Table 3: Recommendation for Policy and Practice.

Social Ecological Model Levels Barriers Policy/Practice Recommendations
Organizational • Language and translation
• Unequal treatment
• Translate patient materials and utilize translators
• Hiring Marshallese staff as community health workers
• Ensure culturally appropriate translations of medical concepts
• Conduct internal reviews of policies
• Provide cultural awareness training to employees
Community • Transportation
• Food insecurity
• Employment and employer sponsored health insurance
• Invest in public transit
• Translate driver’s license testing material
• Implement health food policies at food pantries
• Provide more full-time employment
• Ensure employees understand their insurance benefits
Policy • Federal policies related to Medicaid • Amend PRWORA to include COFA migrants within the category of qualified immigrants