Project Adelante is a project that addresses the critical need of improving the quality of and access to health care for Hispanic people with Limited-English Proficiency (LEP) in South Carolina. The project focuses its efforts in three rural counties in the central part of the state. Significant recent growth in the Hispanic population in South Carolina has rapidly surpassed the public health care system’s preparedness to adequately serve these health care consumers.

General Nature of the Project: To design, develop, implement, deliver instructional training for the South Carolina Bilingual/Bicultural Hispanic Health Initiative, and provide outreach and training at professional meetings.

Overall Goal: To improve the quality and access to healthcare for Hispanic people with limited-English proficiency in South Carolina.

.Adelante Project selected three health areas to target efforts: infant mortality, HIV/AIDS, and immunizations.

Infant Mortality:

1. Research shows higher rates of infant mortality and low birth weight among Hispanics.
2. Research reveals higher rates of risky health-related behaviors.
3. Hispanic mothers are more than three times as likely as non-Hispanic white mothers to have late or no prenatal care.
4. The infant mortality rate has historically been used as an indicator of the utilization and quality of health care.

Immunizations

1. Research shows that less than half of Hispanic children completes their immunization series by age two.
2. Research indicates that Hispanics are less likely than non-Hispanic whites to seek medical treatment until they are ill.
3. Immunizations are a cost-effective preventive health care tool.
4. Education and promotion of immunizations are found to be an effective tool to provide broader health services to the Hispanic community.

HIV/AIDS

1. HIV/AIDS annual incidence rate for Hispanic adults is 3.2 times that of non-Hispanic white adults.
   * In 1994, 37% of the AIDS cases among all Hispanics were due to injecting use.
2. In 1999, Hispanics, who represent 13% of the US population, accounted for 19% of the total number of new AIDS reported cases.
3. A disturbing 24% of all pediatric AIDS cases (children up to age 13) were Hispanic in 1994.
4. HIV/AIDS has a critical effect on the individual and family.
5. HIV/AIDS is preventable through changes in lifestyle, health behaviors, and other health factors that affect health status of Hispanics.

General Objectives: The multitude of factors impacting the provision of adequate health care for Hispanic limited-English speaking individuals requires a variety of strategies which are reflected on the following objectives.

1. By 2003, increase the understanding and provision of culturally competent healthcare services by 115 providers at the three rural county Health Departments and from community healthcare providers.
2. By 2003, increase the understanding and cultural sensitivity (specifically Hispanic LEP consumers) of 150 healthcare providers statewide.
3. By September 2003, increase the number of Hispanic LEP consumers seeking healthcare services to 50% individuals across all three counties.
4. By 2003 there will be a 50% increase in the number of Hispanic LEP individuals receiving services in the three targeted areas of foci – i.e. prenatal care screening and services, HIV/AIDS screening and referrals, and immunizations.
5. By 2003, a minimum of four products will be disseminated statewide to healthcare providers that address the healthcare service needs of LEP Hispanics residing in rural counties throughout South Carolina.