Risk Communication Mark Wieland Risk Communication Mark Wieland

Addressing COVID-19 inequities using bidirectional crisis and emergency risk communication and vaccine clinic interventions: a descriptive study

Im/migrants (immigrants and migrants, including refugees, asylum seekers, and individuals without legal documentation) experience unique assets and needs in relation to coronavirus disease 2019 (COVID-19). Community-based participatory research (CBPR) is one way to engage im/migrant communities.

Im/migrants (immigrants and migrants, including refugees, asylum seekers, and individuals without legal documentation) experience unique assets and needs in relation to coronavirus disease 2019 (COVID-19). Community-based participatory research (CBPR) is one way to engage im/migrant communities.

Rochester Healthy Community Partnership (RHCP) is a CBPR partnership in Rochester, Minnesota. RHCP partners noted that credible COVID-19 information was not available to their communities. In response, RHCP formed a COVID-19 Task Force and adapted the Centers for Disease Control and Prevention’s Crisis and Emergency Risk Communication (CERC) framework to create an intervention that prioritized im/migrant groups experiencing health disparities.

In the CERC intervention, communication leaders delivered COVID-19 health messages to their social networks and documented related concerns. RHCP relayed these concerns to regional leaders to ensure that im/migrant experiences were included in decision making. Once vaccines were available, RHCP continued to deploy the CERC intervention to promote vaccination equity.

The aims of this paper are to (1) describe the implementation of a bidirectional CERC intervention for vaccination equity, and (2) describe a community-engaged and community-based vaccine clinic intervention.

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Risk Communication Mark Wieland Risk Communication Mark Wieland

Adaptation of a bidirectional crisis and emergency risk communication framework by community-engaged research partnerships in rural Mississippi during the COVID-19 pandemic

Community engagement is important for reaching populations at risk for health inequities in the coronavirus disease 2019 (COVID-19) pandemic.

Community engagement is important for reaching populations at risk for health inequities in the coronavirus disease 2019 (COVID-19) pandemic. A community-engaged risk communication intervention implemented by a community-engaged research partnership in Southeast Minnesota to address COVID-19 prevention, testing, and socioeconomic impacts has demonstrated high acceptability, feasibility, perceived efficacy, and sustainability.

In this study, we describe the adaptation of the intervention by a community-academic partnership with rural African American populations in three Mississippi counties with high COVID-19 disparities. Intervention reach was assessed by the number of messages delivered by Communication Leaders to members of their social networks. Perceived scalability of the intervention was assessed by the Intervention Scalability Assessment Tool. Bidirectional communication between Communication Leaders and community members within their social networks was used by the partnership to refine messages, meet resource needs, and advise statewide decision-makers.

In the first 3 months, more than 8482 individuals were reached in the three counties. The intervention was deemed to be highly scalable by partnership members. Adaptation of a community-engaged pandemic CERC intervention is feasible and scalable, and it has the potential to reduce COVID-19 inequities across heterogeneous populations. This approach may be incorporated into current and future pandemic preparedness policies for community engagement.

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Risk Communication Mark Wieland Risk Communication Mark Wieland

Experiences of Hispanic Safety Net Clinic Patients With Diabetes During the COVID-19 Pandemic

The inequitable impact of the COVID-19 pandemic in the United States resulted in substantial loss of life in Hispanic communities. Life expectancy among US Hispanics declined 3 years, the most of any race/ethnicity subgroup, from 2019 to 2020. Although COVID-19 led to a majority of this decline (90%), diabetes was noted as the third leading cause of increased deaths, behind unintentional injuries.

Abstract

Purpose: The purpose of this study was to characterize the material, health (general and diabetes-specific), and social impacts of the COVID-19 pandemic on Hispanic adults with type 2 diabetes who did not experience COVID-19 infection.

Methods: This cross-sectional and longitudinal study used surveys within a clinical trial of 79 Hispanic adult clinic patients with type 2 diabetes. Cross-sectional measures included the Coronavirus Anxiety Scale, items from the Coronavirus Impact Scale, and the Pandemic Impacts Inventory. Longitudinal measures included the Summary of Diabetes Self-Care, health care utilization, and measures of diabetes self-efficacy, social support, and quality of life.

Results: Participants were majority low-income, Spanish-speaking females with poor diabetes control. Coronavirus anxiety was low despite majority of participants having an affected family member and frequent access barriers. More than half of participants reported moderate/severe pandemic impact on their income. Diabetes self-care behaviors did not change between prepandemic and pandemic measures. Diabetes self-efficacy and quality of life improved despite fewer diabetes-related health care visits.

