The Future of Community Outreach: Using Patient Portals to Provide Voter Resources during the Coronavirus Disease 2019 Pandemic.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, there was a concern for the 2020 general election becoming a superspreader event due to in-person voting. OBJECTIVES: Our project addressed this concern by disseminating nonpartisan websites detailing safe voter options in the state of North Carolina to prevent community spread of the virus as much as possible. METHODS: In this study, patient portals were used to disseminate a Research Electronic Data Capture survey containing embedded links to voter resources including nonpartisan websites discussing voting options. The survey also asked for demographic data and sentiments regarding the resources provided. Quick response (QR) codes with the survey link were also placed in the clinics during the study period. RESULTS: The survey was sent to 14,842 patients who had at least one patient encounter in the past 12 months at one of three General Internal Medicine clinics at Atrium Health Wake Forest Baptist. Survey participation through both the patient portals and QR codes was assessed. Patient sentiments toward the voter resources in regard to (1) interest and (2) perceived helpfulness were collected in the survey. In total, 738 (4.99%) patients filled out the survey. Eighty-seven percent of survey respondents reported that the voter resources were helpful. Significantly more black patients than white (29.3 vs. 18.2, p < 0.05) voiced interest in voter resources. There was no statistical significance across gender or reported comorbidities. CONCLUSION: Multicultural, underserved, and underinsured patients perceived the most benefit. During public health crises, patient portal messages can be used to bridge information gaps and promote better health outcomes in a timely and effective manner.

Codesign and community outreach to create COVID-19 safe communities: A Karen community case study.

During the COVID-19 pandemic, government directives for health and community services focused on building capacity for COVID-19 safe behaviors. During 2020-2021, there was mounting pressure to increase vaccination numbers to boost population-wide immunity, thereby enabling the lessening of pandemic response restrictions. The Australian population, in general, faced communication hurdles in understanding COVID-19, government directives and policies, and health initiatives. This was particularly challenging given the rapid changes in disease behaviors and community response requirements. This community case study documents local experience in delivering information about COVID-19 safety and vaccination to a former refugee community (the Karen community) in regional Victoria. Community outreach and codesign approaches established closer engagement between the Karen community and Bendigo Community Health Services (BCHS). This case study is explored through semi-structured interviews conducted face-to-face and via videoconferencing with key Karen community leaders, Karen community members, vaccination clinic volunteers, and BCHS staff and bicultural workers. A hybrid approach that employed community outreach and codesign approaches in tandem built trust and closer ties between the Karen community and BCHS, leading to increased understanding and compliance with COVID-19 safe messages and vaccination uptake. Community-led innovations included codesign of COVID-19 fact sheets and videos in the Karen language, involvement of "local champions," assisting Karen businesses with COVID-19 safe plans, and creation of a COVID-19 information hotline. The latter was facilitated by BCHS bicultural staff. These innovations supported the delivery of vaccination clinics at the local Karen Temple. Embedding multi-level, tailored, and responsive public health approaches is particularly important in complex settings where there are disproportionately high levels of community disadvantage, as occurred during the COVID-19 pandemic.

Virtual community outreach during the COVID-19 pandemic: addressing health disparities for vulnerable populations.

Context: COVID-19 has worsened health disparities among vulnerable populations, including minority and non-English-speaking populations. Community outreach is an effective method to bridge the gap for those populations. Virtual Community Outreach (VCO) emerged as a novel and sustainable approach during the pandemic but is unstudied. Objective: 1) Evaluate the effectiveness and usefulness of VCO. 2) Assess impact on patient health literacy. Study Design: Prospective cohort study at a single site. Dataset: Anonymous survey data collected after each virtual community outreach meeting, May 2020-May 2021 (No July meeting). Excluded data from September 2020 meetings due to inconsistent survey questions. Population studied: Members of an email list commonly subscribed by Japanese in Pittsburgh. Only one survey accepted if multiple family members attended the meetings via one registration. Intervention: Virtual weekend meetings held monthly for two hours. Lectures provided by healthcare professionals about requested topics from previous participants, including how to schedule a healthcare appointment, COVID-19 vaccines, health maintenance in the pandemic. Outcome Measures: age group, gender, length of stay in community, satisfaction level and usefulness of VCO, self-assessed impact on health literacy, patient at our clinic or not, intention to establish care at our clinic. Results: Average attendance 12.6 families per meeting. Survey response rate: 86.2% (119/139). Respondent demographics: Female 71.1% (81/114), Age group 40-49 years old, 38.1% (43/113), followed by 30-39 years old 35.4% (40/113), Length of stay in Pittsburgh (median) 5 years. Satisfaction level with virtual outreach meeting "very satisfied" or "satisfied" 98.3% (117/119). Usefulness of virtual outreach meeting "very useful" or "useful" 96.6% (115/119). Among participants who received care at our clinic, 70.3% (45/64) reported VCO improved their health literacy, including their decision whether to seek care when symptomatic. Among participants who had never been to our clinic 81.3% (39/48) expressed intention to establish care with us. Conclusions: VCO can be a novel and useful method to improve health literacy for those with vulnerability during the COVID-19 pandemic. VCO also may expand primary care access to that population, as attendees meet clinicians through virtual lectures and learn about the clinic. Also, through VCO, the clinic can reach and recruit diverse patients.

