• Caledonia Buckheit, Dwan Pineros, Ardis Olson, Deborah Johnson, and Stephen Genereaux.
• From the Dartmouth Geisel School of Medicine, Hanover, NH (CB, DP); Department of Community & Family Medicine, Dartmouth Geisel School of Medicine, Hanover (AO, DJ, SG); Department of Pediatrics, Dartmouth Geisel School of Medicine, Hanover (AO). Caledonia.K.Buckheit.MED@dartmouth.edu.
• J Am Board Fam Med. 2017 Jan 2; 30 (1): 91-93.

BackgroundDartmouth Geisel Migrant Health (DGMH) is a medical student group that provides on-site health services for Spanish-speaking dairy workers in rural Vermont and New Hampshire in conjunction with a federally qualified health center (FQHC).Study ObjectiveThis project was undertaken to evaluate and improve the services provided by DGMH and the FQHC and to refine understanding of the target population.MethodsWe surveyed 25 workers at 6 collaborating dairy farms to identify health priorities and concerns and perceived barriers and facilitators to health care for these workers. Surveys were administered over 2 weeks in July 2015. Interpreter-mediated appointment and sliding-fee-scale data from a period 7 months that spanned survey administration were also assessed.ResultsDiabetes and hypertension were the most common health concerns. Thirty-two percent of participants reported 10 or more days of depressed mood in the past month. Insurance and language were the most common barriers to health care and employers and on-site clinics were the most common facilitators. Appointments most often addressed women's health, gastrointestinal problems, health maintenance, diabetes, and back pain. Thirty FQHC sliding-fee-scale applications were completed by workers.ConclusionsThese Spanish-speaking dairy-farm workers have many health concerns and perceive substantial barriers to health care. Collaboration between medical students, a rural FQHC, and farm employers provides important services that facilitate health care access among this population.© Copyright 2017 by the American Board of Family Medicine.

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