Culturally Competent Care Improves Immigrant Health in Maine

Holly Lasagna

At A Glance

More than 4,780 immigrants and refugees – 1 in every 10 people – in Lewiston-Auburn, Maine, have improved access to culturally competent health care. In September 2016, Central Maine Community Health Corporation and Healthy Androscoggin worked with United Ambulance and other groups to provide immigrants and refugees, primarily from African countries, better options to improve and manage their chronic illnesses. Paramedics provide prevention and wellness services through culturally competent care, translated documents, and language services.

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Public Health Challenge

In the past 15 years, Lewiston-Auburn had a rise in the number of immigrants, refugees, and asylum seekers. The group known as “New Mainers” makes up more than one-tenth of the area’s population. In a door-to-door survey of 232 New Mainers in 2013, respondents’ most common self-reported health conditions were diabetes (37%), high blood pressure (37%), and stress (33%). Many New Mainers said they were not aware of all the local services available to them, were confused by the complex health care system, or were not insured and couldn’t pay for services. Compounding these serious concerns was a cultural divide that made communication and health care access hard.

Find Out More

Healthy Androscroggin works to improve health and quality of life in Androscoggin County. Through this project, the coalition helped local health providers gain experience and understanding to best serve the rapidly diversifying population. This project is supported by CDC’s Racial and Ethnic Approaches to Community Health (REACH) cooperative agreement. For more information, visit and

Our clients really appreciate having forms available in their preferred language. We like it because it ensures that medical information is understood, and they feel more comfortable knowing that we care about the way we communicate with them.
- Daphne Russell

Holly Lasagna
Healthy Androscoggin
124 Lisbon Street

Lewiston, ME 04240
Phone: 207-795-5990

Atlanta, GA 30348
Centers for Disease Control and Prevention

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Healthy Androscoggin worked with United Ambulance and seven community partners to improve care for New Mainers. Healthy Androscoggin provided cultural competence training to 143 people, including United Ambulance’s community paramedics (CPs), teaching them to be aware of the social and cultural needs of different racial and ethnic groups and develop relationships with patients so they could improve health outcomes. A promotional video was also created for stakeholders, doctors, and potential referrals to highlight United's Home Visit Program. Health care providers refer patients to the program, in which a CP visits patients at home to help them manage pressing health conditions.

What's Next

Healthy Androscoggin will continue to work with United Ambulance and other community partners to help them provide culturally competent care. The relationships established through the REACH initiative will be maintained and used to further train staff and continue outreach efforts to diverse populations in Lewiston-Auburn.


Healthy Androscroggin partners received information and training and were encouraged to refer New Mainer patients to United Ambulance's Home Visit Program for culturally appropriate care. During home visits, CPs provide services such as review of medical conditions, safety checks, basic tools, and resources needed for improved awareness of chronic diseases and other medical problems. United Ambulance and other partners translated documents to Somali and French and began using picture pill cards to help New Mainer patients better communicate their health needs. United Ambulance also updated patient forms to collect race and ethnicity data. Healthy Androscoggin hopes that offering these services will help result in fewer emergency room visits, more people managing their chronic diseases at home, and better health outcomes for New Mainers.