Davison, Sharon L. December, 1989. - ACCESS BARRIERS TO HEALTH CARE OF HISPANIC MIGRANT FARMWORKERS WITH DIABETES Abstract: This thesis details the findings of a study of Hispanic migrant diabetics in Southeastern Hillsborough County, Florida, between August and December, 1987. The purpose of the study was to determine barriers to health care of the migrant workers and examine their perceptions of chronic illness, in order to assist the Ruskin Migrant and Community Health Center (RMCHC) in serving this population. The intern located and interviewed 35 of the 60 patients that had been identified as Hispanic migrant diabetics by the RMCHC. All interviews were conducted in the patients' homes, usually in Spanish, with family members present whenever possible. The 102-item questionnaire consisted of mostly open-ended questions covering the following areas: general diabetes information; treatment; diet; complications; and household information. In addition, clinic providers were interviewed briefly to obtain their views on treating this population. The information gathered was used to provide the Health Center with recommendations to facilitate the long-term managed care of migrant diabetics. Responses from participants indicated that many patients were not compliant with the diabetes regimen and were often confused as to the nature of their illness. They identified numerous logistical problems with accessing care and maintaining their program of therapy. The intern recommended that an effort be made to explain diabetes and its treatment to the migrants in a manner appropriate to their culture, health beliefs, language, educational level, and financial condition. Clinic intervention in the form of an outreach program, expansion of clinic services such as the health center van service, and additional health education, especially diet counseling, was also recommended. .