Building a National Framework to Pair Scientists and Schools During a Global Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic forced the suspension of in-person education in schools serving students in kindergarten through 12th grade (K-12) across the United States. As time passed, teachers, students, and parents struggled with remote education. With limited guidance at the federal level, physicians and school leaders across the country collaborated to develop local solutions for schools. This article describes the lessons learned from the development of 4 academic-community partnerships and collaboration among these partnerships to provide national leadership on managing COVID-19 mitigation in the K-12 environment. In addition, we describe a pathway forward for using academic-community partnerships to improve child health.

Evaluation of community outreach feasibility programmes on improving cancer-related, preventive, health behaviour.

BACKGROUND: The COVID-19 pandemic had a negative impact on cancer services and will have likely led to delayed early detection and diagnosis. In response, the Irish Cancer Society (ICS) planned and delivered seven cancer roadshow events run on 15 days across seven shopping centres in four deprived areas based on Trinity National Deprivation Index, 2016, in Limerick, Cork, Waterford and Dublin regions in Ireland to educate and promote awareness about cancer signs and symptoms, importance of screening, positive lifestyle changes, and encourage medical care-seeking behaviour. METHODS: ICS nurses and trained ICS volunteers conducted health checks such as blood pressure, BMI, and CO2, monitoring (one health check per person maximum), provided health information and conducted motivational interviews in aforementioned regions. Data were collected via an anonymous questionnaire from participants and volunteers. SPSS was used for descriptive and pre-post event comparative analysis. FINDINGS: 98 people, all adults (54 men and 44 women) participated; 88% (n=86) found the information provided useful, 85% (n=83) approved of the health check and 73% (n=71) stated that they would probably make changes to their current lifestyle to reduce their cancer risk. Moderate or high understanding of cancer signs and symptoms (from 62% to 82%; p<0·0001) and moderate or high awareness of cancer risk factors (from 49% to 61%; p<0·0001) both rose after the events. If symptomatic for cancer, 78% (n=76) of participants would probably visit their general practitioner and 74% (n=72) would probably contact ICS. Younger people (aged ≤40 years) were more likely to consider consulting a health-care professional if symptomatic (p=0·0270) and to contact the ICS (p=0·0070) for more information. High numbers of participants (99%; n=97) and volunteers (95%; n=42) recommended a nationwide roll out. INTERPRETATION: With moderate to high levels of public engagement, volunteers reported people discussed cancer screening, information on making lifestyle changes, and ICS services. Such community outreach programmes to promote cancer-related health are feasible and acceptable and might lead to improved knowledge of cancer prevention, early detection, and improved intention to seek help for health concerns. Determination of effectiveness in preventive behaviour, early diagnosis, and cost effectiveness would require longer term follow up. FUNDING: Irish Cancer Society.

Centering Health Equity Within COVID-19 Contact Tracing: Connecticut's Community Outreach Specialist Program.

