title: Reducing the Impact of Immigration Enforcement Policies to Ensure the Health of North Carolinians: Statewide Community-Level Recommendations.
abstract: BACKGROUND
  Research indicates that fear of immigration enforcement among Latinos in North Carolina results in limited access to and utilization of health services and negative health consequences. This project developed recommendations to mitigate the public health impact of immigration enforcement policies in North Carolina.
  
  
  METHODS
  Our community-based participatory research partnership conducted 6 Spanish-language report-backs (an approach to sharing, validating, and interpreting data) and 3 bilingual forums with community members and public health leaders throughout North Carolina. The goals of these events were to discuss the impact of immigration enforcement on Latino health and develop recommendations to increase health services access and utilization. Findings from the report-backs and forums were analyzed using grounded theory to identify and refine common recommendations.
  
  
  RESULTS
  A total of 344 people participated in the report-backs and forums. Eight recommendations emerged: increase knowledge among Latinos about local health services; build capacity to promote policy changes; implement system-level changes among organizations providing health services; train lay health advisors to help community members navigate systems; share Latinos' experiences with policy makers; reduce transportation barriers; increase schools' support of Latino families; and increase collaboration among community members, organizations, health care providers, and academic researchers.
  
  
  CONCLUSIONS
  Representatives from 16 of 100 North Carolina counties participated. These 16 counties represent geographically diverse regions, and many of these counties have large Latino populations.
  
  
  CONCLUSIONS
  Immigration enforcement is a public health issue. Participants proposed developing new partnerships, identifying strategies, and implementing action steps for carrying out recommendations to reduce negative health outcomes among Latinos in North Carolina.
authors.affiliation: research associate, Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina lmann@wakehealth.edu.
authors.forename: Lilli
authors.initials: L
authors.lastname: Mann
authors.affiliation: director of programs, El Pueblo, Inc., Raleigh, North Carolina.
authors.forename: Florence M
authors.initials: FM
authors.lastname: Simán
authors.affiliation: project manager, Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Mario
authors.initials: M
authors.lastname: Downs
authors.affiliation: assistant professor, OHSU-PSU School of Public Health, Portland, Oregon.
authors.forename: Christina J
authors.initials: CJ
authors.lastname: Sun
authors.affiliation: project manager, Department of Family Medicine, Carolinas HealthCare System, Charlotte, North Carolina.
authors.forename: Brisa Urquieta
authors.initials: BU
authors.lastname: de Hernandez
authors.affiliation: project coordinator, Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Manuel
authors.initials: M
authors.lastname: García
authors.affiliation: project manager, Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Jorge
authors.initials: J
authors.lastname: Alonzo
authors.affiliation: doctoral student, School of Geography and Development, University of Arizona, Tucson, Arizona.
authors.forename: Emma
authors.initials: E
authors.lastname: Lawlor
authors.affiliation: professor, Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Rhodes
mesh_terms: D055812:Community-Based Participatory Research; D054242:Emigrants and Immigrants / Q000331:legislation & jurisprudence*; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006630:Hispanic or Latino; D006801:Humans; D035846:Law Enforcement; D009657:North Carolina; D011640:Public Policy