Meeting the heath-care needs of the people of Arizona includes ensuring that those who live along its border with Mexico, home to an estimated 2 million people, are served by a healthcare workforce representative of this unique, vibrant community.
Understanding the bicultural fusion of life among people who share similar resources and are economically and socially interdependent is vital to the improvement of border health-care outcomes.
The Arizona Health Sciences Center is committed to creating a health-care workforce representative of the state and the Frontera Summer Research Internship program, a part of the University of Arizona College of Medicine – Tucson and its Office of Diversity and Inclusion, is working to increase those numbers.
This summer, the Office of Diversity and Inclusion at the UA College of Medicine – Tucson has selected 10 students for the Frontera Summer Internship Program. Frontera (Focusing Research on the Border Area), which is Spanish for border, provides undergraduate and graduate students opportunities to prepare for medical school with a hands-on research experience and an increased understanding of public-health disparities in the U.S.-Mexico border region.
Participants are matched with faculty mentors engaged in biomedical and public health research that has an impact on border communities. They develop an in-depth understanding of the pathway to medical school, including study and test-taking skills, preparations for the MCAT and drafting a personal statement and travel to border communities, visits to health-care facilities and public health agencies, on both sides of the US-Mexico border, and service-learning activities.
On Friday, Aug. 8 at 10 a.m., participants will present the results of their research at the closing ceremony and poster presentation to be held at Kiewit Auditorium, UA Cancer Center, 1515 N. Campbell Ave. They also will participate in a poster session at the 19th Annual UA Undergraduate Research Opportunities Consortium (UROC) Research Conference at the Student Union Ballroom on Monday, Aug. 11.
Research experience is a vital part of the Frontera Summer Internship program. The following summaries highlight the varying degrees of experience in the lab, (from none, to all four years of undergraduate studies) and within border communities, (a lifetime of experience on both sides of the border, to none), of the following selected program participants.
Testing the efficacy of digital storytelling to improve health literacy and comprehension, Corey Benjamin and Kimberly Escarcega embraced the challenge to learn how to make digital videos and to expand their cultural and research knowledge base. Their research project, "Improving Health Literacy in new Arizona Health Care Cost Containment System Patients Using Digital Stories and Promotoras," has the non-tech savvy team investigating the use of “promotoras,” community health advocates, combined with video messaging to test the comprehension of the recent changes in eligibility for health-care coverage and access to Arizona’s Medicaid health care program.
The federal Affordable Care Act was implemented to provide greater access to care and health care coverage for Americans. In Arizona, the act has expanded coverage of the state’s Medicaid program, Arizona Health Care Cost Containment System (AHCCCS), making more people eligible for the health coverage.
Questions on how to educate border communities on the changes to AHCCCs led to the idea of creating a video and combining the information conveyed in the video with the expertise of community health advocates.
Although learning digital technology presented a learning curve for both Benjamin and Escarcega, the team will present the video they created with the feedback of their mentors Ada Wilkinson - Lee, PhD, assistant professor of Mexican American Studies and Martha Moore-Monroy, MA, program director of the UA Center of Excellence in Women’s Health. The video will be shown to AHCCCS-eligible patients to provide a new understanding of coverage and benefits.
Benjamin, a UA physiology senior with a minor in Spanish, is new to Arizona. A Virginia native, he wanted to learn more about the border, its culture and people. He has worked in an orthopaedic research lab and jumped at the opportunity to learn more about the health-care needs of the population he hopes to serve as a physician.
The study provided the opportunity for Escarcega to learn research methodology. A UA biology junior from Douglas, Ariz., Escarcega is aware of the lack of access to specialty care and general disparities within border communities. She has gained experience in patient care, volunteering with the children’s emergency department at the University of Arizona Medical Center – University Campus. But as a first-generation college student at the UA, she said the Frontera program has provided an opportunity to learn more about health-care careers. She now has a greater understanding of research and will decide whether to pursue a medical degree or a graduate degree with a focus on improving the health conditions in border communities.
In another AHCCCS research study, Raymond Larez, a UA nutritional science senior with minors in chemistry and philosophy, began his Frontera summer research to gain insight on physician participation rates in AHCCCS in the four border counties of Arizona.
