Proyecto Juntos

摘要 Proyecto Juntos或“共同项目”是一项健康公平结构性干预措施，旨在改善获得精神/行为健康服务的机会，并最终改善NIH三个优先人群的健康结果：少数民族（即，西班牙裔/拉美裔），社会经济地位较低的社区;和农村服务不足。Proyecto Juntos将由亚利桑那州东南部健康教育中心（SEAHEC）领导，这是一个农村卫生工作者机构，将针对亚利桑那州南部和东部的一个农村四县地区，这些地区的精神/行为健康服务有限。通过社区主导的评估和分析，拟议的项目将确定和解决对目标社区造成不成比例负担的关键结构性和系统性因素，包括：1）缺乏获得文化上尊重/语言上适当的卫生资源的机会。2)无法导航的医疗保健系统/需要护理协调，3）缺乏保险，4）缺乏交通工具，5）对心理/行为健康和健康服务的污名。为了长期解决这些结构性障碍，Proyecto Juntos将利用与社区组织和学术机构的长期合作伙伴关系，并与州、地区和地方机构建立新的跨领域、多部门合作伙伴关系。项目将分三个阶段进行：1）评估/规划/制定干预战略; 2）实施结构性干预措施; 3）评估、传播调查结果和制定可持续性计划。SEAHEC在资源不足的农村和边境社区培养了信任，建立了多部门合作伙伴关系，并且与大学研究人员合作的历史使Proyecto Juntos能够在应用严格的研究和评估方法的同时，对研究和政府努力很少触及的社区的医疗保健进行持久的改变。

Abstract Proyecto Juntos, or "Project Together", is a health equity structural intervention to improve access to mental/behavioral health services and ultimately improve health outcomes for three NIH priority populations: ethnic minorities (i.e., Hispanic/Latinos), communities with lower socioeconomic status; and rural underserved. Proyecto Juntos will be led by The Southeast Arizona Health Education Center (SEAHEC), a rural health workforce agency, and will target a rural, four-county region in southern and eastern Arizona with limited access to mental/ behavioral health services. Through community-led assessment and analysis, the proposed project will identify and address critical structural and systemic factors shown to disproportionately burden the communities being targeted including: 1) Lack of Access to Culturally Respectful/Linguistically Appropriate Health Resources. 2) Unnavigable Health Care System/Need for Care Coordination, 3) Lack of Insurance, 4) Lack of Transportation and 5) Stigma against mental/behavioral health & health services. To address these structural barriers long-term, Proyecto Juntos will leverage long-standing partnerships with community organizations and academic institutions and build new cross-cutting, multisectoral partnerships, with state, regional, and local agencies. Proyecto Juntos will occur in three phases: 1) assessment/planning/developing intervention strategies; 2) implementation of structural interventions; and 3) evaluation, dissemination of findings and development of a sustainability plan. SEAHEC's cultivated trust in under-resourced rural and frontier communities, established multisectoral partnerships, and history working with university researchers uniquely places Proyecto Juntos to make lasting changes to healthcare with communities rarely reached by research and government efforts while applying rigorous research and evaluation methods.