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Cultural Connections. Pipeline to diversity grant aims to increase latino participation, cultural competency in Idaho's Health Care system

Cultural Connections

Pipeline to Diversity Grant Aims to Increase Latino Participation, Cultural Competency in Idaho’s Health Care System

Andrew Taylor

Hailey Lusk’s work interests have come full circle.

“I was once using Spanish to teach health, and now I’m teaching Spanish for health,” said Lusk, an Idaho State University graduate who is a Spanish teacher at American Falls High School and an adjunct Spanish instructor at ISU.

 Lusk previously used her fluency in Spanish working as a health educator for Health West. Now, at American Falls High School, Lusk has 14 students, nine who are Hispanic, enrolled in her Spanish for Health Professions II class, a dual enrollment class, meaning her students can receive college credit and high school credit at the same time. 

“This is definitely a high-level class,” said Lusk, who has a bachelor’s degree in health education and Spanish from ISU and holds a post-baccalaureate certificate in secondary teaching and is working on her masters in Spanish for Health Professions at ISU.  “The kids enrolled are really assertive, bright, hardworking students. They are fun.”

Kneeling L-R: Angelica Hernandez, Erika Martinez, Sadith Laguna, Elizabeth Gutierrez, Carolina Torres
Standing L-R: Samantha Mason, Tiara Grant, Alexis Navarette, Andrea Walker, Hailey Lusk (teacher), Mariah Christensen, Jose Mosqueda, Perla Gonzalez, Brenda Gonzalez Palacios

These students and Lusk are participating in programs offered through ISU’s nearly $1.2-million Pipeline to Diversity Grant from Health Resources and Services Administration (HRSA).

Pipeline students at American Falls, Rigby and Snake River High Schools can get six college credits by taking Spanish for Health Professions I and II and up to 16 additional college credits by taking College Level Examination Program (CLEP) exams. Additional area high schools have expressed interest participating in the program.

Pipeline students can become certified medical interpreters by completing the Morales-Dimmick medical interpreter course and exam. This certification can help them land jobs after graduating from high school. The students also work at health fairs, gaining experience taking health histories and receiving cultural exposure. On top of this, health care professionals from a variety of fields visit the classrooms to share their experience, exposing the students to options in the medical fields.

“What is unique is the native Spanish-speaking kids can relate to Hispanic patients and the non-Hispanic kids can learn about relating to Hispanic patients,” Lusk said.

A hoped outcome of these efforts is to have more Latino students enter the health professions.

The Pipeline to Diversity grant, in its second year of five years, isn’t just for prep students. It includes undergraduate, graduate, post-graduate and certificate students at the university level. Its ultimate goal is to increase Latino participation and Latino cultural competency in Idaho’s and the region’s health care system.

This interdisciplinary program was hatched by Paula Phelps, associate professor in ISU’s Department of Physician Assistant Studies, Helen Tarp, associate professor in the ISU Department of Global Studies and Languages and Melanie Domenech-Rodriguez, psychology professor at Utah State University, who is now a visiting professor in ISU’s P.A. program. This trio of investigators is helping put ISU on the national map as a leader in offering Spanish for the health professions.

“The complexity of what we are doing is very unique,” Phelps said. “ISU and our Physician Assistant program are really focused on Spanish for health professions and increasing the cultural knowledge and Spanish-language acquisition of our providers and providing culturally and linguistically competent rural health providers to Idaho and the surrounding areas.”

For Phelps’ program in particular, the grant’s goals are to increase the number of “bilingual, bicultural” physician assistants practicing primary care in rural and underserved areas. ISU’s P.A. program is working to increase the recruitment and retention of Latino-focused bilingual and bicultural applicants and is changing its curriculum to include more content on cultural competencies and health disparities. It also aims to increase the number of Latino Veterans who enter the P.A. workforce. A “Latino Health Track” has been created within the ISU P.A. program and students will complete more clinical rotations in Latino-focused areas. Stipends are also available to Latino students entering the program.

Phelps noted that there is a health disparity between Hispanic and non-Hispanic whites nationally and in Idaho. Idaho’s Hispanic population has increased by 63 percent in the last 10 years as compared to a 21 percent increase in non-Hispanics and some rural school districts are in areas where Hispanics make up 80 percent of the population. 

“There is a high, unmet need for primary health care providers who are bilingual and bicultural,” Phelps said.

This grant builds on the foundation for teaching medical Spanish that was created by Tarp, who was the driving force behind the ISU Department of Global Studies and Languages. In 2013, Tarp started a Spanish for Health Professions degree program, a joint effort between the College of Arts and Letters and Kasiska Division of Health Sciences.

Hailey Lusk, teaching at American Falls High School.

“Our language program was already based on really good methodology and research, and the program itself was based on student demand. That helped us land this new grant,” Tarp said. “When we talked to providers out in the trenches, they said they needed students not just with the language skills, but they want students with cultural competency and a good understanding of health care systems. We had the structure, systems and attitudes in place and we had the P.A. program with its interest in rural community health, and it all came together.”


Physician Assistant Program Partners to Fight Cervical Cancer in Latino Women

More than 100 women in the Dominican Republic were able to receive cervical cancer screenings, thanks to Idaho State University faculty and a federal grant designed to help provide health care to Latino populations.

In January, as part of a service-learning project, Paula Phelps traveled to the Dominican Republic and joined ISU physician assistant alumna Joanna Nichols, president of the Dallas Rotary International, and Jared Papa, ISU physician assistant program clinical assistant professor and service learning coordinator who is based in Meridian.

The group met with a group of local Dominican Republic doctors and caregivers to provide the cervical cancer screenings and to provide follow-up care on women who had abnormal test results. This health center hadn’t provided this type of service in more than three years.

“These experiences provide us with invaluable cultural knowledge acquisition and increased language skills,” Phelps said. “And our medical services are much needed.”

This particular trip could also be the seed for a much larger health project. Phelps said she is hoping the ISU P.A. program may eventually partner with Rotary International to provide cervical cancer screenings and cervical cancer vaccines to Hispanic women internationally, with the Dominican Republic being a pilot project.

“We’re seeing if we could partner with Rotary International,” Phelps said. “We’d love to see cervical cancer eradication worldwide.”

She explained that if detected early, cervical cancer is nearly 100 percent treatable. There is also a vaccine available that treats the virus that causes the cancer. This vaccine is also nearly 100-percent effective.

From left, ISU assistant professor Paula Phelps, College of Idaho pre-medical student Megan Phelps and two girls from the Palave Clinic neighborhood in the Dominican Republic.

The ISU P.A. program has been doing international medical work at several sites for years, including in the Dominican Republic and Peru.

Phelps noted there is a large health disparity worldwide, nationally and in Idaho between the cervical cancer rates between Hispanic and non-Hispanic whites. Worldwide, cervical cancer is the 14th most common cancer but is the second most common cancer in the United States. Nationally the cervical cancer rates for Hispanic women is 13.8 per 100,000 and for non-Hispanic women is 8.7 per 100,000. This disparity is even larger in Idaho – about 16 cases per 100,000 for Hispanic women and 7 for non-Hispanic.

“The disparity is not due to ethnicity and racial genetics, but has to do with poverty,” Phelps said. “The P.A. program is working locally in Southeast Idaho creating a program to increase access to Latino women to receive cervical cancer care.”

The plan is to create a training program for lay, community health workers to meet face-to-face with women and children in the Latino community and provide education about cervical cancer treatment and prevention.

“Research has found this is the best way to increase the number of patients screened,” Phelps said.