CONTEXT: The COVID-19 pandemic has disproportionately impacted vulnerable populations, including those who are non-English-speaking and those with lower socioeconomic status; yet, participation of these groups in contact tracing was initially low. Distrust of government agencies, anticipated COVID-19-related stigma, and language and cultural barriers between contact tracers and communities are common challenges. PROGRAM: The Community Outreach Specialist (COS) program was established within the Connecticut Department of Public Health (DPH) COVID-19 contact tracing program to encourage participation in contact tracing and address a need for culturally competent care and social and material support among socially vulnerable and non-English-speaking populations in 11 high-burden jurisdictions in Connecticut. IMPLEMENTATION: In partnership with state and local health departments, we recruited 25 COS workers with relevant language skills from target communities and trained them to deliver contact tracing services to vulnerable and non-English speaking populations. EVALUATION: We conducted a cross-sectional analysis using data from ContaCT, DPH's enterprise contact tracing system. Overall, the COS program enrolled 1938 cases and 492 contacts. The proportion of residents reached (ie, called and interviewed) in the COS program was higher than that in the regular contact tracing program for both cases (70% vs 57%, P < .001) and contacts (84% vs 64%, P < .001). After adjusting for client age, sex, race and ethnicity, language, and jurisdiction, we found that the COS program was associated with increased reach for contacts (odds ratio [OR] = 1.52; 95% confidence interval [95% CI], 1.17-1.99) but not for cases (OR = 0.78; 95% CI, 0.70-0.88). Rapid qualitative analysis of programmatic field notes and meeting reports provided evidence that the COS program was feasible and acceptable to clients and contributed to COVID-19 education and communication efforts. CONCLUSION: A COS program employing a client-centered, community-engaged strategy for reaching vulnerable and non-English-speaking populations was feasible and more effective at reaching contacts than standard COVID-19 contact tracing.

Experience of a National Cancer Institute-Designated Community Outreach and Engagement Program in Supporting Communities During the COVID-19 Pandemic.

Coronavirus disease of 2019 (COVD-19) continues to disrupt cancer care delivery efforts and exacerbate existing health inequities. Here we describe the impact of COVID-19 on community outreach organizations partnering with a National Cancer Institute-designated Community Outreach and Engagement (COE) office in New York City (NYC) and lessons learned from these experiences. Between July and September of 2020, we conducted 16 semi-structured interviews with community key-informants to validate and inform efforts to support community organizations in response to COVID-19. Key-informants represented organizations performing a broad range of health and cancer care activities serving historically underserved, low-income, marginalized communities of color in NYC. All interviews were recorded, transcribed, and analyzed using rapid qualitative approaches. We summarize our response to challenges raised by partnering organizations. Themes included the impact of COVID-19 on communities served, challenges faced by organizations, and solutions to address COVID-19 related challenges. The COE and community organizations had to shift priorities and adapt engagement efforts to address the more urgent needs of the community (e.g., emotional distress, food insecurity). COVID-19 disrupted traditional community engagement activities for cancer outreach-calling for creativity and innovation in the community engagement process and shift in priorities. The COE responded by maintaining ongoing dialogue with community partners, by being flexible in scope/priorities beyond cancer prevention and control, and by providing education, outreach, fundraising and other resources, and developing new partnerships to meet needs of community organizations and the populations they serve.

Mississippi INBRE Outreach Scholars program: adapting a summer scholars program to the virtual world amidst the COVID-19 pandemic.

The Mississippi IDeA Networks of Biomedical Research Excellence (INBRE) supported by the National Institute of General Medical Sciences (Grant P20GM103476) launched the new Mississippi INBRE Outreach Scholars (MIOS) summer research program in 2019. The program was designed to offer students community outreach and research experiences related to the study of behavioral and health disparities life sciences. The program was adapted in early 2020 to offer the program in a fully online format in the summer of 2020. This article details the program adaptations and discusses program evaluation data related to scholars' perceptions of program benefits and expectations and their confidence in research-related skills. The program evaluation was a mixed-method approach that included a qualitative postprogram survey and a pre-post quantitative survey. Scholars identified technical and communication skill building and resilience as areas of personal growth. Overall, the program met scholars' expectations for the program and significantly improved their confidence on 8 of the 19 (with confidence interval estimated differences from 0.3 to 2.56, where a difference of 1 is an improvement across 1 anchor on a Likert-type scale) various research-related tasks/skills after completion of the program. The analyses presented demonstrated that a combined qualitative and quantitative analysis approach is useful for examining the extent to which programs such as Mississippi INBRE are meeting goals of providing a rich research experience in health disparities for a diverse student body. Future longitudinal data may be examined to explore the long-term impact of MIOS on career preparation and choices and graduate education.NEW & NOTEWORTHY The Mississippi INBRE Outreach Scholars program is a summer research program for Mississippi college students that was successfully adapted to a fully online environment amidst the coronavirus-19 pandemic.

Development of a Practice-based Community Outreach Intervention to Prevent Inequities in COVID-19 Vaccinations.

