Page 1

Notes from the Director

We would like to take the opportunity to share with you some activities imple-

mented in 2012 and the spring of 2013. Thank you for your support. As we con-

clude different research projects and engage in new educational and research

activities we reassure our commitment to integrating the Center for Advancing

Latino Health as a key element within the University of Kansas Medical Center

(KUMC).

As we celebrate our first year, we received the very prestigious Carlos F. Cortes

Humanitarian of the Year Award at the 35th Gala Night of the Hispanic Chamber

of Commerce of Greater Kansas City. We feel honored to receive this recogni-

tion for working towards eliminating health disparities and building healthier

communities for the underserved Latinos in Kansas.

Considering how fast the Latino community is growing in the state of Kansas,

we know that we have a long road ahead of us to improve the health of Latinos.

We will renew our current programs and partnerships to engage in new ones to

better face the challenges ahead of us. Thanks again for your continuing sup-

port.

JUNTOS Center for Advancing Latino Health

Summer 2013

University of Kansas Medical Center

Department of Preventive Medicine and Public Health

Promotores de Salud from Liberal, KS and Juntos Team: (left to right) Victoria

Varela, Arturo Ponce, Hortencia Villezca, Irma Ortega, Susana Hernandez, Raquel

Hernandez, Balbina Nava, Carmen Castillo, Rudy Alfaro, and Yazmin Reyna

Paula Cupertino and JUNTOS team

Page 2

Growing International Partnerships in Kansas

One of Juntos objectives is to develop coordinated bilateral efforts between

KUMC and Latin American countries, primarily Mexico, to conduct research,

teaching, and information exchange in the field of Latino Health.

2012 was a successful year for growing our international partnerships:

The inaugural ceremony for the Ventanilla de Salud Movil program was

held on March 6th, 2012 at the Garden City Community College.

In October 2012, we welcomed the First Lady of Chihuahua, Bertita

Gómez de Duarte, and the Director of Seguro Popular of Chihuahua,

Pedro Hernández Flores for a two-day visit to the State of Kansas. Mrs.

Duarte made a strong commitment to enhance the collaboration with Jun-

tos and the Ventanilla de Salud program in Southwest Kansas.

To Strengthen our collaboration with Mexico, Dr. Cupertino along with

other Ventanillas de Salud programs (Oregon, Fresno, Washington - DC,

and New York) continues to work closely with the Secretaria de Salud de

Mexico to develop standardized procedures for VDSs.

Children’s Mercy Hospital has formally joined our partnership working col-

laboratively in medical education, community service and research pro-

jects with Mexico.

Juntos has developed a formal educa-

tional exchange program with the Uni-

versity of the State of Morelos-

Cuernavaca. The exchange program al-

lows 6th-year medical students to com-

plete their one-year community service

requirement at KUMC. Objectives of

this program include:

Increasing understanding of public

health initiatives for Mexican immi-

grants in Kansas.

Developing skills and knowledge on

bi-national health initiatives.

Conducting clinical shadowing expe-

rience to enhance students under-

standing of US health care system.

Yazmin Reyna arrived at

KUMC in August 2012. At

Juntos she has been en-

gaged with the Ventanilla

de Salud Movil Program.

She has also developed

and implemented Promo-

tores de Salud trainings in

Southwest Kansas.

Alejandro Gutierrez

Ocampo started his com-

munity service program in

January 2013. At Juntos

he has been engaged with

the Diabetes Initiative Pro-

gram which provides dia-

betes risk assessments to

Latinos in Kansas.

Kansas-Mexico Medical International Rotation

Page 3

Ventanilla de Salud Movil for 2012

The Ventanilla de Salud (VDS) is a program of the Government of

Mexico developed and implemented by the Department of Health and

the Ministry of Foreign Affairs in 50 Mexcican Consulates throughout

the US. In Kansas, the program was designed to empower rural Lati-

nos with access to preventive health screening to eliminate existing

health disparities among Latinos in SW Kansas. In our first year, we

organized nine events and reached 1,031 Mexicans throughout the

state of Kansas. To implement this effort, we rely on more than 21 or-

ganizations and 150 volunteers. Trained Promotores de Salud are es-

sential leaders making this program a complete success.

