Referral Tools Help Latinos in San Diego County Prevent Chronic Diseases

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At A Glance

More than 1,550 low-income Latinos in San Diego County, California, have increased access to chronic disease prevention programs to help them better manage and improve their health. From October 2014 to September 2016, Project Concern International (PCI) trained 205 community health workers (CHWs) to streamline referrals to clinicians who specialize in preventing chronic disease. Community presentations focused on preventing chronic diseases and reducing  barriers to care faced by this population.

By Connie Lafuente

Public Health Challenge

The Centers for Disease Control and Prevention (CDC) defines health disparities as differences in health outcomes and their causes among groups of people. In San Diego County, some of the leading health disparities Latinos face include lack of health insurance, delays in care, and lack of access to health care compared to other ethnic groups, including Asians and Somalis (2012 San Diego County Health Status Reports). Death rates per 100,000 for Hispanics/Latinos are also more than 1.5 times higher in certain areas compared to San Diego County: 85.2 in National City vs. 41.9 for heart disease; 26.4 in Southeastern San Diego vs. 16.9 for stroke; 20.1 in Mid-City vs. 13.9 for diabetes; and 106.5 in National City vs. 71.6 for overall cancer (2013 SD County Community Profiles).


The PCI initiative focused on Hispanic/Latina women of reproductive age (15-44 years), with cancer, heart disease and stroke, and type 2 diabetes. PCI launched “Project ALCANCE” (Advancing Latina Chronic Disease Prevention through Awareness Networking, Collaboration, and Education). “ALCANCE” means “reach” in Spanish. “Project ALCANCE” focuses on training predominately Latina CHWs to connect patients with local organizations that can help them treat and even prevent common chronic diseases for free or of low cost. A CHW Leadership Academy helps prepare CHWs to be leaders, share health information in their community, and lead presentations about how Latinos can help prevent chronic diseases.

I learned that we can prevent disease if we start with healthy changes. I changed my habits. I drink a lot of water instead of soda. I reduced the amount of bread with sugar like donuts or cakes. This kind of food can damage your body.
- Perla Ledesma


The CHW Leadership Academy prepares Latinos to be leaders and share health information in their community. Lessons include written and oral communication and an orientation to public health and policy. From October 2014 to September 2016, “Project ALCANCE” trained 205 CHWs who used the Referral Pathway Tool to increase contact and connect 1,554 people mainly in Latino communities to appointments at one of the participating clinics and/or local chronic disease prevention organizations for free or low cost care. Bilingual community health educators deliver customized presentations in English and Spanish to nonprofit organizations about how to help the Latinos they serve prevent chronic diseases. Project ALCANCE organizers and partners host free workshops to teach Latinos how to prevent or treat chronic diseases.

What's Next

PCI continues to empower people to improve their health and overcome barriers to good health. PCI is working with the San Diego Chronic Disease Coalition to make connections between health programs, community partners, and residents, and expand the Community Health Worker Leadership Academy. Other partners include Family Health Centers of San Diego, La Maestra, Mid City Community Clinic, Operation Samahan, American Cancer Society, American Diabetes Association, American Heart Association, and American Lung Association. Project ALCANCE will continue to meet quarterly to share outcomes, improve processes, and make plans for sustaining the program.

Find Out More

This project is supported by CDC’s Racial and Ethnic Approaches to Community Health cooperative agreement. “Project ALCANCE” improves referrals to health care in San Diego County by engaging community members and empowering them with knowledge to improve their own health and prevent chronic diseases. Learn more about Project ALCANCE by visiting:


Connie Lafuente
Project Concern International
4305 University Ave. Suite 345

San Diego, CA 92105
Phone: 619-791-2610
Fax: 619-791-2600

Centers for Disease Control and Prevention

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The findings and conclusions in this success story are those of the author(s) and do not necessarily represent the official position of the funding agencies or the Centers for Disease Control and Prevention (CDC).

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