Having grown up on the border, Larez was aware of the access to health-care issues in border communities, such as trying to find Spanish-speaking doctors to care for his ailing grandmother. But Larez was surprised at the many complexities in health-care access within these communities.
Therefore, he began a research project to assess how many border physicians were accepting AHCCCS patients to see if there were enough physicians to treat these patients. His mentor, Howard Eng, DrPH, UA assistant professor of public health and pharmacy practice, has been tracking Pima County physician enrollment in the AHCCCS plan, including Spanish speakers, and tracking which AHCCCS plans the physicians are accepting.
Larez’s research has the same focus but is centered on border communities, where he found that a serious physician shortage exists in border communities, and the few physicians who practice there do not accept AHCCCS.
He also found that few people in border communities have signed up for AHCCCS, even though they are eligible. And even if they have signed up for AHCCCS, they only access emergency services.
Even before he began studying at the UA, Larez was introduced to health-care professions through the UA’s Med-Start program in high school. Med-Start is a bridge program that introduces health-care careers to high school students and is a sister program to the Frontera internship at the UA College of Medicine – Tucson Office of Diversity and Inclusion.
Larez said the Frontera research project has taught him the complicated interconnection between health-care policy and health outcomes. His interest in improving health disparities has only intensified his interest in becoming a physician. “I appreciate the Office of Diversity and Inclusion for its efforts to provide experience in research while providing a pathway for medical school,” he says.
Maria Rocio Torres was born in Tijuana, Mexico, and immigrated to the United States after high school. She graduated from the UA in 2013 with degrees in physiology and Spanish and a minor in biochemistry. She currently is a graduate student at the UA Mel and Enid Zuckerman College of Public Health.
Her Frontera research study, under the mentorship of Valentine Nfonsam, MD, MS, assistant professor of surgery, involves an investigation into colorectal cancer among the ethnic races in Arizona. She also will assess the differences in the anatomical location and the stages of presentation of cancer within the five ethnic groups she is studying. The study will assess differences and similarities (socio-economic status, insurance, weight) to help find therapies.
The Frontera internship is her first research experience and she is has found that research is a team effort, reaching out to find a plethora of resources on the UA campus for help. She plans to apply to medical school and hopes to study at the UA College of Medicine – Tucson.
Abel Villalobos is
a senior at the UA. A molecular and cellular biology major with a minor in Spanish, Villalobos was born in Douglas, but resided on the Mexico side of the border, in Agua Prieta, Sonora, for most of his life and made a daily commute to attend school in Douglas.
The first person in his family to attend college, Villalobos’ project, “Understanding the Role of HIV-1 diversity in HIV Disease Progression,” is investigating the hypothesis that HIV diversity influences disease progression in infected patients. Nafees Ahmad, PhD, associate professor of immunobiology, is his mentor.
Villalobos grew up liking science but thought becoming a doctor was a far-fetched dream. He focused on finding work and earning money – but still enrolled at Cochise College and Pima Community College, taking one class at a time. Upon acceptance to the UA, he became more determined in his goal to become a doctor with the help of various programs offered by the Office of Diversity and Inclusion for those interested in health-care careers.
“If it weren’t for them, I wouldn’t be here. They fill a much needed gap making the path a little easier in the difficult road to get accepted into medical school.”
Quyymun Rabby moved to the United States from Bangladesh at age 9. A Glendale High School and UA graduate in biology with a minor in Spanish, she begins graduate school at the UA Mel and Enid Zuckerman College of Public Health this fall.
Her Frontera research focus is on the influence of television and acculturation on the eating habits and physical activity in risk factors for childhood obesity at the Nogales border. Eyal Oren, PhD, MS, assistant professor of epidemiology and biostatistics at the Mel and Enid Zuckerman College of Public Health, is her mentor.
Although she has strong research experience, having worked in labs at the UA during all four years of college, she was interested in the Frontera internship to expand her understanding of border health disparities and to gain insight to major areas of need along the border. She hopes to gain admission to medical school and serve as a physician within these border regions.
For more information on the Frontera Program, please visit: https://diversity.medicine.arizona.edu/frontera