Health screening opportunities brought to local communities are invaluable considering that 71% of partic-

ipants reported not having health insurance. The initial screenings give us an opportunity for early detec-

tion and health education.

67.3% of the participants were overweight or obese

26% had high blood pressure

15.4% were diabetic or pre-diabetic

Despite being a young population, we are seeing a trend towards the development of chronic diseases.

Therefore, our screening is focused on lowering the risk of disease by providing culturally sensitive educa-

tional materials on the importance of healthy lifestyles and providing referrals to local community health

clinics for participants and their families.

Our health screening events... 2012 Number of Participants

Our Lady of Guadalupe Church - Dodge City March 24th 63

Smoky Hill Education Service Center—Salina April 28th 46

Garden City Community College—Garden City May 12th 68

San Antonio de Padua Church—Liberal June 23rd 81

Prince of Peace Church—Great Bend August 4th 72

Garden City Community College—Garden City August 25th 177

San Antonio de Padua Church—Liberal September 8th 228

UMMAM Community Health Center—Liberal October 9th 29

Saint Patrick’s Church—Garden City November 17th 267

Total 1,031

Thanks to our partners who have joined us in this effort to provide access to preventive

health screening in SW KANSAS!

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Less than 3% of all adult cancer patients participate in cancer research studies. Participation is even lower among Latinos, particularly recent immigrants in underserved rural communities. Pro-motores de Salud (community health workers) have been effective in conducting outreach and delivering health interventions to underserved populations. To address this issue, we developed and implemented a culturally and linguistically sensitive three session training on Cancer and Cancer Research. The program was developed as part of the pilot research project entitled “Latino and American Indian Community Health Workers Pro-moting Cancer Research Studies” of the U54 Kansas Community Cancer Health Disparities Net-work funded by the National Cancer Institute (NCI—Dr. Greiner, PI). Implementing this research project, we: 1) formed a community advisory board (CAB); 2) recruit-ed and trained Promotores using an empowerment-based curriculum to enhance leadership, or-ganization, interpersonal skills, and community health event implementation; and 3) executed a cancer 101 and cancer research studies training program in Spanish for Promotores de Salud in a rural Latino community.

Empowering Promotores de Salud as Partners in

Cancer Research in Rural Southwest Kansas

It focused on six basic cancer education topics:

1) Definition and types of cancer

2) Cancer disparities and barriers to screening

3) Cancer screening and early detection

4) Cancer diagnosis and staging

5) Cancer risk factors and risk reduction

Se

ssio

n 1

:

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ut

Can

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r

Promotores interacted with key cancer re-

search studies concepts including:

1) Randomization

2) Eligibility

3) Informed consent

4) Types of research studies

Se

ssio

n 2

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Em

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we

ring

the

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om

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ab

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earc

h

Stu

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s

Promotores interacted with the NCI’s website

and 1-800-4-CANCER telephone line. Partici-

pants identified:

1) Barriers to participating in cancer research studies

2) Risks and benefits

3) What do I need to ask to make an in-formed decision to participate in a re-search study

Se

ssio

n 3

:

Pa

rticip

atin

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Ca

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r R

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ea

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Stu

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Promoting health

education with

Enrique Rodriguez

The media continues to be the main

avenue for reaching and engaging

Latinos in health programs in Kan-

sas. Together with Promotores de

Salud from Liberal, KS, we devel-

oped two Public Service Announce-

ments and a cancer information

poster (right picture) to disseminate

information about clinical trials with

the community at large. Posters

have been displayed in more than

200 local Latino business and com-

munity centers.

Engaging the Latino community through

media

For the past two years, JUN-TOS has been partnering with Radio La Mexicana 101.5 and 92.2, a leading Latino media venue in Southwest Kansas. Together we promote health education programs, Ventanilla de Salud events, and Con-sulado móviles in Kansas.

