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Background: The global epidemic of diabetes calls for innovative interventions. This study evaluated the effectiveness of the Project Dulce model, with and without wireless technology, on glycemic control and other clinical and self-reported outcomes in patients with poorly controlled type 2 diabetes in Mexico.

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Students and faculty from one Mexican and one U. The course addresses clinical, ethical, cultural, population-specific issues and the structure, financing and delivery of medical care in Mexico. The clinic implements an electronic medical record and is developing telemedicine for consulting on complex cases.

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Despite challenges related to sustaining adequate funding, this program may be replicated in other border communities. The closest government health center near downtown is not fully operational as it was closed for renovation in Prevalence of HIV and latent TB infection are elevated among these vulnerable populations, many of whom lack access to timely and affordable healthcare.

Efforts to provide healthcare to vulnerable populations residing in free sex text tijuana Zona Norte are needed. We describe a binational, free student-run clinic which aims to promote healthcare access in the Northern border region while also providing training opportunities for medical school students and other professionals. HFiT serves vulnerable persons, including sex workers, substance users, deportees, homeless, and indigent patients.

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HFiT also receives in-kind support e. Donations enable the clinic to provide medications, basic laboratory tests, social services and refreshments to patients, most of whom live in extreme poverty. First through third-year medical school students interested in attending the clinic must first enroll at their medical school, in an HFiT course consisting of two components: 1 didactic classroom-based training and 2 primary care medicine internships under the direct supervision of clinical faculty from UCSD or UABC.

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The didactic course addresses provision of healthcare in Mexico among disadvantaged populations who typically seek care at the clinic Table 1. The clinic also trains students in cultural competency issues and aims to improve their understanding of factors that contribute to health disparities and barriers to healthcare access in Mexico.

All students are trained in personal safety measures. Faculty mentors advise students in clinical history taking, medical exams, and triaging patients to health and social services e.

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HFiT provides a broad range of free medical services to adults including diagnosis and care for sexually transmitted infections including HIV testing and linkage to care, abscesses resulting from injection drug use, prenatal services, diabetes and other conditions. A telemedicine The clinic uses an electronic medical record EMR which facilitates the administrative oversight and long-term care provision. Due to academic schedules and resource constraints, the HFiT clinic is open every Saturday, serving all who seek care.

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Patients needing specialized care e. Anecdotally, students from both universities report increased familiarity with the presentation of diverse health conditions among patients with multiple comorbidities as well as a greater sensitivity to working with disadvantaged populations. Mental health services constitute an emergent need in the HFiT patient population.

Clinic directors are exploring collaborations with other universities and disciplines e. While the EMR software implemented is free, it is only available in English, and it is used inconsistently due to lack of familiarity and language barriers by volunteer physicians.

Introduction

Ongoing training and implementing a procedural checklist will ensure consistent use of the EMR. Since the HFiT clinic is staffed by volunteers, student schedules and long-border waits i. It is recommended that U. Anecdotally, the clinic has been well received in the community and among both Mexican and American students and faculty. HFiT may be an important first contact with healthcare for some patients.

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This clinic model may be replicated in other U. We are grateful to our collaborators Dr. Manuel Gallardo, Mr. Luis Alberto Segovia and Dr. National Center for Biotechnology InformationU. J Immigr Minor Health. Author manuscript; available in PMC Jun 1. Victoria D. Vargas-Ojeda3 Steffanie A. Strathdee1 David Goodman1 and Jose L. Burgos 1. Find articles by Victoria D. Find articles by Amy Eppstein.

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Remedios Lozada 2 PrevenCasa; Ave. Find articles by Remedios Lozada. Adriana C. Steffanie A. Find articles by Steffanie A. Find articles by David Goodman. Jose L. Find articles by Jose L. Author information Copyright and information Disclaimer.

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Corresponding author: Victoria D. Phone: Fax: ude. Copyright notice. The publisher's final edited version of this article is available at J Immigr Minor Health.

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See other articles in PMC that cite the published article. Keywords: Mexico, medical school education, access to care, student-run free clinic, migrants. HFiT Training Opportunities First through third-year medical school students interested in attending the clinic must first enroll at their medical school, in an HFiT course consisting of two components: 1 didactic classroom-based training and 2 primary care medicine internships under the direct supervision of clinical faculty from UCSD or UABC. Open in a separate window.

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Acknowledgements We are grateful to our collaborators Dr. Bibliography 1. Instituto Nacional de Estadistica y Geografia.

Establishing a binational student-run free-clinic in tijuana, mexico: a model for u.s.-mexico border states

Principales Resultados del Censo de Poblacion y Vivienda Aguascalientes, Ags. Journal of Urban Health. Qualitative Health Research. How to successfully select and implement electronic health records EHR in small ambulatory practice settings. Menachemi N, Collum T. Benefits and drawbacks of electronic health record systems.

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