Orthopaedic Education and Care in the Latinx Community: A Culturally Tailored Outreach Initiative with the Charlottesville Latino Health Initiative.

Updated: Apr 15

VJM Spring Edition 2026

Authors: Abel Ruiz Diaz, BS¹; Kathryn Schultz, MD¹; Angelo Dacus, MD¹; Kacy Peek, MD¹; Hilda Landaverde²; Paige Saunders²; Max Luna, MD^3,4

Author Affiliations:

¹ Department of Orthopaedic Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA

²Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, USA

³Latino Health Initiative, University of Virginia, Charlottesville, Virginia, USA

⁴Division of Cardiology, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA

Potential conflicts of interest: The authors have no conflicts of interest to disclose.

Funding sources for the manuscript: None.

Abstract

Limited English proficiency and unfamiliarity with the healthcare system limit access to specialty care and are significant barriers to orthopaedic care for the Latinx community. To address these disparities, we developed and implemented a community-based orthopaedic outreach program through the Latino Health Initiative (LHI) in Charlottesville, Virginia. Embedded within the LHI’s established Tardes de Salud Familiar framework. Tardes de Salud Familiar is a bilingual, community-based health education program. This specific initiative aimed to improve orthopaedic health literacy, reduce barriers to orthopaedic care, and strengthen trust between the Latinx community and orthopaedic providers. In June 2024, a culturally tailored educational session addressing common orthopaedic conditions was delivered by bilingual orthopaedic providers. Following the session, community members were offered free, private, individualized orthopaedic consultations and facilitated referrals to local care resources. Approximately 15 community members attended the in-person event and 8 were seen in consultation by orthopaedic providers. Additional outreach was achieved through a complementary virtual session that accrued over 500 views on social media platforms. Qualitative feedback from participants and community leaders indicated high engagement and perceived value of specialty access within this trusted community setting. This initiative demonstrates the feasibility and impact of integrating orthopaedic specialty outreach into community-based, culturally responsive health programs. Such models represent a scalable approach to improving equity in orthopaedic care among underserved populations.

Introduction

Health disparities among underrepresented populations remain a persistent public health challenge in the United States. The Latinx community comprises approximately 19.5% of the U.S. population and faces multiple systemic barriers to care.¹ Factors such as limited English proficiency, lack of insurance coverage, immigration-related obstacles, and unfamiliarity with the healthcare systems, all contribute to a system that disadvantages minority populations.^2,3 Numerous studies have shown that social determinants of health negatively impact the patient experience and result in significantly worse health outcomes.^4,5 Orthopaedic care is particularly affected by social determinants of health. Underserved populations are at higher risk for orthopaedic problems due to physically intensive jobs, repetitive tasks, and direct occupational injuries; however, they are less likely to pursue care.⁶ Additionally, studies have found that within the Latinx population, self-care with over-the-counter remedies was the predominant method of treating injuries rather than seeking professional medical care.⁷ These inequities contribute to preventable downstream consequences including chronic pain, long-term disability, and increased healthcare expenditures. Addressing these disparities in orthopaedic care represents a crucial yet often overlooked opportunity to improve health system performance and patient outcomes.

At the University of Virginia, the Latino Health Initiative (LHI) seeks to address and mitigate health disparities through culturally tailored, community-centered engagement. Founded in 2017, its mission is to promote health equity, deliver linguistically and culturally relevant care, and foster trust between healthcare providers and the Latinx community. Its programs include La Clínica Latina, which provides primary care services, and the Cardiovascular Initiative, a longitudinal screening and lifestyle counseling program for individuals at-risk for cardiovascular conditions . Furthermore, a cornerstone of LHI’s outreach is Tardes de Salud Familiar, a bimonthly community health education series designed to improve health literacy and connect participants with local healthcare resources. Sessions are co-developed with trained community health workers known as Promotores de Salud, who play a critical role in ensuring cultural relevance, linguistic accuracy, and community trust. Events are hosted at numerous locations including a local community center and the local community church, both of which are trusted social hubs for the Latinx population. LHI also partners with local organizations including Sin Barreras, a nonprofit providing immigration and legal support as well as health navigation services, and the local free clinic, which offers no-cost primary and preventive care to the uninsured community.⁸ Together, these partnerships aim to expand healthcare access, improve health literacy, and connect underserved Latinx individuals to appropriate medical services.

