Master of Public Health Field Experience Report EXPLORING FRONTIERS AT THE UNITED STATES-MEXICO BORDER: HEALTH LITERACY COMMUNICATION IN THE U.S.-MEXICO BORDER REGION OF NEW MEXICO AND CO- ORDINATING THE SUMMER 2012 FRONTIER PROGRAM FIELD TRIP IN LAS CRUCES, NEW MEXICO by JENNIFER E. ENGEL, DVM MPH Candidate submitted in partial fulfillment of the requirements for the degree MASTER OF PUBLIC HEALTH Graduate Committee: Justin Kastner, Ph.D. Abbey Nutsch, Ph.D. Jason Ackleson, Ph.D. Field Experience Site: Office of Border Health, New Mexico Department of Health, Las Cruces, New Mexico Frontier Program May 14, 2012 – July 27, 2012 Field Experience Preceptor: Paul Dulin, M.S. KANSAS STATE UNIVERSITY Manhattan, Kansas 2014 i Copyright JENNIFER E. ENGEL 2014 ii Abstract The New Mexico Department of Health (NM DOH) Office of Border Health in Las Cruces, New Mexico, conducted a survey in the summer months of 2012 concerning information about access to healthcare within the Hispanic population in their jurisdiction. The NM DOH Office of Border Health was interested in directing their resources to improve outreach to the Hispanic population that they serve. During my internship with the NM DOH Office of Border Health I contributed to this project. I created a survey instrument, aided in its translation to Spanish, compiled “goody bags” to use as incentives and distribute to participants, conducted the survey in various locations in Doña Ana County, input data into the Epi InfoTM computer program used at the NM DOH Office of Border Health, and helped to interpret results. The second part of my field experience culminated during the week of Monday, June 18, 2012 through Saturday, June 23, 2012, when the Frontier Program hosted an experiential learning field trip that brought students, faculty and staff from different universities across the United States to the Las Cruces, New Mexico area and the Santa Teresa Border Crossing. I assisted the Frontier Program Coordi- nator in Las Cruces, New Mexico, with planning the logistical aspects of the portion of the field trip in Las Cruces through visiting locations and meeting with key people at the Santa Teresa Border Crossing, J.H. Rose Logistics, LLC, New Mexico State University, and at La Posta de Mesilla historic Mexican restaurant. This report summarizes my experiences working with both the NM DOH Office of Border Health and the Frontier Program while in Las Cruces, New Mexico. I also outline, provide, and explain the mate- rials created for each of these projects. iii Table of Contents Summary .............................................................................................................................. iii Table of Contents ................................................................................................................. iv List of Figures ........................................................................................................................ v Chapter 1 – Field Experience Scope of Work........................................................................... 1 Introduction to the Scope of Work ............................................................................................. 1 Introduction to the US-Mexico Border and Its Health Status .................................................... 2 Introduction to the Frontier Program ......................................................................................... 5 Chapter 2 – Learning Objectives ............................................................................................. 7 Activities Performed: New Mexico Department of Health Office of Border Health .................. 7 Products Developed: New Mexico Department of Health Office of Border Health .................. 7 Activities Performed: Frontier Program ..................................................................................... 8 Products Developed: Frontier Program .................................................................................... 10 Chapter 3: Field Experience and Culminating Project ............................................................ 11 New Mexico Department of Health Office of Border Health ................................................... 11 Data Analysis ............................................................................................................................ 14 Results and Data .................................................................................................................................. 15 Interpretation and Discussion ........................................................................................................... 23 Chapter 4 Conclusion and Knowledge Gained ...................................................................... 26 Acknowledgements ............................................................................................................. 28 References .......................................................................................................................... 29 Appendix A - Health Literacy Guided Interview Instrument – English .................................... 30 Appendix B - Health Literacy Guided Interview Instrument – Spanish ................................... 35 Appendix C - Healthcare Service Provider Questionnaire .................................................... 40 Appendix D - Frontier Field Trip Agenda Poster .................................................................... 42 Appendix E - Frontier June 20th 2012 Itinerary ..................................................................... 43 Appendix F - Frontier Field Trip Week Itinerary .................................................................... 45 iv List of Figures Figure 1.1: The US-Mexico Border Region ...................................................................................... 2 Figure 3.1: Participation Goody Bags ............................................................................................ 13 Figure 3.2: Language Preference .................................................................................................. 15 Figure 3.3: Radio Listening ............................................................................................................ 15 Figure 3.4: Radio Station Language Preference ............................................................................ 15 Figure 3.5: US vs. Mexico Radio Stations ...................................................................................... 16 Figure 3.6: Television Watching .................................................................................................... 16 Figure 3.7: Television Station Language Preference ..................................................................... 17 Figure 3.8: Television Reception ................................................................................................... 17 Figure 3.9: House Phone/Land Line .............................................................................................. 18 Figure 3.10: Cell Phone Ownership ............................................................................................... 18 Figure 3.11: Texting Use of Cell Phones........................................................................................ 18 Figure 3.12: Internet on the Cell Phone ........................................................................................ 18 Figure 3.13: Internet Usage .......................................................................................................... 19 Figure 3.14: Facebook Usage ........................................................................................................ 19 Figure 3.15: Health Website Use .................................................................................................. 19 Figure 3.16: Specific Health Website Use ..................................................................................... 19 Figure 3.17: Newspaper Reading .................................................................................................. 20 Figure 3.18: Flyers in the Community .......................................................................................... 20 Figure 3.19: Billboards Visibility ................................................................................................... 20 Figure 3.20: Knowledge of Promotor/a ........................................................................................ 21 Figure 3.21: Visited by Promotor/a.............................................................................................. 21 Figure 3.22: Health Announcements in Newspaper .................................................................... 22 Figure 3.23: Health Announcements on Radio ............................................................................. 22 Figure 3.24: Health Announcements on Television ..................................................................... 22 Figure 3.25: Obtainment of Health Care Information .................................................................. 22 v Chapter 1: Field Experience Scope of Work Introduction to the Scope of Work During the summer months of 2012, I had the unique experience of integrating many aspects of public health. I traveled from Kansas State University in Manhattan, Kansas, to Las Cruces, New Mexico. During my time in Las Cruces, I was able to participate in a project with the New Mexico Department of Health Office of Border