The State of California is called home by more Hispanic- and Latinx-Americans than any other state. Nearly 40% of the state’s residents are Hispanic or Latinx, making Spanish the second-most spoken language in the state.
In Northern California, the Community Health Investment team at Providence St. Joseph Health identified a need for Spanish-speaking mothers who had been delivering babies without much formal preparation in their native language or support for labor and delivery. To make culturally and linguistically appropriate services more accessible to these families, Providence St. Joseph Health began partnering Spanish-speaking moms with midwives who could teach birth preparation and newborn parenting classes in Spanish.
Paso a Paso: Culturally and Linguistically Appropriate Services for Spanish-Speaking Mothers
This program, called Paso a Paso, or Step by Step, now offers preventative information and support to the entire Latino community. The bilingual staff provides childbirth education, breast feeding support, parenting classes, home visits, resource referrals, and support groups to communities served by St. Joseph and Redwood Memorial Hospitals. Spanish-speaking women and their families are supported in an atmosphere built on kindness and respect, allowing them to discover and build their independence and recognize their own strengths. Program services are provided in a safe environment where feelings, concerns and beliefs can be confidentially shared.
“Today, they teach over 100 classes in Eureka and Fortuna. They still provide childbirth education but they also provide breastfeeding support, parenting education, support groups for moms and dads, and a class for parenting teenagers,” according to Martha Shanahan, Director of Community Health Investment at Providence St. Joseph Health.
When COVID-19 presented challenges to resource accessibility, the Paso a Paso team mobilized their typical in-person efforts, enabling clients to safely continue perinatal care from the comfort of their home. It’s been critical to the Paso a Paso team to understand what the unmet needs are for their clients, and to supply diapers, culturally appropriate foods, masks and hand sanitizer through resource fairs and home drop-offs.
How the Community Health Needs Assessment Prioritized the Paso a Paso Program
The Community Health Needs Assessment (CHNA) process at Providence St. Joseph Health is guided by the fundamental understanding that much of a person and community’s health is determined by the conditions in which they live, work, play, and pray. In gathering information on the communities served by the hospitals, they looked not only at the health conditions of the population, but also at socioeconomic factors, the physical environment, health behaviors, and the availability of clinical care.
Within this guiding health framework for the CHNA, publicly-available data was sought that would provide information about the communities (at the city and zip code level when available) and people within their service area. In addition, comparison data was gathered to show how the service area communities are faring compared to the county or state. In total, 81 indicators were selected to describe the health needs in the hospitals’ service areas.
The process of collecting qualitative community input took three main forms: Community Resident Focus Groups, a Nonprofit and Government Stakeholder Focus Group, and a Community Forum. Each group was designed to capture the collected knowledge and opinions of people who live and work in the communities served by their hospitals.
The CHNA process identified that there are limited mental health and substance use services throughout Humboldt County. There is a particular need for more psychiatrists, counselors, inpatient care for Serious Mental Illness (youth and adult), follow-up care, harm reduction services and preventative care. As a result of this ongoing assessment process, the Providence St. Joseph Health team has continued to invest staffing and financial resources in the Paso a Paso program, and has expanded the scope of services provided by the Paso a Paso team.
How the Paso a Paso Team Uses Activate Care
Activate Care and local partner NCHIIN, the North Coast Health Improvement and Information Network, have supported three implementations of Activate Care’s care coordination platform at St. Joseph Hospital (a Care Transitions program and the Paso a Paso program) and the Humboldt County Department of Health and Human Services outpatient mental health case management programs.
The Activate Care platform, integrated with NCHIIN’s HIE, serves as an essential tool allowing staff to manage tasks across teams, document and keep a record of corresponding activity in a central place, avoid duplication through clear task responsibility, establish workflow processes, and alert staff in real-time to near-real time about a variety of client events (emergency department admissions, jail-related events, etc.) as well as make connections to community resources and referrals.Paso a Paso continues to ease the perinatal experience for Latinx parents and serve as a reminder that the community will persevere through teamwork.