The art of meeting people where they are: A community partnership approach for COVID equity

–By Jessica Otero. Originally published on the Harvard Medical School Primary Care blog.

Historic factors driving health disparities among the diverse Latino population in the U.S. include social determinants of health that have created barriers in COVID-19 prevention. As COVID-19 disparities became evident, dedicated clinicians, scientists, and public health professionals from around the country partnered under the umbrella of the National Institutes of Health (NIH) Community Engagement Alliance (CEAL) Against COVID-19 Disparities to reduce COVID-19 related health disparities. These teams sought to understand the needs of the communities they were serving and how they could sustainably meet them. The Florida CEAL (FL-CEAL) team specifically focused on partnering with Black and Latino communities in Florida to reduce these disparities.

According to the Kaiser Family Foundation (KFF) COVID case tracker, Latinos make up 27% of the Florida population yet represent 42% of COVID-19 cases. Before addressing these disparities, the FL-CEAL team took the time to learn from those in the community through a series of focus groups. They asked intentional questions to understand what people’s fears were as the pandemic continued to develop. For example, many had a hard time trusting COVID-19 guidance, while others were fearful of the COVID-19 vaccine. The goal was to understand what would be most effective in sharing accurate information. For example, who do they trust? What were the things that triggered them, or kept them from being open to learning about COVID-19 prevention?

Findings from the focus groups were used to develop tailored interventions that were implemented across Florida. In addition, the FL-CEAL team continued to seek out community leaders and members to understand what would help as the pandemic developed. These community leaders reminded the FL-CEAL team of the effectiveness of meeting people where they are and using community-based solutions to address community issues. This completely shifted the way the FL-CEAL team approached community outreach.

The Art of Meeting People Where They Are

The concept of meeting people where they are stems from genuine care, intentionality, and mutual relationship. It is about going to the places people love, trust, and frequent, rather than expecting them to come to an institution or organization. It is also about recognizing that reducing disparities is an “all hands on deck” effort and that no one organization can do it on its own. The following lessons were learned from members of the community:

Lesson 1: Using Effective and Accessible Science Communication 

The FL-CEAL Alliance held a variety of educational events to disseminate accurate information using the Zoom platform. The CEAL team recognized that, for hesitant communities to consider following COVID-19 recommendations, they needed someone to listen, empathize, and speak to their fears. For that reason, the FL-CEAL team held a series of panel events where people could share all their concerns about the COVID-19 pandemic and the COVID-19 vaccines. In the first panel, which featured NIH Vaccine Team Lead Dr. Kizzmekia Corbett, panelist Jessica Malaty Rivera expressed the importance of science communication. Jessica shared renowned English medical scientists Mark Walport’s important quote “science is not finished until science is communicated,” perfectly explaining the necessity of sharing accurate health information in a way that is understandable and accessible to the community.

These events were promoted through social media channels and existing partners. This approach changed, however, after FL-CEAL team members realized that community members did not know about the organization and where to find them. In addition, these methods assume that people knew how to navigate these social platforms to access the information that was being shared. After consulting with community members on what would be most effective, the events were made accessible on Facebook Live, shared with various Facebook groups, and shared with community influencers.

This science-to-science communication was not complicated but rather enhanced by meeting people where they are. The main focus was on tackling misinformation through accessible and relatable language, straying away from intimidating scientific jargon and terminology. It was important to speak to peoples’ questions and confusions surrounding COVID-19 epidemiology with empathy and respect. Ultimately, FL- CEAL focused on empowering community members to make informed decisions about their health.

Lessons 2: Centering Trusted Partnerships and Intergroup Relationships

While the panel events were very successful, those attending were individuals who had access to technology and at least some access to educational resources. The FL-CEAL team did not stop hosting these panels, but rather supplemented this outreach strategy by partnering with trusted community leaders. They found that there was a need for COVID-19 education in undocumented communities who often did not have access to health information and had a fear of their documentation status being exposed.

The Osceola County Department of Health proved to be an invaluable partner that knew about the needs in the community and was willing to do what they could to address them. Along with the FL-CEAL, they partnered with food drives that were frequented by the undocumented community. The structure of these food drives involves a standard routine, as cars line up at the same place and at the same time. The FL-CEAL and DOH staff went to each car offering masks, answering questions, sharing health resources, and providing information on vaccination sites. In these settings, community members felt comfortable sharing about their undocumented status and asking clarifying questions. In a FL-CEAL event, for example, a community member felt so excited at the possibility of being safely vaccinated that she called five people to inform them of what she had learned. This was a reminder that good news is meant to be shared. The vaccine is good news but needs to be shared through trusted messengers.

Through these events, over 300 people received masks and accurate health information. These individuals also learned where they could receive their COVID-19 vaccine, and over 150 received assistance in registering for the vaccine. What led to this positive impact was receiving their COVID-19 information from other trusted members of the community rather from a removed health professional who they do not have a relationship with.

Lesson 3: Supporting Collaborations Across Community-Serving Organizations and Institutions  

Since the start of the COVID-19 pandemic, the FL-CEAL team connected with various community-serving organizations throughout the state. Collaborations looked different across various organizations, but they all had the same goal of serving the Latino community. When there was a need in the community, it was shared among the organizations until a solution was found.

In Alachua County, Dr. Michael Lauzardo, Chief of the Division of Infectious Diseases and Global Medicine at the University of Florida, started a bi-weekly task force that consisted of different community leaders, such as local government officials, faith leaders, clinicians, and public health professionals, to discuss gaps in vaccine distribution and how they can help mitigate them. A product of these meetings were various vaccination events around the County that leveraged the influence of trusted community leaders. This result inspired the FL-CEAL team to replicate these efforts in other counties across Florida.

Looking Towards the Future

The concept of meeting people where they are requires a special kind of humility to admit that even those dedicated to public health and health disparities are part of the systems that pose barriers to community members. It is a skill that requires one to re-center their efforts towards empowering those who are already doing impactful work in the community. Organizations must come together to address their community’s needs, answer their questions, and allow them to make informed decisions to care for themselves and those around them. It is evident that working together is the only way to overcome this pandemic.