Miyamoto Robin ES, Hermosura Andrea H, Acido Debieh Ar Miguel
Department of Native Hawaiian Health, Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (RESM, AHH).
Physician Center Mililani, University Health Partners, Mililani, HI (DARM).
Hawaii J Med Public Health. 2019 Jun;78(6 Suppl 1):78-82.
Greater medical and psychological concerns coupled with disparities in income and education and experiences with cultural distress have created an unprecedented demand for health and mental health services for Native Hawaiians. With 75% of the healthcare system moving to a value-based system within the next 2 years, a low-cost workforce that brings added value will be in high demand. The addition of community health navigators to an existing integrated patient-centered medical home may result in a culturally congruent, preventive, and responsive model of wellness that promotes health equity. The purpose of this paper is to discuss the culturally-based navigation framework we used to implement a pilot program in an integrated primary care setting, describe the intervention that was used, and examine the lessons learned throughout the process. Outcomes will be provided at a later date. We believe that our model will not only redesign an existing clinical practice but also will provide a reproducible model that can be translated into other settings to increase the health care utilization among Native Hawaiians and lead to improved outcomes.
更大的医疗和心理担忧,再加上收入和教育方面的差距以及文化困扰经历,使得夏威夷原住民对健康和心理健康服务产生了前所未有的需求。随着75%的医疗保健系统在未来两年内转向基于价值的系统,能带来附加值的低成本劳动力将供不应求。在现有的以患者为中心的综合医疗之家增加社区健康导航员,可能会形成一种符合文化习惯、具有预防性和响应性的健康模式,促进健康公平。本文的目的是讨论我们用于在综合初级保健环境中实施试点项目的基于文化的导航框架,描述所采用的干预措施,并审视整个过程中吸取的经验教训。结果将在稍后提供。我们相信,我们的模式不仅将重新设计现有的临床实践,还将提供一个可复制的模式,可推广到其他环境中,以提高夏威夷原住民的医疗保健利用率并改善结果。