急剧增加，这些移民中的大多数没有医疗保险，获得医疗服务的机会有限。
设计适合社区的项目——“瓦尔哈拉经验”：可及且具备文化能力的医疗保健项目（ACCHCP）的目的是为南卡罗来纳州奥科尼县的服务不足人群提供护理，同时为健康服务专业的学生提供农村教育机会。该项目由美国卫生与公众服务部的卫生资源与服务管理局资助，旨在通过流动诊所提供符合文化习惯、贴心、可及、负担得起且富有同情心的护理。在这个跨学科项目中，执业护士、健康教育工作者、双语口译员、住院医生以及克莱姆森大学的学生和教授都发挥了关键作用。社区中的女性还担任健康促进者或非专业健康顾问。该项目在利用教育举措和创新策略为这个服务不足的社区提供医疗保健方面独具特色，并为针对少数群体的农村医疗保健举措提供了重要信息。本文报告了在南卡罗来纳州瓦尔哈拉开发和实施ACCHCP项目过程中的挑战与成功经验。
