A primary health care approach using Hispanic outreach workers as nurse extenders

In an effort to improve the health of Hispanic families, particularly prenatal women and infants, the county health department instituted a program of intensified home visits using bilingual, bicultural nurse extenders within a framework of primary health care. The outreach workers offer basic health information to improve families' skills and knowledge, and to assist with linkages to community resources. Public health nurses provide assessment, establish a plan of care, evaluate progress, and supervise the workers. The program has resulted in increased numbers of individuals receiving services, more women registering earlier for prenatal care and the Women, Infants, and Children's (WIC) program, and increased numbers of infants receiving WIC services and regular medical supervision. Public health nurses report increased knowledge and positive changes in families' health behaviors. In addition, the program has strengthened relationships between the health department and Hispanic families.