The first Wednesday of the month, 9:00 AM – 10:00 AM with the support of Radio La Mexicana, JUNTOS has launched a public awareness campaign to disseminate infor-mation about cancer research studies among recent Latino immigrants in southwest Kan-sas. Arturo Ponce, Ventanilla de Salud outreach worker, has been at the radio discussing different topics including Seguro Popular and importance of health screenings.

Since October 2012, listeners from Radio La Mexicana in Gar-den City and Liberal have heard the conversations of “Maria and Ruperta” and “Chano y Chon,” which are the two PSAs created by Promo-tores de Salud from Liberal.

Special thanks to Enrique Ro-driguez (upper picture) for shar-ing his talent and personality with our health promotion activi-ties.

Radio PSA (Spanish)

Maria: Comadre, ¿cómo estas?

Ruperta: Pues más o menos, fíjate que

vengo del hospital porque a mi mamá

le diagnosticaron cáncer de seno y no

sé qué hacer.

Maria: Pero ¿cómo comadre? ¿Has

escuchado de los estudios clínicos?

Quizás tu mamá califique...

Ruperta: No he escuchado, ¿qué son?

Maria: Son estudios para prevenir o

tratar el cáncer. Yo llamé al 1800-4-

CANCER para estar más informada.

Ruperta: Suena interesante. Yo

también voy a llamar al 1800-4-

CANCER.

Radio PSA (English)

Maria: Comadre, how are you?

Ruperta: Well, more or less, I’m com-

ing from the hospital because my mom

got diagnosed with breast cancer and I

do not know what to do.

Maria: But how comadre? Have you

heard of clinical trials? Maybe your

mom qualifies...

Ruperta: I haven’t heard, what are

they?

Maria: Are studies to prevent or treat

cancer. I called 1800-4-CANCER to be

more informed.

Ruperta: Sounds interesting. I will

also call 1800-4-CANCER.

Page 6

Women who participat-

ed were between the

ages of 18 and 74.

233 women completed

an individualized

educational session.

50 women participated

in outreach group

sessions.

60 were referred for a

mammogram.

18 completed a

mammogram.

35 Promotoras

completed Cancer 101

and Breast Cancer

101 curriculum training

In an effort to fight breast cancer among Latina women, Juntos in collaboration with Healthy Living Kansas, the Mexican Consulate and El Centro launched the Pro-motoras de Salud and Community Health Center Collaborative fund-ed by the American Cancer Socie-ty and the NFL. The goal of this project was to empower women to take an active role in the care of their health; particularly to take ac-tions to decrease their risk of breast cancer, to know their breasts and be aware of signs of breast cancer, and to utilize breast cancer screening services availa-ble in the community in an in-formed manner.

In this context, Juntos and Healthy Living Kansas developed a radio campaign consisting of several PSAs on different topics such as cancer, mammography, false posi-tive, risk factors, and early detec-tion. Dr. Cupertino and Dr. Engel-man utilized a culturally sensitive approach to ensure that the mes-sages were appealing to Latinas in the community. In addition, Maria-na Ramirez, the project coordina-tor for this initiative, and Sandra

Flores, a promotora (community health worker) from El Centro, delivered a Breast Cancer 101 educational curriculum to community health workers to equip them with knowledge and tools needed to disseminate the valuable infor-mation among the community. The last component of the pro-ject included outreach at com-munity health fair events. At these events, women wore breast simulators where they could practice palpation tech-niques and experience how breast abnormalities feel. They also interacted with breast models that showed different cancer-related pathologies while staff members explained key concepts about cancer and emphasized the importance of early detection through mam-mograms and clinical breast exams.

We would like to specially thank Aracely Van Kirk, the Ventanilla de Salud Coordinator at the Mexican Consulate, for her outstanding collaboration

in this project.

