The populations of New Mexico are ethnically diverse, with large Hispanic and Native American components, and live in communities that are geographically dispersed and economically challenged. The University of New Mexico is located in Albuquerque, the state's only major urban area, and houses the state's only academic health sciences center. In 1986, the University received a grant from the W.K. Kellogg Foundation to establish health promotion/disease prevention curricula for health science students and create two Wellness Centers on campus. The Wellness Centers train students to be providers of health information and learn how to counsel and assist people with changing health-related behaviors. A campus-wide employee health promotion program was also implemented. Most of the instructional and service programs initiated by the grant have continued with stable institutional support. A later phase of the project was to encourage other agencies and organizations throughout New Mexico to adopt or expand their own health promotion initiatives. An operating premise of this phase was that local initiatives should respond to locally perceived priorities. To accomplish this, a program of mini-grants was designed to assist in creating health promotion programs within a variety of topic areas. Thirteen mini-grants were awarded to agencies representing diverse groups and cultures throughout New Mexico. Our experience with the mini-grants and the ability of organizations to sustain the activities past the period of grant support are described. The successful use of mini-grants has been reported elsewhere in the literature.

A variety of environmental health issues occur within homes along the US/Mexico border region. Individuals living in this region are often not aware that specific issues, including pesticide safety, occur in their homes and may not understand the potential adverse effects of pesticide use on their families’ health. The Environmental Health/Home Safety Education Project created by the Southern Area Health Education Center at New Mexico State University, utilizes promotoras (community health workers) to educate clients on pesticide safety issues. Data from 367 pre/post tests and home assessments were collected from 2002-2005. The data were analyzed to detect changes in clients’ knowledge or behavior as they related to protecting themselves and their families against unsafe pesticide use and storage. Statistically significant changes occurred with both knowledge and behavior in regards to safe pesticide use. Through this culturally appropriate intervention, the promotoras provide practical information allowing clients to make their homes safer.

The Environmental Health/Home Safety Education Project (Proyecto de Salud Ambiental y Seguridad en el Hogar) has been developed in response to a wide array of severe and often preventable environmental health issues occurring in and around homes on the U.S.-Mexico border. Utilizing well-trained community members, called promotoras , homes are visited and assessed for potential environmental hazards, including home fire and food safety issues. Data analyzed from project years 2002 to 2005 shows a significant impact in knowledge levels and initial behavior change among targeted participants as it relates to fire and food safety issues. Since the initiation of the project in 1999, hundreds of participants have improved their quality of life by making their homes safer. The project has proven to be sustainable, replicable, flexible, and attractive to funders.

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Purpose: Hepatitis C incidence is higher among American Indian/Alaskan Native populations than any other racial or ethnic group in the United States. Chronic Hepatitis C complications include cirrhosis of the liver, end stage liver disease, and hepatocellular cancer. Direct acting antiviral treatment taken orally results in > 90% cure, yet rural primary care providers lack the training and confidence to treat and monitor patients with chronic Hepatitis C. Rural patients are reluctant to travel to urban areas for Hepatitis C treatment. Project ECHO is an innovative tele-mentoring program where specialists mentor primary care providers via videoconferencing to treat diseases they would otherwise be unable to manage. The purpose of this quality improvement project was to increase Hepatitis C treatment at a rural Navajo health clinic through partnership with Project ECHO specialists. Methods: This quality improvement project was guided by Lippitt’s Phases of Change Theory. The systematic process plan included a protocol for roles and expectations of all members of the healthcare team, a documentation and communication plan, and a tracking system for monitoring patient progress through the plan of care. Outcomes were analyzed by descriptive statistics. Findings: Following partnership with Project ECHO, six patients (31.6%) consented to receiving Hepatitis C treatment at the rural Navajo health clinic. All six were contacted by outreach staff at multiple points during the project. Five (26.3%) completed the full course of drug therapy. Four (21.1%) completed follow-up lab work, of which three (15.8%) had a documented cure by sustained virologic response. Conclusions: Hepatitis C care via Project ECHO-rural clinic partnership was affordable, feasible and not excessively time consuming for a facility with substantial patient outreach resources. Key words: Rural health clinic, Hepatitis C, Project ECHO, tele-mentoring, Native American