Prior work stemming from LHI’s dermatology outreach demonstrated that community-based specialty education and screening can increase knowledge and confidence in accessing specialty care among the Latinx populations.⁹ With the existing data and prior success of other specialty organizations, in June of 2024 the University of Virginia Department of Orthopaedic Surgery partnered with the LHI’s Tardes de Salud Familiar to deliver an orthopaedic-focused educational session. The goals of this initiative were to increase health literacy regarding orthopaedic conditions, reduce barriers to specialty care, and facilitate connections between community members and local orthopaedic resources through a culturally responsive engagement model. An additional aim of this initiative was to improve community trust between the Latinx population and the orthopaedic surgery department.

Methods

Program Design and Setting

This initiative was delivered through LHI’s Tardes de Salud Familiar, a bilingual community-based health education program, in collaboration with the University of Virginia Department of Orthopaedic Surgery. In-person sessions were hosted at the Church of the Incarnation in Charlottesville, Virginia. Trained community health workers, titled Promotores de Salud, supported session development and delivery to ensure cultural and linguistic appropriateness.

Outreach and Information Dissemination

Promotional materials, including a monthly virtual newsletter, printed flyers, and event invitations, were distributed through both digital and physical channels (Figure 1). Online dissemination occurred via social media platforms, including Facebook Live and YouTube, while physical materials were posted at the Church of the Incarnation and the Southwood Community Center (Figure 2). This multi-modal approach was designed to maximize reach across varying levels of digital access. A non-measured metric included person-to-person dissemination and communication among community members.

Figure 1: Community Education and Outreach Materials. Representative examples of bilingual educational and promotional materials, including newsletters and social media posts, used to engage Spanish-speaking community members and increase awareness of common musculoskeletal conditions.

Figure 2: Bulletin invitation for a Tardes de Salud Familiar session disseminated to the Charlottesville Latinx community through physical postings and electronic platforms. Spanish-language version shown; bilingual materials were distributed.

Educational Content and Clinical Services

The educational content focused on common musculoskeletal conditions, including arthritis, ligament sprains, overuse injuries, tendinitis, fractures, and joint dislocations. Content was delivered in a case-based format and addressed symptom recognition, conservative management strategies, red-flag symptoms requiring urgent evaluation, and available local resources for specialty care. All components of the program were conducted in Spanish by certified bilingual providers. Following the didactic session, attendees were offered free, one-on-one orthopaedic consultations with orthopaedic providers. These consultations included focused history-taking, physical examination, recommendations, and referrals for longitudinal care when indicated. Participants also received information regarding UVA Financial Assistance, the Charlottesville Free Clinic, and the UVA Orthopaedic Center Clinic.

Results

Approximately 15 community members were in in attendance at the orthopaedic-focused Tardes de Salud Familiar session. Following the presentation, eight participants elected to receive free, individualized orthopaedic consultations provided by UVA providers. A complementary virtual session was held on June 28, 2024 for community members unable to attend the in-person session. The virtual presentation consisted of a 60-minute educational presentation mirroring the in-person session, and was streamed via Facebook Live and subsequently archived on the UVA Latino Health Initiative YouTube channel. At the time of manuscript preparation, the virtual session had accrued over 500 views on Facebook and over 25 views on YouTube. Though no formal surveys were utilized, engagement was reflected through participation in both in-person and virtual formats, active audience involvement during question-and-answer sessions, and uptake of same-day clinical consultations. Qualitative feedback from participants and community leaders following the events suggested positive reception and reinforced the value of specialty engagement within this community-based framework.

Discussion

Our initiative demonstrates the feasibility and value of integrating orthopaedic specialty education and clinical access within an established, community-trusted health education framework. By embedding orthopaedic outreach within LHI’s Tardes de Salud Familiar, the program leveraged longstanding community relationships to address common access barriers to specialty care, including language discordance, limited health literacy, and distrust of the healthcare system. Several design elements likely contributed to the program’s effectiveness. Collaboration with Promotores de Salud ensured that educational content was linguistically accurate, culturally responsive, and vetted by trusted community members prior to dissemination, facilitating bidirectional communication and reinforcing credibility. The presence of bilingual orthopaedic faculty delivering education and offering same-day consultations in Spanish translated didactic material into immediate, actionable access to care, reducing delays and lowering activation barriers for community members. The hybrid delivery model expanded reach beyond in-person attendees, with virtual dissemination mitigating logistical barriers such as transportation, work schedules, and childcare responsibilities. Collectively, these elements fostered meaningful engagement and strengthened trust between the Latinx community and orthopaedic providers.

