2. Notes from the Director
In 2011, JUNTOS Center for Advancing Latino Health came into existence at the University of Kansas Medical Cen-
ter to join forces with outstanding organizations with the overarching task of addressing health disparities faced by
Latinos in the state of Kansas. At JUNTOS we have an important role to play in strengthening our Latino communi-
ty – a task that cannot be accomplished alone. We strongly believe that we would not exist without the essential
support of our friends, partnering organizations, donors, and funders. Moreover, we would not be successful with-
out the commitment and support from staff, departments, and centers at our University of Kansas Medical Center.
Our gratitude to the research collaboration with Drs. Ellerbeck, Engelman, Choi, Collins, and Cox among others. We
continue to hold strong implementing our four core objectives:
Objective 1: Develop a sustained program in community-based participatory research to advance Latino health
in rural and urban areas of Kansas
Objective 2: Reduce cancer-related disparities among Latinos by advancing research on cancer screening,
smoking cessation trials and disseminating cancer prevention messages among Latinos in Kansas.
Objective 3: Promote educational programs of existing and future health care providers in Kansas to master
cultural competency and provide high quality care to Latinos..
Objective 4: Develop coordinated bilateral efforts between KUMC and Latin American countries (primarily Mexi-
co) to pursue research, teaching and clinical excellence in the field of Latino health.
During this year, we have achieved our objectives by solidified important partnerships including our work with the
Mexican Consulate, Ventanilla de Salud, Universidad Autonoma del Estado de Morelos, Universidad Autonoma del
Estado de Hidalgo, Riverview Health Services, Inc, Enroll Wyandotte, ACS/NFL Promotores de Salud, Latino Health
for All, Duchene Clinic, Samuel U Rodgers Health Center, KUMC Healthy Living Kansas, KUMC Office of Cultural
Enhancement and Diversity, KUMC Office of International Programs, k-12 KUMC pipeline, and Children Mercy Hos-
pital - Offices of Equity and Diversity and Adolescent Medicine.
A special acknowledgement goes to every single organization or individual
that interacted with JUNTOS in the previous year. In special we must ap-
plaud our team Liliana Abdualla, Johana Bravo, Mariana Ramirez, Arturo
Ponce, Ramiro Diaz, Brenda Cartujano, Alejandro Gutierrez, Victor Mar-
tinez, Andrea D’Achiardi, Stefany Paredes, Sophy Paulino, Fabiola Hernan-
dez, and Luis Barboza. Thanks to our amazing interns for all the energy
and support they bring Idaima Calderon, Abril Negrete, Andros Garcia,
Ruth Pedraza, Montserrat Jimenez, and Jehieli Arteta. Finally, to Joanne
McNair, Marilyn Painter, and Glenn James for their incredible support as
a part of our Department of Preventive Medicine and Public Health.
Thanks to your support, collaborative work and friendship we received the
Community Engagement faculty Award for excellence in Developing En-
gaged Scholarship Initiatives in 2014. It is an honor to work with and
learn from each one of you. I strongly believe JUNTOS is just in the begin-
ning steps of much more to come. Looking forward to 2015!
Sincerely,
Paula Cupertino
3. Affordable Care Act Counselors at Juntos
Enroll Wyandotte is an effort led by the Community
Health Council of Wyandotte County to provide in-
formation and resources, and ultimately promote
enrollment in the new health insurance market-
place created under the Affordable Care Act. Jun-
tos joined Enroll Wyandotte efforts to increase en-
rollment among Latino Kansas residents. A total of
8 bilingual staff members received training to be-
come ACA counselors and assisted in the educa-
tion and enrollment efforts. Throughout the
months of October 2013 to March 2014, Juntos
counselors assisted a total of 50 Latino Kansas
residents and provided education to many others.
In March 2014, Juntos co-sponsored the ‘ACA To-
day” Health Fair. The health event took place at
the Memorial Hall in Kansas City, KS were many
health care services and free health screenings
were available to participants, in addition to assis-
tance to enrollment in the health marketplace.