Promotores de Salud and Community

Health Center Collaborative

OUTCOMES

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Adelante Juntos Controlamos la Diabetes

New models of chronic disease management

are needed to engage patients in a productive

and interactive way with their health care pro-

viders. Unfortunately, few Latinos with diabetes

have the training and resources that they need

to engage the health care system effectively,

and many Latinos lack the knowledge and so-

cial support they need to adequately manage

their disease.

In March 2012, the Adelante Juntos Contro-

lamos la Diabetes Initiative was funded by the

University of Kansas Medical Center - Depart-

ment of Preventive Medicine. The Adelante

Juntos con Diabetes – KC (Empowering Lati-

nos to Control Diabetes) project developed and

tested a culturally and linguistically relevant

web-based platform for diabetes management

tailored to the needs of the regional Latino

community. It is titled “Juntos Controlamos la

Diabetes” (Together We Control Diabetes) in

the spirit that it takes a team to manage diabe-

tes – yourself, your family, friends, and your

health care team. Our vision is that this site

will eventually become a centralized repository

of credible, relevant information that can be

viewed by those with diabetes, or those help-

ing to manage diabetes (at home or in a health

care setting).

Our website contains evidence-based multi-

media information (videos, music and PDFs)

that fit the competencies outlined by the Amer-

ican Association of Diabetes Educators 7 Self-

Care Behaviors and the National Standards

for Diabetes Self-Care Education. The web-

site uses the concept of a diabetes road map,

which is found on the home page (see figure

1). This map allows visitors to make stops

where they would like on the path to their ulti-

mate goal – managing diabetes.

Dr. Ellerbeck led the project team in the crea-

tion of this site. He worked side-by-side with

the project director and several volunteers

(pharmacists, dietitians, and doctors from Lat-

in America) to create culturally relevant, evi-

dence-based information. The website is cur-

rently hosted on a local drive at the University

of Kansas Medical Center. Plans to publish

this website and open it up to the public are

currently being discussed.

Figure 1: Controlamos la diabetes main website page Figure 2: Screenshot of healthy recipe options

Page 8

Reaching and Treating Latino Smokers

In the spring of 2013, we concluded our pilot project Decidete, a

case management approach to reaching and treating Latino

smokers.

A community-based intervention method was used for recruit-

ment. A total of 80 participants were enrolled in the program.

Participants were given information about medication for quitting

smoking and free telephone counseling through state-funded quit-

line. Half of the participants also talked with a case manager to

help guide them through the process of treatment selection. A

baseline survey and a 6 month follow-up survey was administered

to assess the demographic of participants, smoking history, medi-

cation and quitline utilization.

The average number of smoked cigarettes per day (cpd) by par-

ticipants at baseline was 10 cigarettes. At the end of intervention

the average of cpd by participants was 4 cigarettes. A total of 15

participants quit smoking after the intervention.

This study was supported by funding from the National Heart, Lung, and Blood Institute of

the National Institutes of Health. Thank you to all the research staff that collaborated.

RESULTS

Case Management calls Almost half (48.1%) of partici-

pants completed 3 or more case management calls.

Connecting with pharmacother-apy

Most participants (74.1%) were interested in phar-machotheraphy.

Half of smokers interested in varenicline received medica-tion at low or no cost.

Connecting with quitline 37% of smokers were con-

nected with the free state–funded smoking cessation

Vacunas en Acción—Immunizations in action

In 2012, Juntos joined efforts with Heart to Heart International, KU

Pediatrics, and El Centro, Inc. Together they implemented an infant

immunization initiative which aims to strengthen community partner-

ship, educate the community about immunization guidelines, and vac-

cinate Latino children who are behind on their recommended immun-

izations. A total of 9 community-based events were organized in Wy-

andotte and Johnson County throughout the project .

OUTCOMES:

427 Children, Adolescents & Adults were vaccinated

247 Adult TdAP vaccines were administered

108 people were screened but not vaccinated

Call 1-800-QUIT-NOW (784-8664)

Page 9

Increasing Latino Presence in Healthcare

Students from across the state reach out to JUNTOS searching for guidance as they apply to KUMC School of Medicine. To-gether we work on the interview process, and guide them in the application process.

