The world continues to deal with COVID-19 and herd immunity is not reached and skepticism, resistance and hesitation about vaccines continues representing a major obstacle. During the first few months of the vaccination effort, filmmaker Chris Newberry and his team followed a diverse set of health professionals as they gained the trust of at-risk communities across Minnesota. The resulting documentary is a tribute to the doctors, nurses, organizers and influencers who are embracing community-led efforts to overcome vaccine doubts.
Discussion guides for the documentary can be found here: English / Spanish
Watch the conversation with the film's creators and a panel of experts:
For anyone who would like to contact the producers with questions or for help in organizing their own TRUSTED MESSENGER event, they can reach us here:
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Agricultural workers are at significant risk for heat stress. Heat stress results when the body cannot get rid of excess heat and its core temperature rises. Heat stress may lead to more severe heat illness including heat exhaustion, heat cramps, heat stroke, and even death if left untreated. Agricultural work, which requires performing physically demanding work for long hours in hot and sometimes humid weather, places workers at high risk.
This guide provides information to clinicians on the prevention and treatment of heat-related illness. Since workers may not be familiar with all of the symptoms of heat stress, it is important that clinicians discuss heat illness symptoms and prevention with agricultural workers and others who are at risk.
This joint FJ and MCN publication was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of awards totaling $1,949,598 with 0% financed with non-governmental sources. The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement by, HRSA, HHS, or the U.S. Government. For more information, please visit HHS.gov.
- 2021_Heat-Stress_Clinicians-Guide_0.pdf (1.02 MB)
These image-centric, editable vaccine resources in multiple languages help you reach refugee, immigrant, and migrant communities with important information regarding getting a vaccine as well as safety measures to take after being vaccinated. These colorful flyers, in English, Spanish, and Haitian Creole, offer a Maryland, Virginia, and Delaware-specific option to choose from or editable versions for users to insert their own state-specific information such as their state vaccine logo, vaccine sign-up website and phone number, and organization logo. Along with these fliers, MCN has created a simple ‘how-to’ video (see above) for editing the fliers. The original designs for this new resource were created by a staff member of East Coast Migrant Head Start Project who is the daughter of a farmworker, and who had once gone to East Coast Migrant Head Start Project centers herself. The flyers were then adapted by MCN.
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- What-To-Expect-COVID19-Vaccine_ENGLISH_flyer.pptx (1.06 MB)
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Show your support of the vaccine in your community! MCN’s #YoMeLaPuse campaign offers five beautifully designed posters showing people of various ages after their vaccination that are available for download and printing. A sixth poster is customizable, allowing communities to paste in a photo of a local religious leader, or community health care providers, or other community leader who is proud to have gotten the vaccine. The posters are accompanied by a short video in Spanish, which can be played at community events and in waiting rooms.
Templates for creating your own posters are available below.
The analysis encouraged by these Five Key Questions, developed by the Center for Media Literacy (CML), can inform the decision-making or actions that we may take in a media-driven world.
A Prezi presentation that includes the Five Key Questions accompanied by links out to related resources is available to view here: https://prezi.com/view/2zUKL4KGQWaysr1BertD/
- Deconstructing-Health-Messages_Handout.pdf (154.66 KB)
Diabetes is a common but complicated health condition facing agricultural workers within the United States. To help assist agricultural workers in learning about this diagnosis, Migrant Clinicians Network has partnered with professional artist and collaborator Salvador Sáenz to create “Mi salud es mi tesoro: Un guía para vivir bien con diabetes,” or, “My Health is My Treasure: A Guide to Living Well with Diabetes.” This low-literacy comic book explores the topic through the full-color story of an agricultural farmworker named Goyo, whose recent diagnosis of diabetes prompts him to engage in conversations with other agricultural workers on topics of diet, exercise, and illness prevention while facing the unique hurdles of living a life of migration. The comic book was originally produced in Spanish, and is now available in English below. Please click "Leer en español" above to access the Spanish-language version.
Download a digital copy of the comic book below!
Are you PCMH certified?
Is your health center certified as a Patient-Centered Medical Home?