Conclusions: Despite high levels of access barriers, financial strain, and COVID-19 infection of family members, Hispanic adults with type 2 diabetes continued to prioritize their diabetes self-management and demonstrated substantial resilience by improving their self-efficacy and quality of life.

Keywords: type 2 diabetes, immigrant and refugee health, social determinants of health, COVID-19

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Risk Communication Mark Wieland Risk Communication Mark Wieland

Pilot Social Network Weight Loss Intervention With Two Immigrant Populations During the COVID-19 Pandemic

Immigrants often arrive to the United States (US) at a healthier weight compared to the general US population, but these healthy weight advantages disappear over time, and the rates of obesity, with associated complications, rise.

American Journal of Health Promotion 2022, Vol. 0(0) 1–14 © The Author(s) 2022

Abstract

Purpose: To examine the feasibility and acceptability of a social network weight loss intervention delivered by lay health promoters (HPs) to immigrant populations.

Design: Single-arm, non-randomized, pilot study of a social network weight loss intervention developed by a community-based participatory research partnership and delivered by HPs. Setting: Community-based setting in Southeastern Minnesota, United States.

Sample: Somali and Hispanic immigrants to the United States: 4 social networks of adults (2 Hispanic and 2 Somali) with 39 network participants.

Intervention: Twelve-week behavioral weight loss intervention delivered by HPs (4 weeks in-person and then 8 weeks virtual).

Measures: Feasibility was assessed by recruitment and retention rates. Acceptability was assessed by surveys and focus groups with HPs and participants. Behavioral measures included servings of fruits and vegetables, drinking soda, and physical activity. Physiologic measures included weight, blood pressure, glucose, cholesterol, and triglycerides.

Analysis: Paired t-tests of pre- to post-intervention changes at the end of 12 weeks of treatment.

Results: Recruitment was feasible and post-intervention was 100%. Participants highly rated the intervention on satisfaction, motivation, and confidence to eat a healthy diet, be physically active, and lose weight. Participants were motivated by group social support and cohesion of their social networks. On average, participants lost weight (91.6 ± 15.9 to 89.7 ± 16.6 kg, P <.0001), lowered their systolic blood pressure (133.9±16.9 to 127.2 ± 15.8 mm Hg; P < .001), lowered their diastolic blood pressure (81 ± 9.5 to 75.8 ± 9.6 mm Hg; P < .0001), had more servings of vegetables per day (1.9 ± 1.2 to 2.6 ± 1.4; P < .001), and increased their physical activity (2690 ± 3231 to 6595 ± 7322 MET-minutes per week; P = .02).

Conclusion: This pilot study of 2 immigrant communities who participated in a peer-led weight loss social network intervention delivered during the COVID-19 pandemic demonstrated high feasibility and acceptability. Participants lost weight, improved their health status, and improved their health behaviors.

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Risk Communication Mark Wieland Risk Communication Mark Wieland

Community-Engaged Bidirectional Crisis and Emergency Risk Communication With Immigrant and Refugee Populations During the COVID-19 Pandemic

Crisis and emergency risk communication (CERC) frameworks encourage public participation in pandemic prevention and containment, but effective implementation depends, in part, on reaching populations with a history of health disparities and limited access to culturally and linguistically tailored health information.

SAGE Publishing and Public Health Reports. 2022

Abstract

Objectives: This study was conducted to assess an intervention that was created by a community–academic partnership to address COVID-19 health inequities. We evaluated a community-engaged bidirectional pandemic crisis and emergency risk communication (CERC) framework with immigrant and refugee populations during the COVID-19 pandemic.

Methods: A 17-year community-engaged research partnership adopted a CERC framework in March 2020 to address COVID-19 prevention, testing, and socioeconomic impacts with immigrant and refugee groups in southeast Minnesota. The partnership used bidirectional communication between communication leaders and their social networks to refine messages, leverage resources, and advise policy makers. We conducted a mixed-methods evaluation for intervention acceptability, feasibility, reach, adaptation, and sustainability through multisource data, including email communications, work group notes, semistructured interviews, and focus groups.

Results: The intervention reached at least 39 000 people in 9 months. It was implemented as intended and perceived efficacy was high. Frequent communication between community and academic partners allowed the team to respond rapidly to concerns and facilitated connection of community members to resources. Framework implementation also led to systems and policy changes to meet the needs of immigrant and refugee populations.

Conclusions: Community-engaged CERC is feasible and sustainable and can reduce COVID-19 disparities through shared creation and dissemination of public health messages, enhanced connection to existing resources, and incorporation of community perspectives in regional pandemic mitigation policies.

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Risk Communication Nate Nordstrom Risk Communication Nate Nordstrom

The Disproportionate Impact of COVID-19 on Racial and Ethnic Minorities in the United States.

