PT  - JOURNAL ARTICLE
AU  - Buckheit, Caledonia
AU  - Pineros, Dwan
AU  - Olson, Ardis
AU  - Johnson, Deborah
AU  - Genereaux, Stephen
TI  - Improving Health Care for Spanish-Speaking Rural Dairy Farm Workers
AID  - 10.3122/jabfm.2017.01.160174
DP  - 2017 Jan 01
TA  - The Journal of the American Board of Family
                Medicine
PG  - 91--93
VI  - 30
IP  - 1
4099  - http://www.jabfm.org/content/30/1/91.short
4100  - http://www.jabfm.org/content/30/1/91.full
SO  - J Am Board Fam Med2017 Jan 01; 30
AB  - Background: 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).Study Objective: This project was undertaken to evaluate and improve the services provided by DGMH and the FQHC and to refine understanding of the target population.Methods: 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.Results: 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.Conclusions: 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.