Health centers that are designated as Patient Centered Medical Homes aim to connect primary care, private practice providers, specialists, hospitals, outreach, and behavioral health, along with relevant community-based organizations, to not only deliver care but to support healthy lifestyles and safe environments for the community. Studies suggest that implementing an effective Patient Centered Medical Home framework will increase patient acceptance and satisfaction while reducing the total costs. In one study, PCMH recognition was associated with 4.9 percent less total Medicare spending per beneficiary. Another study concluded that the longer a practice had been transformed, and the higher the risk of the patient pool in terms of comorbid conditions, the more significant the positive effect of practice transformation, especially in terms of cost savings.
Visit HRSA Accreditation and Patient-Centered Medical Home Recognition Initiative webpage to get started.
Download HITEQ’s PCMH Self-Assessment Tool to gauge your health center’s readiness for meeting the NCQA 2017 PCMH Requirements.
Are your clinic sites that serve special populations like mobile agricultural workers also PCMH certified?
The majority of health centers have achieved PCMH at one or more of their sites. Many health centers, however, have not brought PCMH to the clinics that serve their most vulnerable, and at times most challenging, patients. Yet, these patients, like mobile agricultural workers, may benefit the most from PCMH processes, if the processes are adapted for the barriers the patients may face.
Here are some resources to get you started:
Read “Approaches for Establishing a PCMH for Mobile Patients,” an article from MCN’s in-print quarterly clinical publication, Streamline.
MCN’s PCMH for Mobile Patients webpage, which includes a recent poster presentation.
The Patient-Centered Primary Care Collaborative 2017 evidence report, “The Impact of Primary Care Practice Transformation on Cost, Quality, and Utilization,” found that “the longer a practice had been transformed, and the higher the risk of the patient pool in terms of comorbid conditions, the more significant the positive effect of practice transformation, especially in terms of cost savings.”
Does your health center clearly identify the occupation of your patients including mobile and agricultural worker patients through your intake process?
Patient-centered means knowing who your patient is and what health risks they may encounter. Simple and effective adjustments to intake methods and a health center’s EHR can assure that you understand the special needs of all your patients and that high risk patients such as agricultural workers and their family members are being correctly identified.
Here are some resources to get you started:
Identifying Migratory and Seasonal Agricultural Workers in Your Clinic: MCN’s resource, in English and Spanish, to guide your intake process.
Do you identify the social determinants of health that your agricultural workers face such as chemical exposure, poor housing, mobility?
Through a robust PCMH, a comprehensive care team forms to provide coordinated care for patients. By identifying the social determinants of health among a patient population and for an individual patient, care teams can plot a path to health that makes sense for the patient. In general, agricultural workers face numerous obstacles to a healthy life that your overall patient population may manage to avoid. Agricultural workers may suffer health issues or lose health access because of pesticide exposure, mobility, language and cultural differences, transportation issues, and more.
Here are some resources to get you started on identifying and addressing social determinants for agricultural worker patients:
Read the WHO’s page on social determinants and how to address them at “A Conceptual Framework for Action on the Social Determinants of Health.”
MCN’s Environmental and Occupational Health Screening Questions for Primary Care (available in English and Spanish) is EHR friendly.
Read how one health center used MCN’s Centers of Excellence program to integrate environmental and occupational health into its medical practice.
MCN and Farmworker Justice teamed up to create Clinician Guides for Farmworker Health and Safety Regulations.
Not all agricultural workers face the same social determinants. Read the summary of 2017 research to hear how subgroups of agricultural workers face different barriers: Recent Research on Agricultural Workers’ Social Determinants of Health and Health Outcomes.
National Association of Community Health Centers PRAPARE Implementation and Action Toolkit
Visit the Medical-Legal Partnership’s SDOH Academy.
Does your health center practice comprehensive team-based coordinated care with these social determinants findings in mind?
Read “Behavioral Health Integration: Obstacles & Successes,” an article by the Patient Centered Primary Care Institute on how Yakima Valley Farmworkers Clinic has built its PCMH to meet the unique needs of its largely agricultural worker population, with a strong emphasis on behavioral health and addressing the social determinants of health.