In 2013, two of our students were accepted into the KUMC Post-Baccalaureate program.

Stefany Paredes is originally from Quito, Ecuador. She has a Bachelor of Arts in Biology from the University of Kansas. She wishes to pursue a career in pri-mary care to continue helping underserved multicultural com-munities.

Carlos Pacheco III earned an athletic scholarship to play foot-ball at Benedictine College in 2006. He graduated Cum Laude with a Bachelor of Arts degree in Mass Communications in 2010. He is looking forward to the challenge and privilege of advancing Latino health. Carlos is from KCKCC Argentine Com-munity.

CONGRATS TO MARIANA

AND JOHANA

For the past two years Juntos

research team members have

attended the Exito! Latino

Cancer Research Leadership

Training at the Institute for

Health Promotion Research

at the University of Texas

Health and Science Center in

San Antonio, Texas.

This year, Johana Bravo de

los Rios and Mariana

Ramirez, both graduate re-

search assistants at Juntos

were selected to participate in

the one-week long training in

San Antonio along with 20

national students. It is a very

competitive program whose

primary goal is to increase

ethnic diversity in the field of

Latino cancer health dispari-

ties research.

The program aims to increase

participants’ understanding of

the power of research to af-

fect change; theory and inter-

ventions; interest in cancer

control; and research, net-

working, and motivation and

ability to successfully apply to

a doctoral program.

Juntos first generation of

Promotores de Salud in

Southwest Kansas graduat-

ed in October 2011.

Continuing the efforts to-

ward empowering rural La-

tinos with knowledge for

them to work as equal part-

ners we joined efforts with

Seward County Community

College to enroll Promo-

tores de Salud in their Cer-

tified Nurse Assistant pro-

gram.

In March 4th, 2013 the first

generation of Promotores

de Salud from Liberal, KS

obtained their CNA certifi-

cation. The following Pro-

motores de Salud complet-

ed the program and re-

ceived their diplomas:

Lucina Perez

Erika Rosales

Raquel Susana

Hernandez

Hortencia Villezcas

Victoria Varela

CNA Training in Liberal

Page 10

Special Thanks to:

Liberal, KS Ventanilla de Salud Health Fair

Saturday July 27th and Sunday July 28th from 9:00AM to 3:00PM. Health

fair will provide educational material, basic health screenings and doctors

available on-site.

Kansas City, KS Wyandotte County Back to School Health Fair

Saturday August 3rd from 9:00AM to 1:00PM at 7250 State Ave.

Health fair will provide health screenings, sports physicals and immuniza-tions. In addition, to free school supplies, books and haircuts.

Kansas City, MO Donnelly Health Fair

Saturday September 21st from 8:00AM to 4:00PM at 608 N. 18th St.

Providing information on local health services, counseling to family fitness and general wellness information.

Kansas City Binational Health Week Fair

Monday October 14th to Friday October 18th from 9:00AM to 2:00PM.

Health fair will provide educational material, basic health screenings and

doctors available on-site the whole week.

Liberal, KS Ventanilla de Salud Health Fair

Saturday November 23rd and Sunday November 24th from 9:00AM to

3:00PM. Health fair will provide educational material, basic health screen-

ings and doctors available on-site.

Garden City, KS Ventanilla de Salud Health Fair

Saturday December 14th and Sunday December 15th from 9:00AM to

3:00PM. Health fair will provide educational material, basic health screen-

ings and doctors available on-site.

Upcoming Events—Summer/Fall 2013

Juntos Center for Advancing Latino Health University of Kansas School of Medicine

Department of Preventive Medicine and Public Health

4125 Rainbow Boulevard MS 1056 Kansas City, KS 66160

July 2013. For more information, please contact Paula Cupertino, PhD at acupertino@kumc.edu or (913)588-2783.