ASU Partners with Guadalupe’s Las Fuentes Clinic to Provide Better Health Care

 

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For Dr. Carol Baldwin and her nursing students, providing quality health care depends on more than knowing what medicines you can prescribe for a patient. It also depends on how well you understand your patient’s cultural beliefs, folk medicine practices, and attitude toward the Western medical system.

 

“In the United States, we have a wonderful blend of ethnic groups, but this means we have to be more culturally responsive to Latinos, African Americans, Asian Americans, and Native Americans,” states Baldwin, an Associate Professor in the College of Nursing & Healthcare Innovation at ASU’s Downtown Phoenix campus. She finds some ethnic groups can perceive health problems differently from other ethnic groups and insist on different treatments, which can prevent health care providers from effectively diagnosing and treating an illness unless they are familiar with the patient’s culture.  

 

In an effort to develop a better understanding of different cultural groups in the community, Baldwin and her students have been working with Las Fuentes Clinic, a low-cost medical clinic in the Town of Guadalupe, since 2003. Through this partnership, students learn more about the cultures of the clinic’s primarily Latino and Yaqui Indian clientele by observing doctors and nurses, talking to patients about their medical histories, and developing culturally relevant health care plans for patients.

 

Students also volunteer at the clinic’s health fairs where they provide blood sugar, cholesterol, and blood pressure tests for community members and educate them about diabetes and heart disease. Since some students are bilingual, community members are more willing to ask for information about treatments for such health problems. 

 

“Training to be a nurse practitioner in the Town of Guadalupe gives you a more community-based approach to medical care,” says Dr. John Molina, founder and director of Las Fuentes Clinic.  “It gives you a chance to take care of patients who are uninsured, speak different languages, and have different ideas of the kind of treatment they need.”

 

Molina speaks from experience. Having served as a social worker in the Town of Guadalupe in the 1980s, he saw many Latinos and Yaqui Indians suffering and even dying in their homes due to lack of insurance and distrust of Western medicine. In response, he earned his medical degree from the University of Arizona and established Las Fuentes Clinic in 1995 to provide his community with a clinic that would respect their cultural health practices by offering both Western and folk medicine treatments.

 

By making both treatments available, patients see the clinic understands and respects their cultural beliefs, helping them trust clinic doctors and nurses if they suggest a more Western treatment for an illness – such as insulin shots for diabetes.

 

“One of the most useful skills I learned at the clinic is how to be culturally aware,” states Anamarie McNeese, a recent graduate of the Family Nurse Practitioner Program who did her practicum training at Las Fuentes Clinic. “At school they teach you medical skills, but cultural awareness is really hard to teach unless you submerge yourself in a community and serve its members.”

 

By caring for patients at the clinic, McNeese saw how cultural knowledge can improve treatments for health problems such as diabetes. She notes that in Western diabetic education, patients are discouraged from eating white rice which goes against the traditional diets of many ethnic groups. By being aware of this, however, a health provider can design a dietary program that will accommodate for such practices, increasing the likelihood that a patient will follow the program.

 

“You have to earn their trust,” says McNeese. “If they feel you have assumptions about them or their practices, they’ll just tell you what they think you want to hear, and then you’ve lost that patient – because when you don’t have their trust, how can you accurately diagnose them and provide care?”

 

Recently, Las Fuentes Clinic has begun working even more closely with ASU. In 2005, Baldwin was elected to serve on the Las Fuentes Board of Directors, a position that helps her be a better liaison between the clinic in the Town of Guadalupe and ASU.

 

“Dr. Baldwin came to our clinic at a good time,” states Molina. “It’s good to have a clinical person on the board because it helps us develop strategies for medical interventions among ethnic minorities. And the research she does here is important because a lot of the Latino population is sometimes left out of research studies.”

 

This research includes a recently funded National Institutes of Health sleep study that Baldwin and several students will conduct at the clinic beginning in July. Baldwin feels this study is important since few studies have examined sleep disorders, such as insomnia or sleep apnea among Latinos, conditions that are linked to other health problems, including diabetes, obesity, and high blood pressure.

 

“Insomnia for Spanish-speaking Mexican-Americans may occur for reasons similar to the Anglo population, like overwork or worrying, but may mean different things for Latinos,” says Baldwin, who notes a large number of Mexican-Americans believe their problems may be a result of God’s will. “We’re working on finding out more about the meanings of these sleep disorders among Latinos so we can create medical interventions that are more culturally relevant.”

 

To ensure the accuracy of the research study, Baldwin seeks to make the research practices as culturally sensitive as possible. Because Spanish-speaking patients will be involved in the study, Baldwin has asked for bilingual ASU nursing students to interview the patients. Students must also accommodate for the different Spanish dialects spoken by the participants and the different ways one is expected to speak to people from the Latino community based on age, gender, and other factors.      

 

“You have to interact with individuals here in a respectful way,” states Manuela Vital, a graduate student in the Adult Nurse Practitioner program who will interview Town of Guadalupe residents for the sleep study. “If I communicate incorrectly, I might ruin an opportunity to talk with that person. [But] when they see someone they feel a relationship to, they can share their experiences more openly.”

 

In the future, Baldwin, Molina, and the nursing students hope more ASU students from the College of Nursing & Healthcare Innovation volunteer at Las Fuentes Clinic to learn about other cultures and improve health care in Arizona.  

 

“We need to understand how different ethnic groups perceive certain diseases,” says Vital. “We can’t make a blanket perception that everyone in the world experiences health problems the same way.”   

 

Dr. Carol Baldwin is a scholar in the Southwest Borderlands Initiative, an organization that unites professionals across ASU to collaborate on issues specific to the Latino community. To help promote health education and cultural understanding of Latinos in Arizona and along its borders, she has created the Southwest Borderlands-Nursing web site, which provides resources for future research and educational direction for faculty, prospective faculty, students, and health care providers.

 

Las Fuentes Clinic is a non-profit corporation that provides medical care to uninsured people in the Town of Guadalupe, Arizona. Over 4,500 visits are made yearly to the clinic. Medical care consists of family medicine, women's health, acupuncture, chiropractic, naturopathic and traditional medicine. An extensive community outreach program provides health education to local community schools, agencies and events. In addition, Las Fuentes serves as a clinical training site for medical residents, medical students, nursing students, and medical assistants. Learn how you can contribute to this clinic by visiting its web site.

 

Michael Jung, ASU in the Community feature writer
Michael.Jung@asu.edu
480-727-8339

 

To learn more about how ASU is engaged with the community, please visit ASU in the Community’s Program Database which connects you to a wide variety of specific ASU outreach efforts.