Beyond its local impact, this model offers a scalable framework for improving access to specialty care across medical and surgical disciplines. Similar community-embedded outreach initiatives in dermatology have demonstrated improved engagement, increased disease awareness, and successful connection to specialty services among underserved Latinx populations.⁹ The present initiative extends this approach to orthopaedic surgery, a specialty in which disparities in access and downstream outcomes remain pronounced.¹⁰ By prioritizing cultural co-design, language concordance, and partnerships with trusted community organizations, specialty outreach programs can move beyond episodic care toward sustained engagement. Future efforts should incorporate structured outcome measures, longitudinal follow-up, and institutional support to enhance durability and assess the impact on care utilization and health outcomes. As healthcare systems seek equity-focused solutions, specialty-driven community partnerships represent a practical and adaptable strategy for reducing disparities and advancing trust-based care delivery.

References

1.Funk, Cary, and Mark Hugo Lopez. Hispanic Americans’ Experiences with Health Care. Pew Research Center, 14 June 2022, www.pewresearch.org/wp-content/uploads/sites/20/2022/06/PS_2022.06.14_hispanic-americans-science_REPORT.pdf.

2. Morales, Josefina Flores. “Can’t Buy Me Health-Care Access: Qualitative Experiences of U.S.-Born Latinx Adults’ Health Insurance Coverage and Health-Care Use Post ACA.” RSF: The Russell Sage Foundation Journal of the Social Sciences, vol. 10, no. 4, 2024, pp. 173–190, https://www.rsfjournal.org/content/rsfjss/10/4/173.full.pdf

3. Berger, Zackary, and Yael Peled. “Language and Health (In)Equity in US Latinx Communities.” AMA Journal of Ethics, vol. 24, no. 4, 1 Apr. 2022, pp. 313–318, journalofethics.ama-assn.org/sites/joedb/files/2022-03/msoc3-peer-2204_0.pdf.

4. Brandt EJ, Tobb K, Cambron JC, et al. Assessing and Addressing Social Determinants of Cardiovascular Health: JACC State-of-the-Art Review. J Am Coll Cardiol. 2023;81(14):1368-1385. doi:10.1016/j.jacc.2023.01.042

5. White-Williams C, Rossi LP, Bittner VA, et al. Addressing Social Determinants of Health in the Care of Patients With Heart Failure: A Scientific Statement From the American Heart Association. Circulation. 2020;141(22):e841-e863. doi:10.1161/CIR.0000000000000767

6. Rabah, Nicholas M et al. “Are There Nationwide Socioeconomic and Demographic Disparities in the Use of Outpatient Orthopaedic Services?.” Clinical orthopaedics and related research vol. 478,5 (2020): 979-989. doi:10.1097/CORR.0000000000001168

7. Anthony, Maureen J et al. “Self care and health-seeking behavior of migrant farmworkers.” Journal of immigrant and minority health vol. 12,5 (2010): 634-9. doi:10.1007/s10903-009-9252-9.

8. “About the UVA Latino Health Initiative.” UVA Latino Health Initiative, University of Virginia School of Medicine, med.virginia.edu/uva-latino-health-initiative/about/. Accessed 16 Jan. 2026.

9. Lyons, Catherine E., et al. “Improving Dermatologic Health Equity: Community-Based Outreach in the Hispanic Population of Charlottesville.” SKIN: The Journal of Cutaneous Medicine, vol. 10, no. 1, 2026, pp. 2874–2877, https://skin.dermsquared.com/skin/article/view/3440/2739

Faust AM, Dy CJ. Achieving Health Equity: Combatting the Disparities in American Access to Musculoskeletal Care : Disparities Exist in Every Aspect of Orthopaedic Care in the United States - Access to Outpatient Visits, Discretionary and Unplanned Surgical Care, and Postoperative Outcomes. What Can We Do?. Curr Rev Musculoskelet Med. 2024;17(11):449-455. doi:10.1007/s12178-024-09926-7