Minority groups are disproportionately affected by chronic medical conditions and lower access to healthcare that may portend worse COVID-19 outcomes. Furthermore, minority communities are more likely to experience living and working conditions that predispose them to worse outcomes.

Clinical Infectious Diseases. February 2021.

Abstract: The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected racial and ethnic minority groups, with high rates of death in African American, Native American, and LatinX communities. Although the mechanisms of these disparities are being investigated, they can be conceived as arising from biomedical factors as well as social determinants of health. Minority groups are disproportionately affected by chronic medical conditions and lower access to healthcare that may portend worse COVID-19 outcomes. Furthermore, minority communities are more likely to experience living and working conditions that predispose them to worse outcomes. Underpinning these disparities are long-standing structural and societal factors that the COVID-19 pandemic has exposed. Clinicians can partner with patients and communities to reduce the short-term impact of COVID-19 disparities while advocating for structural change.

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Risk Communication Nate Nordstrom Risk Communication Nate Nordstrom

Emergency Preparedness and Risk Communication Among African American Churches: Leveraging a Community-Based Participatory Research Partnership COVID-19 Initiative

Partnerships with faith-based organizations are pivotal in rapidly engaging with racial/ethnic minority populations, who are often socially and economically marginalized and medically underserved, to address public health crises.

Preventing Chronic Diseases. December 2020.

Abstract: The coronavirus disease 2019 (COVID-19) crisis has disproportionately affected the African American population. To mitigate the disparities, we deployed an emergency preparedness strategy within an existing community-based participatory research (CBPR) partnership among African American churches to disseminate accurate COVID-19 information. We used the Centers for Disease Control and Prevention Crisis and Emergency Risk Communication framework to conduct a needs assessment, distribute emergency preparedness manuals, and deliver COVID-19-related messaging among African American churches via electronic communication platforms. A needs assessment showed that the top 3 church emergency resource needs were financial support, food and utilities, and COVID-19 health information. During an 8-week period (April 3-May 31, 2020), we equipped 120 churches with emergency preparedness manuals and delivered 230 messages via social media (Facebook) and email. For reach, we estimated that 6,539 unique persons viewed content on the Facebook page, and for engagement, we found 1,260 interactions (eg, likes, loves, comments, shares, video views, post clicks). Emails from community communication leaders reached an estimated 12,000 church members. CBPR partnerships can be effectively leveraged to promote emergency preparedness and communicate risk among under-resourced communities during a pandemic.

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Risk Communication Nate Nordstrom Risk Communication Nate Nordstrom

Leveraging community engaged research partnerships for crisis and emergency risk communication to vulnerable populations in the COVID-19 pandemic

Crisis and emergency risk communication frameworks are currently being applied in the public health response to the coronavirus disease 2019 (COVID-19) pandemic to encourage public participation in disease containment. Common principles of these frameworks are to be correct, credible and respectful, to promote action and to engage with communities in order to empower decision making.

Journal of Clinical and Translational Science. 15 May 2020

Background: This study aims to demonstrate the use of a CEnR health partnership with vulnerable populations leveraging its social networks, credibility, and technical expertise to promote bidirectional crisis and emergency risk communication for the COVID-19 pandemic.

Vulnerable populations and minorities are more likely to have communication gaps due to socioeconomic disadvantage, low health literacy, immigration status, and limited English proficiency,5 compounded by language and cultural discordance and mistrust of health institutions.6  The Centers for Disease Control and Prevention (CDC) Crisis and Emergency Risk Communication Manual describes three levels of community engagement (low, medium, high), and acknowledges that a high level of engagement that starts prior to any emergency is needed to reach vulnerable populations in times of crisis.

Methods: Community and academic partners from Rochester Healthy Community Partnership (RHCP), a CEnR partnership with a 15-year history of participatory research with immigrant populations in Southeast Minnesota,9 adopted the CDC Crisis and Emergency Risk Communication framework for co-creation of an intervention framework aimed at populations with limited English proficiency.  RHCP community partners observed that credible COVID-19 information was being produced, but it was not reaching immigrant communities.    

Results: The intervention was delivered by 24 Communication Leaders (11 Somali, 6 Hispanic, 2 Cambodian, 3 South Sudanese, 1 Anuak, 1 Ethiopian).  In addition to the 3 main message maps, 8 COVID-19 updates were translated and disseminated.  In addition to bidirectional communication between all partners on daily telephone conferences, 40 emails, text messages or phone calls were sent to Communication Leaders in response to new COVID-19 developments or community concerns.  

Conclusion: By leveraging existing networks and credibility, CEnR partnerships may effectively implement crisis and emergency risk communication to vulnerable populations in the COVID-19 pandemic.

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