Extensive planning took place to provide all coun-
selors with personalized computers for enrollment.
A total of 25 stations were setup, and the event
was very successful with a total of 200 partici-
pants attending
the event.
KUMC post bac-
calaureate stu-
dents Carlos
Pacheco and
Scott Ogan
worked together
with Arturo Ponce
to assess aware-
ness, knowledge,
and intention to
enroll among Lati-
nos in rural and
urban areas.
Juntos will continue to collaborate with Enroll Wyandotte during
the enrollment session for 2015. Contact us for enrollment
events and referrals at (913) 945-7874.
ACA KNOWLEDGE AND INTENTION TO
ENROLL AMONG LATINOS (N=107)
Among Latino urban and rural resi-
dents less than 50% believe the
ACA will increase the quality and ac-
cess to health care
Less than 20% knew that Kansas
has not expanded Medicaid.
Even though 77% of Latinos are
aware of the penalty fine for not ob-
taining health insurance, only 50%
reported intention to enroll in the
ACA.
Overall, Latinos are fairly familiar
with most aspects of the new health
care law, but rural residents are less
likely to enroll compared to urban
residents.
4. VENTANILLA DE SALUD
Improving the health of Mexican immigrants in the US
Kansas Latino Population
‘Average age of US Latino immigrants: 27 years old’ - Hispanic Pew Research
31%
At high risk of
diabetes
82%
Overweight or
obese
26%
Hypertension
10%
Diabetic
The Ventanilla de Salud (VDS) program was designed to
improve the physical and mental health of Mexicans living
in the US and to increase access to primary and preventive
health resources. We continue our efforts in Southwest
Kansas and counties of high concentration of Latinos. We
provide free access to basic health needs, and culturally
sensitive information on specific health topics such as;
healthy lifestyles, breast cancer, skin cancer, STDs, smok-
ing cessation, diabetes, and hypertension. In 2013-2014,
Juntos organized 11 events reaching a total of 1,504 Lati-
nos. Our local partners, promotores, and research staff con-
tinue to assess health, educate on healthy lifestyles, and
their risk for developing chronic diseases. Participants at
high risk of developing any chronic disease are referred to
UMMAM, the local bilingual safety net clinic.
We continue to better understand the health needs of the
Latino community across Kansas to better served them,
and provide the necessary resources to build a healthier
community.
Demographics of Participants Frequency
Percentage
Average age (SD) 39 years old (11.3)
Female 899 (60.5%)
Mexican 1,425 (95.0%)
Recent immigrants < 10 years in the US 360 (27%)
Less than high school education 979 (65%)
Have health insurance 436 (29%)
Findings (N=1504)
10% are current smokers
50% have unhealthy lifestyles, overweight
and/or not physically active.
51% have not heard about HPV
Only 12% have been vaccinated for HPV.
59% don’t know if they’ve received a colon-
oscopy or FOBT in the past.
Only 31% of women over the age of 40
have performed a mammogram in the past
2 years.
Wichita
Garden City
Great Bend
Wyandotte
5. Second Generation—VDS para Niños
The University of Kansas Medical Center, Children’s Mer-
cy Hospital, and the Mexican Consulate in Kansas City,
MO joined together to develop Ventanilla de Salud para
Niños in August 2013. Dr. John Cowden, pediatrician
from Children’s Mercy, Co-PI of the project has joined with
Juntos research staff to implement the specialized and
culturally relevant program for Latino families with chil-
dren in rural Kansas. Two medical students from Mexico,
Alejandro Gutierrez and Victor Martinez, helped pilot test
and evaluate the program. Research Intern Idaima Calde-
ron has also been collaborating on this project, focusing
on obesity in Latino children in rural Kansas.
This multidisciplinary team of researchers developed and
implemented the evidence--based community-based par-
ticipatory research program focused on five pediatric
health themes: vaccination, obesity/nutrition, dental
health, reproductive/sexual health, and behavioral/
mental health.
