Critical Elements in the Design of Culturally Appropriate Interventions Intended to Reduce Health Disparities: Immunization Rates Among Hispanic Seniors in New Mexico
CELINDA LEVY, SUSAN CARTER, GALINA PRILOUTSKAYA, and GERTRUDE GALLEGOS
JHHSA, Vol. 26 No. 2, (2003)
The importance of immunization in protecting seniors against
influenza and pneumonia has long been recognized. Nevertheless,
immunization rates among Medicare beneficiaries continue to fall short
of what is both desirable and achievable. The problem is even more
acute among certain racial and ethnic groups in the United States within
which rates are below the rate for the country as a whole. This is true in
New Mexico where 40 percent of the population is estimated to be
As part of its work on behalf of the Centers for Medicare & Medi-
caid Services (CMS), the New Mexico Medical Review Association
(NMMRA) undertook a project aimed both at reducing the disparities
that exist in immunization status between the Hispanic and non-
Hispanic population in the state and attempting to increase overall rates
in the state for all groups. Developing interventions to reduce dispara-
ties in immunization rates between Hispanic seniors and the rest of the
senior population requires more than a straightforward review of the
literature and must take into account not only the cultural differences
that exist between Hispanics and non-Hispanics but, certainly, in the
case of New Mexico, it must attempt to understand the richness and
diversity that exists within the Hispanic communities across the state.
To do otherwise runs the risk of designing interventions that are at best
ineffective and at worst culturally insensitive and potentially damaging
to future efforts to improve health status.
This article describes the process undertaken by NMMRA, a Medi-
care Quality Improvement Organization (QIO), to collect qualitative
data from three culturally different groups of Hispanics in New
Mexico. The data are used to design interventions that will increase
immunization rates for all Hispanics in New Mexico.
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