Buckheit Caledonia, Pineros Dwan, Olson Ardis, Johnson Deborah, Genereaux Stephen
From the Dartmouth Geisel School of Medicine, Hanover, NH (CB, DP); Department of Community & Family Medicine, Dartmouth Geisel School of Medicine, Hanover (AO, DJ, SG); Department of Pediatrics, Dartmouth Geisel School of Medicine, Hanover (AO).
J Am Board Fam Med. 2017 Jan 2;30(1):91-93. doi: 10.3122/jabfm.2017.01.160174.
Dartmouth Geisel Migrant Health (DGMH) is a medical student group that provides on-site health services for Spanish-speaking dairy workers in rural Vermont and New Hampshire in conjunction with a federally qualified health center (FQHC).
This project was undertaken to evaluate and improve the services provided by DGMH and the FQHC and to refine understanding of the target population.
We surveyed 25 workers at 6 collaborating dairy farms to identify health priorities and concerns and perceived barriers and facilitators to health care for these workers. Surveys were administered over 2 weeks in July 2015. Interpreter-mediated appointment and sliding-fee-scale data from a period 7 months that spanned survey administration were also assessed.
Diabetes and hypertension were the most common health concerns. Thirty-two percent of participants reported 10 or more days of depressed mood in the past month. Insurance and language were the most common barriers to health care and employers and on-site clinics were the most common facilitators. Appointments most often addressed women's health, gastrointestinal problems, health maintenance, diabetes, and back pain. Thirty FQHC sliding-fee-scale applications were completed by workers.
These Spanish-speaking dairy-farm workers have many health concerns and perceive substantial barriers to health care. Collaboration between medical students, a rural FQHC, and farm employers provides important services that facilitate health care access among this population.
达特茅斯盖泽尔移民健康组织（DGMH）是一个医学生团体，它与一家联邦合格健康中心（FQHC）合作，为佛蒙特州和新罕布什尔州农村地区讲西班牙语的奶农提供现场医疗服务。
开展该项目是为了评估和改进DGMH及FQHC提供的服务，并加深对目标人群的了解。
我们对6个合作奶牛场的25名工人进行了调查，以确定他们的健康优先事项和关注点，以及他们认为的医疗保健障碍和促进因素。调查于2015年7月的两周内进行。我们还评估了在涵盖调查实施的7个月期间由口译员协助安排的预约以及按比例调整费用的数据。
糖尿病和高血压是最常见的健康问题。32%的参与者报告在过去一个月中有10天或更多天情绪低落。保险和语言是医疗保健最常见的障碍，而雇主和现场诊所是最常见的促进因素。预约就诊最常涉及女性健康、胃肠道问题、健康维护、糖尿病和背痛。工人完成了30份FQHC按比例调整费用的申请。
这些讲西班牙语的奶农有许多健康问题，并且认为在获得医疗保健方面存在重大障碍。医学生、农村FQHC和农场雇主之间的合作提供了重要服务，促进了这一人群获得医疗保健。