In February 2014, Dr. Romina Barral from Children’s Mer-
cy joined the team as an expert in adolescent health. She
will be conducting research on teen pregnancy prevention
among Latino adolescents.
Since the start of the pilot program, the team has as-
sessed the health needs of 177children from over 100
Latino families in rural Kansas, providing direct health
services and information on the program’s five health
themes. As the program continues to grow, the team will
be adding to the preliminary data shown to the right.
6. In an effort to eliminate disparities in breast cancer among Lati-
na women, Juntos and Viva Saludable en Kansas launched the
A.M.I.G.A. program in January 2014; funded by the American
Cancer Society and the National Football League. The program
aims to decrease the incidence of breast cancer among Latina
women by providing information about breast cancer (particularly
breast physiology, screening, risk factors and prevention) and to
encourage women to utilize free and/or low-cost breast cancer
screening services available in the community.
The Promotoras de Salud that are participating in this effort are
Catalina Reyes, Lucia Martinez, Norma Paredes, and Gloria Cor-
tes. They are based at two safety net clinics serving a large pro-
portion of Spanish-speaking Latinas in the Kansas City metro
area, Duchesne Clinic and Cabot Westside Health Center. As
Latina patients wait for their appointments, Promotoras reach
out to them in a linguistically and culturally appropriate way.
From palpable breast models to bright breast anatomy illustra-
tions, Promotoras use different tools to explain the importance of
breast cancer screening for early detection in one-on-one ses-
sions where women feel comfortable to share thoughts and ask
questions. Promotoras encourage women to talk to their provid-
ers about their breast health, discuss their risk factors, and the
best screening tests for them. Overall, they work to empower
women to take control of their own wellbeing.
After their first contact, Promotoras follow up with every age-
eligible women they contact via telephone to make sure they are
able to complete their screening. When necessary, they navigate
women in scheduling appointments with their clinics or referring
them to other services and resources as needed such as Early
Detection Works which is part of the National Breast and Cervical
Cancer Early Detection Program. “Yo le voy a dar seguimiento, yo
no la voy a dejar” (I will follow up with you, I won’t leave you
alone) is the commitment they make with every women they talk
to.
Mariana Ramírez, MSW
Project Manager. Originally
from Mexico City, she coor-
dinates the activities for
education, outreach and
research under the
A.M.I.G.A. program.
Fabiola Hernandez, Stu-
dent Research Assis-
tant, is in charge of da-
tabase management for
the program.
A.M.I.G.A.
Program
A special thank you to the American Cancer Society and
National Football League for their support funding the
A.M.I.G.A. program.
7. INCREASING MAMMOGRAM SCREENINGS
FOR LATINO WOMEN IN KANSAS
The Promotoras de Salud are actively involved in their
community and conduct outreach in different health
fair events and at the Mexican Consulate every week.
They also partner with several organizations to host
breast cancer workshops where they share information
on healthy lifestyles to prevent breast cancer, explain
key concepts about cancer and refer women for free or
low cost mammograms. Some of the community part-
ners they have worked with include Westside CAN Cen-
ter, Parents as Teachers program, Guadalupe Center,
Iglesia El Sagrado Corazon de Guadalupe, and YMCA
Wyandotte.
Besides tracking all their activities, planning events,
and having weekly coaching meetings, Promotoras par-
ticipate in monthly training sessions about different
health topics in the Latino community. These sessions
are also conducted in collaboration with KUMC and
community partners such as Enroll Wyandotte, Alzhei-
mer’s Association, KanCare, and Kansas Family Part-
nership.
The Promotoras are extremely passionate and dedicat-
ed in the work that they do. They have surpassed pro-
gram outcomes, the following table shows how many
women have been contacted so far this year:
A TOTAL OF 157 WOMEN HAVE RECEIVED A FREE
MAMMOGRAM IN THE 10 MONTHS OF THE PROGRAM.
