Closing the Gap on Health Care Disparities – 2009 Grant Summaries

The Closing the Gap on Health Care Disparities grant area provides two years of support to 11 coalitions across Massachusetts seeking to reduce health disparities on the basis of race, ethnicity, immigration status, age, mental illness, and sexual orientation. These organizations undertook a one-year planning process to assess community needs, gather data, and build community and provider participation. They developed models that focus on clinical practice effectiveness and increase public awareness about disparities and social determinants of health. The implementation grants are just over $113,600 per year (awards total $1,250,000). These 11 grantees will have the ability to have their funding renewed for a second implementation year in 2010.

The Closing the Gap on Health Care Disparities program area is designed to support innovative programs serving groups with poorer health outcomes and/or reduced access to quality health care. These grants include a focus on collaboration between consumers and providers as a means for changing health care delivery and other systems to help eliminate health disparities. This collaborative approach is intended to promote community voice and to raise public awareness about achieving health equity.

An innovative component of this grant area is the statewide “learning community” that builds relationships and allows for sharing of effective practices and solutions among those who work in reducing health care disparities in the state.

The following organizations have been awarded grants in the Closing the Gap on Health Care Disparities grant program area:

AIDS Action Committee (AAC)
Collaborator: Massachusetts General Hospital (MGH)
Boston

Funding supports the AAC to run a peer navigation program in the Infectious Disease Clinic at MGH to improve access to and retention in optimal care for HIV positive women of color. Program strategies include: increased training for providers, training HIV positive women to be Peer Navigators, and changing clinical practice by integrating those Peer Navigators into the MGH Infectious Disease Clinic. They will reach at least 50 new women in this pilot project and will assess the impact of Peer Navigators on the health and health care seeking behaviors of women of color living with HIV.

Cambridge Cares About AIDS (CCAA)
Collaborator: Institute for Community Health
Greater Boston

Funding supports efforts to address the disparities in health care for HIV positive men of color who have sex with men. The We’re Still Here Health Disparities Project will strengthen community-based networks for HIV-positive Black men and their partners in Greater Boston and the MetroWest area, train three cohorts of HIV positive Black men in theater and leadership skills to identify their care needs, and work with providers to implement system changes to better serve this group for whom late entry to and inconsistent medical care contributes to a higher mortality rate.

Casa Latina
Collaborators: Northampton Area Pediatrics, Valley Medical Group, Cooley Dickinson Hospital
Hampshire County (Amherst, Easthampton, Northampton) 

This funding supports the Bridges to Latino Health/Puentes A La Salud Latina program to improve access to culturally competent primary care, leading to more effective care and communication and reductions in health disparities for Hampshire County Latinos. Specific strategies to be implemented by the Bridges project include: implementing organizational changes with two multi-site medical care practices, training community health workers to serve as a bridge between providers and patients, consumer education to promote prevention activities and chronic disease self-management, and building community awareness of health equity and disparities.

Central Massachusetts Area Health Education Center
Collaborators: MetroWest Mental Health and Substance Abuse Task Force, Advocates, South Middlesex Opportunity Council, Wayside Youth and Family Support Network, Framingham Community Health Center
Framingham/MetroWest

Funding supports a multi-pronged approach to increase access to behavioral health services for Latinos and Brazilians in the Framingham area. The project intends to increase knowledge and capacity about behavioral health issues and services in the Latino and Brazilian communities. They will work to increase the level of cultural sensitivity and accessibility of behavioral health agencies emphasizing innovative approaches and locations, enhance the capacity of behavioral health providers to serve under- and uninsured and/or undocumented individuals, and promote continued collaboration between mental health and substance abuse services in the MetroWest area. The project will use community health workers to build community knowledge and awareness.

Community Health Center of Cape Cod
Collaborators: Cape Cod Immigrant Center; Falmouth, Mashpee, Bourne and Barnstable Public Schools; Barnstable County Human Rights Commission
Cape Cod

Funding supports the Healthy Immigrant Families (HIF) project to implement a comprehensive education, community development and media plan to enhance opportunities for healthy eating and exercise among immigrant children on Cape Cod. The HIF project plan addresses core social determinants of obesity disparity including stress, immigrant community concerns, lack of access to affordable healthy foods, long work hours, and lack of access to affordable and/or traditional exercise options. HIF will reach 5,000 immigrants through school workshops and public awareness activities. The project emphasizes coordination between schools, families, health care providers and other organizations to provide consistent health messages, foster positive health behavior change and to make systemic changes, such as better food choices in schools, in order to enhance an individual’s ability to make healthy choices.

