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As Latino population increases, so do needs by Heather Woolwine Public Relations In recognition of National Hispanic Heritage Month, members of the MUSC community shared projects initiated to aid the increasing Lowcountry Hispanic population during a panel discussion Oct. 5.   Dubbed “MUSC Outreach to the Hispanic/Latino Community,” the discussion was the third presentation in the Hispanic Heritage Month noontime series sponsored by the Alliance for Hispanic Health. It highlighted three programs geared toward the Hispanic and Latino communities.   Panel presenters included: Deborah Williamson, DHA, College of Nursing certified nurse midwife; Dianna Inman, pediatric nurse practitioner in developmental pediatrics; Sylvia Martin, Hollings Cancer Center (HCC) Breast Health Patient Navigation Program; Debbie Bryant, R.N., HCC director of outreach services; and Michael de Arellano, M.D., MUSC National Crime Victims’ Research and Treatment Center. Mom’s Morning Out     Women of various ethnic groups are more likely to live below the poverty level than white women, according to numerous socio-economic studies. It can be difficult for young Hispanic women to pull themselves and their families from the talon-like grasp of poverty when resources to do so are not easily accessible, if even available. For decades, world leaders have proclaimed education as the pathway to prosperity. In response, education for young Hispanic children and their mothers is the core of a collaborative program among the MUSC’s College of Nursing, Department of Pediatrics, College of Dental Medicine, the Charleston and Dorchester County mental health services, Charleston County School District, Trident Literacy Association, and Midland Park Community Ministries.       “Mom’s Morning Out” combines early childhood development activities for children with health promotion information and activities, and ESL (English as a Second Language) classes for mothers.   Co-principal investigator Williamson and project coordinator Inman offered data from the 2002 South Carolina Child Care Survey that indicated children of impoverished and poorly educated mothers are less likely to be enrolled in child development programs. “Yet many of these mothers do not have the resources needed to promote their child’s development and school readiness,” the proposal reports. “The lack of resources in the early social, emotional and physical environment sets up these children for low educational performance or failure in school, leading to under-employment and a life of poverty. Immigrant children, in addition to the language barrier, often grow up in households lacking the resources to assist with their readiness for school.”   “Once these children are branded as ‘behind,’ it’s hard to catch up,” Inman said during the presentation. “The program is designed to work with children and their families so that they are ready for four-year-old kindergarten and can move through the education system successfully.”   The program is offered at Midland Park Elementary school in North Charleston, where concerned teachers and the principal discovered the need for the program to better prepare rising Hispanic and Latino populations for school. Families with two-and three-year-old children of Latino descent were recruited from the school’s most recent open house event. “Mom’s Morning Out” is the first program of its kind to serve an immigrant population and incorporate the health concerns of mothers. “These are mothers with children already in school who have a desire to see all of their children get a good education,” Inman said.   As for the first day, Oct. 5, 10 children and six mothers were enrolled in the program.   Two mornings a week from 8:30 until 11:30 a.m., mothers will have the opportunity to meet as a group for health information and English classes while their toddlers participate in educational activities. Greeted with the sounds of Spanish nursery rhymes, bilingual books and concepts taught in English and Spanish, the program seeks to be sensitive to the Latino and Hispanic cultures while helping participating families find a better way through the system. Mothers and children participate in reading and craft activities together, and all enrolled children will receive developmental assessments provided by a pediatric nurse practitioner. A bilingual, certified early childhood development teacher and assistant will tutor children in their classroom while a bilingual Trident Literacy Association teacher works with mothers. MUSC faculty and students will provide the health education component.   Inman said the program’s goals are to: increase school readiness; increase language development using evidence-based curriculum and interventions; teach English as a second language to mothers; provide health information including parenting skills, normal child growth and development, and women’s health topics and services; provide access to community and health services; get children into a medical system; offer preventative, mental health and substance abuse services; provide dental care; and remain culturally and linguistically sensitive at all times. Hollings Cancer Center Patient Navigation Program Bryant and Martin explained the patient navigation concept and how the approach is touted at the national level as a way to reduce health disparities.   “Hollings outreach services has several branches that provide services to Hispanic populations, including the breast health patient navigation program, the mobile health unit, and other efforts to eliminate health disparities,” Bryant said. “Patient navigation is the new frontier in relieving barriers to the large and intimidating health care system.”   MUSC’s breast health patient navigation delivers and assists the state’s medically underserved populations to obtain timely cancer diagnostic treatment services.   Funding for the service was provided through a grant from the Avon Foundation for breast cancer patients. “After noting the gap for underserved patients was in diagnostic care, we realized that more efforts to link the patient from screening all the way through treatment was necessary for many of those patients,” Bryant said. “Having Sylvia (Martin) has been great; she’s been a godsend for me. Having a Hispanic navigator is a must because it is a population that faces many barriers to treatment.”   Martin shared examples from her work as a navigator, noting, “I help them with medications, figuring out appointments. They are often nervous and crying and I tell them that I’m a cancer survivor. We become close; it’s like having many sisters.” Taking services to the patient Meanwhile, two new grants were acquired by the MUSC National Crime Victims’ Research and Treatment Center, de Arellano said. Both will provide programs for Hispanic and Latino children or adults who are victims of abuse or a traumatic event. Since his arrival at MUSC 11 years ago, de Arellano has noticed the difficultly Hispanics have had in making office appointments for mental health services. He mentioned the need to work or care for family members as the top two reasons for people missing appointments or never seeking mental health help in the first place. It also can be difficult for Hispanic parents to worry about behavioral problems or other mental health issues at home or school when the primary concern is whether the child has a home at all. As one parent expressed, basic survival needs must be met before parents can worry about mental health. In response, de Arellano sought to find a way around that barrier to get Hispanic children the services they needed.   “So what we decided to do was offer school-based services, church-based services, or work-based services to bring the care to those who need it,” he said. “I can remember one grandmother who wanted to help her grandchild, but as the owner of a restaurant, she couldn’t get away to take him to appointments. So we brought the service to that family at their grill and bar.”   One of the two grants will continue this type of service for Hispanic children age 12 months to 17 years old using evidenced-based behavioral and cognitive therapy to treat anxiety and depression.   The second grant will fund a program called the Violence against Hispanic Women Network. This network will provide case management in mental health services for victims of domestic violence, stalking and rape, and will work with the help of the organizations People against Rape and My Sister’s House, a shelter for battered and abused women. The center has some vehicles to transport victims of trauma to related treatment appointments like rape exams, follow-up visits, and abuse exams and assessments.   “We’re learning that the Hispanic population is highly victimized, whether it be immigration-related trauma (physical or sexual assaults, witnessing murders while coming across the border) or other mental health problems,” de Arellano said. “There is a lot of anecdotal evidence from the parents of Hispanic children whom we are treating that indicates a highly traumatized adult population as well.”   The two programs offer many opportunities for clinical and research experience, and de Arellano concluded by encouraging students and others to help care for the underserved Hispanic population.   For more information or to volunteer, contact de Arellano at 792-3332.     Friday, Oct. 27, 2006 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.