Despite disproportionately higher rates of morbidity and mortality from COVID-19 among Black and Hispanic adults in the United States, ethnoracial disparities in vaccination rates emerged rapidly. The objective of this quality improvement study was to rapidly develop and implement an equity-focused community outreach intervention that facilitated COVID-19 vaccine appointments. Using the Plan-Do-Study-Act model, this multipronged, primary care-based outreach intervention developed call/recall systems that addressed vaccine hesitancy and facilitated real-time vaccine scheduling. Through 5058 calls to 2794 patients, 1519 patients were successfully reached. Of the 750 patients eligible for vaccine scheduling, 129 (17.2%) had a vaccine appointment scheduled by the caller and 72 (9.6%) indicated a plan to self-schedule. Low confidence in the vaccine was the most cited reason for declining assistance with a vaccine appointment. Primary care practices may wish to consider introducing similar outreach interventions in the future to address ethnoracial inequities in vaccination distribution.

A Rapid Survey of State and Territorial Public Health Partnerships With Faith-Based Organizations to Promote COVID-19 Vaccination.

During the COVID-19 pandemic, media accounts emerged describing faith-based organizations (FBOs) working alongside health departments to support the COVID-19 response. In May 2021, the Department of Health and Human Services, Centers for Disease Control and Prevention, and the Association of State and Territorial Health Officials (ASTHO) sent an electronic survey to the 59 ASTHO member jurisdictions and four major US cities to assess state and territorial engagement with FBOs. Findings suggest that public health officials in many jurisdictions were able to work effectively with FBOs during the COVID-19 pandemic to provide essential education and mitigation tools to diverse communities. (Am J Public Health. 2022;112(3):397-400. https://doi.org/10.2105/AJPH.2021.306620).

Mobilizing Established School Partnerships to Reach Underserved Children During a Global Pandemic.

The coronavirus disease 2019 pandemic has led to drastic public health measures, including school closures to slow the spread of severe acute respiratory syndrome coronavirus 2 infection. Reopening educational settings by using diagnostic testing approaches in schools can help accelerate the safe return of students and staff to on-site learning by quickly and accurately identifying cases, limiting the spread of severe acute respiratory syndrome coronavirus 2, and ultimately preventing unnecessary school and work absenteeism. Although the National Institutes of Health has identified community partnerships as the foundation for reducing health disparities, we found limited application of a community-based participatory research (CBPR) approach in school engagement. Guided by the CBPR conceptual model, we provide case studies of 2 established and long-standing school-academic partnerships built on CBPR processes and practices that have served as a research infrastructure to reach underserved children and families during the coronavirus disease 2019 pandemic. The process described in this article can serve as an initial platform to continue to build capacity toward increasing health equity.

From Research to Policy: Reopening K-12 Schools in North Carolina During the COVID-19 Pandemic.

School-aged children experienced substantial challenges to health and well-being as a result of school-building closures due to the coronavirus disease 2019 pandemic. In hopes of supporting equitable and safe school reopening for every student across North Carolina (NC) and improving child health, researchers from Duke University and the University at North Carolina at Chapel Hill established the ABC Science Collaborative (ABCs) in July 2020. The ABCs collected data related to in-school severe acute respiratory syndrome coronavirus 2 transmission and adherence to mitigation strategies. These data were presented to NC government officials, including the NC Department of Health and Human Services, the NC Department of Public Instruction, and Democratic and Republican representatives from the NC General Assembly. These data-sharing practices led to the implementation of in-person school legislation in early 2021 in which in-person school access for every student was required, the full-time in-person reopening of NC public schools was supported, and weekly reporting to the ABCs of coronavirus disease 2019 infections from >1 000 000 children and adults was required.

School-Academic Partnerships in Support of Safe Return to Schools During the COVID-19 Pandemic.

Safely returning underserved youth to school during the coronavirus disease 2019 (COVID-19) pandemic through diagnostic testing and health education is imperative to mitigate the ongoing negative impact of COVID-19 and reduce health inequalities in underserved communities. The Rapid Acceleration of Diagnostics-Underserved Populations program is a consortium of research projects across the United States funded by the National Institutes of Health to understand the factors associated with the disproportionate burden of the pandemic among underserved populations and to leverage mitigation strategies, including diagnostic testing, with a focus on reducing health disparities. In this article, we provide an overview and introduce the articles from 8 Rapid Acceleration of Diagnostics-Underserved Populations projects featured in the supplement "Navigating a Pandemic in the K-12 Setting: Keeping Our School Communities Safe" published in Pediatrics. These projects funded in the program's first phase focus on COVID-19 diagnostic testing approaches for youth and employees at schools in underserved communities to support safe in-person learning. In the articles comprising the supplement, researchers present barriers and facilitators of the community engagement process necessary to establish school-academic partnerships. These efforts showcase school-based implementation testing strategies during the COVID-19 pandemic but are translatable to tackling other challenges related to reducing health disparities.