Lowell Community Health Center
Collaborators: Greater Lowell Health Alliance, Mental Health Association of Greater Lowell, AfriCare, Lowell General Hospital
Lowell

Funding supports the Gateways to Care (GTC) Program to improve the overall well being of individuals suffering from depression, particularly Cambodian, African, Brazilian, and Latino immigrants. The GTC Program will address gaps in access to mental health treatment services through the enhancement and coordination of services within LCHC, better coordination of services among local agencies, and increased community education about depression, myths related to depression and available services. Among other strategies, Gateways will incorporate evidence-based depression screenings into health promotion events and create a mini-grants program that distributes $25,000 per year for community level education projects and to build community voice.

Mt. Auburn Hospital
Collaborators: Power Program, Waltham Alliance to Create Housing, Waltham Family School and the Joseph M. Smith Community Health Center
Waltham

Funding supports Listen and Learn, a program focused on reducing Type 2 diabetes among Latinos in Waltham. The Listen and Learn project will educate providers about health disparities, support the development of a Latino Health Leadership Group, and lead a public awareness campaign about health disparities. In addition, this multi- pronged strategy will support an effort to institutionalize system changes proposed by the Latino Health Leadership Group in the health care organizations.

Partners for a Healthier Community
Collaborators: Food Bank of Western Mass, MLK Community Center, Health Care For All’s Disparities Action Network, Health New England, Bay State Health, Springfield Partners for Community Action
Springfield

Funding supports a coalition effort to implement connected strategies to reduce childhood obesity in Springfield and contribute to long-term reductions in type 2 diabetes. The coalition developed goals in four areas of focus: schools, neighborhood, social networks, and health care systems. The project seeks to reduce obesity by implementing targeted interventions that promote family behavior change, alter health care system approaches, and increase food access and fitness opportunities in three Springfield neighborhoods. One strategy is to run institutes to train residents as community health workers to educate and lead their neighbors. The project will focus on families with children who are at risk of obesity while doing broad public education.

ServiceNet, Inc.
Collaborators: NAMI Western Mass, United ARC of Franklin and Hampshire Counties, Valley Medical Group of Massachusetts, FIT Together
Franklin and Hampshire Counties

Funding supports a coalition to improve the health and wellness of individuals with cognitive and mental health challenges in Northampton and Western Massachusetts. The ServiceNet project proposes ensuring primary care providers are part of a supportive network – including support staff and mental health providers – that can effectively communicate with individuals with severe mental illness about maintaining their health. In addition, support staff will be trained to adapt and implement evidence-based wellness programs to address health issues among this population, and to create healthy lifestyle opportunities for consumers. The impact of this effort will be widened through public awareness activities and sharing best practices both locally and nationally.

Tapestry Health
Collaborator: Youth Empowerment Adolescent Health (YEAH) Network
Holyoke and Springfield

Funding supports a project to expand access to health care by identifying and examining the relationships between health care practices and teen births in the Latina/Latino community in Hampden County. The project will use a Promotora-type community health worker to improve cultural competency and outreach at Tapestry Health and implement service delivery model changes recommended by a coalition of community advisors. In addition, a teen coalition will be used to engage youth and promote advocacy, and a media campaign will be implemented to raise awareness of disparities and identify possible solutions.

The YWCA of Central Massachusetts
Collaborators: Family Health Center of Worcester, Great Brook Valley Health Center, UMass Medical School, Massachusetts College of Pharmacy and Health Sciences, Community Build
Worcester

Funding supports Worcester Healthy Weight Now/Worcester Peso Sano Ahora, a project to address disparities in obesity among Latinos in Worcester. The multi-faceted intervention will work to increase healthy eating and physical activity across the lifespan of Latinos living in four Worcester neighborhoods. The proposed Worcester Healthy Weight Now project will target individuals to participate in regular physical activity and healthy eating, support environmental projects that promote food access, foster system changes amongst medical providers to track physical activity, and build peer support. The program will kick off with a Worcester-wide public awareness effort.