Thanks to the information that Promotoras collect, we
have been able to obtain a baseline with information on
the number of women current with their screenings, the
time it takes them to make an appointment and the
rate of completed mammograms. This information has
enabled the program to share with health care provid-
ers the lessons learned to improve screening rates and
address barriers to early detection in Latinas. Another
aspect of the A.M.I.G.A. breast cancer program is con-
ducting a study assessing effectiveness of the Promo-
tora model and its impact in Promotora skills such as
self-efficacy and health literacy.
Location Number of
women contacted
Health fairs and commu-
nity settings
694
Clinics 288
Total 982
Meet our A.M.I.G.A. Promotoras
Lucia Martinez, original-
ly from Chihuahua, Mex-
ico. Came to the US 8
years ago and is study-
ing to become a Nurse.
She is already CNA cer-
tified.
Norma Paredes, origi-
nally from Quito, Ecua-
dor . She recently
moved to Kansas and
is excited to work and
educate the Latina
women.
Gloria Cortes originally
from Mexico. She’s
been in Kansas for 11
years. She has being a
Promotora de Salud
since January and has
started her own clean-
ing business.
Catalina Reyes, from
Veracruz, Mexico. She
has being in Kansas
since 2006 and has
been a Promotora de
Salud for 6 years.
8. TRAINING FUTURE
HEALTHCARE PROVIDERS
Latino Medical Student Association
(LMSA)
LMSA at the University of Kansas School of Medi-
cine (KUSOM) serves the Kansas City community
and medical students interested in health care for
Kansas City's growing Hispanic population, as well
as other medically and socially underserved popu-
lations. LMSA is also committed to increasing en-
rollment and success of medical students from
diverse backgrounds within KUSOM. LMSA has
seen the support of the Office of Cultural En-
hancement and Diversity (OCED) and Juntos
throughout the entirety of their events. Members
of LMSA are highly involved in a variety of commu-
nity service activities and health fairs. Many have
an interest in learning Spanish and gaining valua-
ble experiences within the Latino community. Jun-
tos has helped us host one of the best programs
implemented by LMSA “60 Minutos” an inter-
professional medical Spanish workshop. Around
175 students have benefited from those work-
shops. "60 Minutos” was recently awarded the
Outstanding Campus Program of 2014. Juntos is
therefore, supporting future healthcare providers
and bridging the gap between Latino populations
and culturally competent health care providers.
by Stefany Paredes—LMSA secretary
Web-based comprehensive Medical Span-
ish Curriculum at KuSoM
While the number of Spanish-speaking patients in
Kansas continues to grow, Spanish speaking physi-
cians is scarce, and where existing, lacks rigor. Lan-
guage barriers are associated with decreased access
to services, lower patient satisfaction, limited adher-
ence to treatment and worse health outcomes. The
National Standards for Culturally and Linguistically
Appropriate Services (CLAS) mandate health care or-
ganizations to provide care to patients in their pre-
ferred language and in a manner compatible to their
cultural beliefs. Nevertheless, healthcare providers,
particularly those in states with large rural areas such
as Kansas, struggle to provide for Limited English Pro-
ficiency (LEP) patients due to workforce shortages
and rising costs. The need for healthcare providers
who are linguistically and culturally equipped to work
with an increasingly diverse patient population is a
public health priority.
Over the last two years, the University of Kansas
School of Medicine (KUSoM) experienced an expo-
nential increase in student demand for Medical Span-
ish as an elective course with 165 students enrolling
the past year. Unfortunately, Medical Spanish curricu-
la in healthcare programs tend to focus on mastering
lists of decontextualized vocabulary rather than on
communicative competence. Therefore, the Office of
Cultural Enhancement and Diversity (OCED) got fund-
ed to develop a comprehensive Medical Spanish pro-
gram rooted on second-language acquisition research
principles and focused on oral, aural, and cultural pro-
ficiency. Juntos bilingual research staff has been
providing support in the development of this signifi-
cant and important project to increase the number of
culturally competent providers for the underserved
Latino community of Kansas.