Has your health center established relationships with community-based organizations to further address barriers to care?
Community-based organizations can help mobile agricultural worker patients tackle many health concerns outside of the clinic’s walls.
Consider gathering these types of resources for your area
- Transportation resource
- Food resource
- Legal services?
- Migrant head start?
- Housing Shelter resources
Here are a couple of resources to get you started
Does your health center have systems in place to serve a patient who intends to leave the service area before care can be completed?
Health Network, MCN’s bridge case management system for mobile patients, was specifically designed to assure continuity of care for patients who will be leaving the service area. Patients with any ongoing health concern may be enrolled. Clinicians enroll patients for free, after which MCN’s Health Network Associates contact the patient to arrange for the continuation of care and records transfer in the patient’s next location, following the patient for as long as that patient is mobile and in need of care.
Health Network and PCMH together can assure better care for mobile patients.
Read how MCN’s Ed Zuroweste, MD, Co-Chief Medical Officer, developed a version of PCMH that worked for mobile patients in his practice.
Here are some additional resources:
Open Access Scheduling for PCMH
Does your health center regularly evaluate your systems to assure program effectiveness?
A comprehensive evaluation of interventions to improve the provision of PCMH for mobile patients should include a systematic review of four areas that are critical to performance improvement.
1. Identifying the social determinants of the patient
- Who are they
- What do they do
- What are their needs
2. Employing comprehensive, team based coordinated Care
- Integration of behavioral health
- Continuity and Follow up
3. Establishing clinical-community relationships
4. Evaluating the value
- Return on Investment
Here are some evaluation resources to assure your efforts continue to meet the needs of your community while best utilizing the center’s limited finances.
Data for Population Health Management from HITEQ Center
This guide is intended to support new and existing community health center program grantees in the State of California to successfully navigate through their unique and complex environment, particularly in regards to financial and operational processes at both the state and federal levels. Offered for free on the California Primary Care Association Store.
copy deeplink Staff Orientation to the use of Health Information Technology (HIT) to achieve the Triple AimStaff Orientation to the use of Health Information Technology (HIT) to achieve the Triple Aim
"HITEQ developed a series of eLearning modules for new staff that focus on Health IT and the Triple Aim, but provide a good deal of health center context as well:"
- Staff Orientation to the use of Health Information Technology (HIT) to achieve the Triple Aim - Part I
- Staff Orientation to the use of Health Information Technology (HIT) to achieve the Triple Aim - Part II
- Staff Orientation to the use of Health Information Technology (HIT) to achieve the Triple Aim - Part III
copy deeplink Scholarship: Underserved Occupational Populations Section Resident and Student ScholarshipScholarship: Underserved Occupational Populations Section Resident and Student Scholarship
Application Deadline: 04/15/2018 at 5 pm CST
The Underserved Occupational Populations Section of ACOEM is sponsoring one $1,000 scholarship to qualified residents and medical students interested in making significant contributions to the field of underserved occupational medicine.The scholarship was established in honor of Joseph A. Fortuna, MD, FACOEM who founded the Underserved Occupational Populations Section of ACOEM and who was a tireless supporter of underserved workers and their families.
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This new poll, taken by Migrant Clinicians Network in January and February 2018, reflected the experiences of clinical staff from 26 states across the country. Respondents came from every corner of the clinic; occupations listed include Physician, Executive Director, Dental Assistant, Outreach Specialist, Therapist, Community Health Worker, Registered Nurse, and 24 other occupations. The poll follows up on MCN’s 2017 poll, in which 63 percent of respondents indicated that immigrant and mobile patients’ attitudes and feelings toward health care access had changed.
- Poll Results February 2018.pdf (92.89 KB)
"The Global Report on Internal Displacement presents the latest information on internal displacement worldwide caused by conflict, violence and disasters."
"These materials are designed to be simple and useful in helping physicians and health-care professionals to meet the needs of their patients who may be undocumented or suffering stresses related to close family or community members being undocumented. While there are many toolkits being developed, we hope that these materials might be very easy to use and enable the physician or other health-care professional to address the most immediate needs of such patients."
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