9. Binational Medical Exchange Programs
RUTH PEDRAZA, a second year
medical student at KUMC from Michoacan,
Mexico, wanted to go back to her country
to better understand the health care system
and get more clinical experience with a cul-
turally sensitive prospective. The summer
between the first and second year of medi-
cal school, students take the opportunity to
get involved in research or have an interna-
tional clinical experience. Ms. Pedraza, cur-
rent LMSA president, knew about the op-
portunities for a 6-week medical rotation in
Mexico with the different partnerships es-
tablished between KUMC, Juntos, the Uni-
versity of Morelos, and the University of
Hidalgo. She shadowed residents on high
risk pregnancy consults, and regular rou-
tine visits, assisted in cesareans, and deliv-
eries, and obtained colonoscopy training.
Ruth wants to become an OBGYN physi-
cian serving Latinos, and other under-
served communities in the US.
One of Juntos goals is to develop coordinated bilateral ef-
forts between KUMC and Mexican governmental and aca-
demic entities to conduct research, teaching, and infor-
mation exchange in the field of Latino health. In the past
three years, Juntos Director Dr. Cupertino has developed
important partnerships with the Universidad Autónoma del
Estado de Morelos (UAEM) and the Universidad Autónoma
del Estado de Hidalgo (UAEH) to mentor and lead Mexican
medical students at KUMC during their last year of commu-
nity service. In August 2014, we welcomed the fourth 6th
year medical students from UAEM, for a 1-year community
service program. Medical students from Mexico are im-
mersed in our community-based programs to increase
their understanding of public health initiatives for Mexican
immigrants in Kansas, develop skills and knowledge on
binational health initiatives, and conduct clinical shadow-
ing experience to enhance their understanding of the US
health care system.
In the summer of 2014, we connected a KUMC 1st year
medical student with Mexico. Ruth Pedraza was part of a
6-week medical rotation to better understand the public
health system of Mexico, and to get clinical experience in
OBGYN from the two medical universities (UAEM and
UAEH). In addition, Juntos is working with the international
office at KUMC to send 4 medical students in the 2014-
2015 winter break to complete their international clinical
rotation. Students will be matched with their specialties of
preference and receive one-on-one mentoring from spe-
cialized physicians in the respective hospitals.
Exchange programs with Mexican medical universi-
ties are available for medical students, MPH stu-
dents, KUMC residents, and faculty. The exchange
program agreements are for clinical rotation, basic
science research, trainings, and public health pro-
grams. If you are interested in taking part of an ex-
change program contact Liliana Abdualla at:
labdualla-martinez@kumc.edu or (913)945-7065.
10. THANK TO ALL OUR PARTNERS AND
SPONSORS
Upcoming events
November 2014. For more information, please contact Lilliana Abdualla at labdualla-martinez@kumc.edu or (913)945-7065.
Juntos Center for Advancing Latino
Health
University of Kansas School of Medicine
Department of Preventive Medicine
and Public Health
4125 Rainbow Boulevard MS 1056
Kansas City, KS 66160
Liberal, KS Ventanilla de Salud Health Fair
Saturday November 22nd and Sunday November 23rd from
9:00AM to 4:00PM. Health fair providing educational material,
basic health screenings and doctors available on-site.
Kansas City, KS Affordable Care Act Enrollment Fair
Saturday December 5th from 8:00AM to 5:00PM at Memorial
Hall (600 N 7th Street Trafficway). Bilingual certified counse-
lors will be available for ACA enrollment. Additionally, educa-
tional material, and basic health screenings available on-site.
Garden City, KS Ventanilla de Salud Health Fair
Saturday December 13th and Sunday December 14th from
9:00AM to 4:00PM. Health fair providing educational material,
basic health screenings and doctors available on-site.
