Abstract
Path to racial health equity: The role of community health workers in operationalizing a federal health equity act for all
Melissa Jones, MPA1, Andrea Jacobo, MPH2, Justin Merrick, MA3, Deyanira Zavala, MPA4 and Kathryn Lawler, MPP5
(1)Bay Area Regional Health Inequities Initiative (BARHII), Oakland, CA, (2)UC Berkeley, El Cerrito, CA, (3)Center for Transforming Communities, Memphis, TN, (4)Mile High Connects, Denver, CO, (5)Atlanta Regional Collaborative for Health Improvement, Atlanta, Georgia
APHA 2021 Annual Meeting and Expo
Grassroots organizations have contributed to community-based health strategies to address the social, economic, and structural inequities experience by Black, Indigenous, Latinx, and people of color (POC). Community organizing principles help build capacity to address health equity concerns more effectively with a justice oriented and culturally relevant practices. More specifically, community health workers have contributed to significantly to bridging gaps of knowledge, skills and resources in addressing health concerns at the population level. Highlighting the roles of grassroots organizations and community health workers have in addressing health disparities at the community and policy level is necessary towards building a long-term public health infrastructure. Therefore, a shift of priorities is needed to reimagine health in all policies and sectors to address socioeconomic and structural determinants of health.
An inter-organizational, multi-sectored coalition of local advocates and national organizations across sectors is pursuing long-term federal funding to address racial and health equity. The Federal Health Equity for All Act (FHEAA) coalition is a people-centered national network of local public health departments, hospitals, and community-based organizations focused on addressing health equity.
The FHEAA will institute infrastructure and mechanisms to fund communities in creating conditions for well-being and aims to reinvent our health infrastructure to promote inclusive, community-driven, and localized interventions, with well-being and equity as core metrics. There are two approaches in the act: (1) a network of health equity innovation hubs led by community-based organizations and (2) supporting social entrepreneurs through flexible and non-programmatic funding streams to change the system from the ground up.
Advocacy for health and health education Diversity and culture Planning of health education strategies, interventions, and programs Public health or related education Public health or related public policy Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Adaptation of unidos during covid-19: The role of CHWs and implications for practice
Kiera Coulter1, Maria Velasco, MA2, Maia Ingram, MPH3, Ada Wilkinson-Lee, PhD, MS1, Abby Lohr, MPH3, Gloria Coronado, MA4, Cynthia Espinoza, MD4, Stacey Monge5, Maria Esparza, BA6, Carlos Figueroa1, Lee Itule-Klasen5, Magdalena Bowen7 and Scott Carvajal, PhD, MPH3
(1)University of Arizona, Tucson, AZ, (2)El Rio Community Health Center, Tucson, AZ, (3)Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, (4)Yuma County Public Health Services District, Yuma, AZ, (5)Pima County Health Department, Tucson, AZ, (6)Yuma County Health District, Yuma, AZ, (7)Sunset Community Health Center, Yuma, AZ
APHA 2021 Annual Meeting and Expo
Community health workers (CHWs) are integral to addressing social determinants of health (SDOH) needs during the Covid-19 pandemic, particularly among ethnic-minority populations, by connecting residents to resources, facilitating access to healthcare, and/or providing social support. We describe the process within an academic-community partnership of adapting UNIDOS, a CHW-led community-clinical linkage intervention, to respond to SDOH challenges emerging from the pandemic among Latino adults in the U.S.-Mexico border region. In partnership with CHWs, and clinical and community partners, the intervention objectives, participant recruitment, CHW training, data collection measures, and mode of intervention delivery were altered to maximize participant safety while addressing housing assistance, economic security,health concerns, emotional wellness, internet access, etc. Consistent with community-based participatory research (CBPR), academic and community-based partners made decisions regarding changes to the intervention over regularly scheduled meetings via Zoom. CHWs’ knowledge of the communities served was not only vital to implementing the adapted intervention, but also ensuring that UNIDOS is responsive to the cultural background of Latino participants and challenges imposed by Covid-19. In sum, the pandemic has prioritized the need to respond to SDOH inequities, and CHWs are ideally positioned to lead these efforts. Insights from this case study demonstrate the effectiveness of CHWs in tailoring health promotion interventions to residents’ pandemic-related SDOH needs. Given that UNIDOS focuses on Latino adults in the border region, the insights of the CHWs were critical to adapting the program to effectively address SDOH, be culturally congruent, and provide adequate “socially distanced” psychosocial support.
Diversity and culture Program planning Public health or related research
Abstract
Feasibility and acceptability of a peer-driven intervention to mitigate the impact of COVID-19 on Latino immigrants in Philadelphia
Claudia Zumaeta Castillo, MPH1, Mariana Lazo, PhD, ScM, MD1, Haruko Arango-Kautz, MPH (c)1, Yoshiaki Yamasaki, M.S. Ed.2, Cristina Perez, M.S.3, Omar Martinez, JD, MPH, MS4 and Ana Martnez-Donate, PhD5
(1)Drexel University, Philadelphia, PA, (2)The Philadelphia AIDS Consortium, Philadelphia, PA, (3)Women Organized Against Rape, Philadelphia, PA, (4)Temple University, Philadelphia, PA, (5)Drexel University Dornsife School of Public Health, Philadelphia, PA
APHA 2021 Annual Meeting and Expo
Statement of problem Latino immigrants have been disproportionally affected by COVID-19. We adapted a previous peer-driven intervention, Cultivating Resilient & Strong Opinion Leaders (CRiSOL), to respond to the needs and effects of the COVID-19 pandemic on Latino communities of Philadelphia, PA. In the adapted CRiSOL Contigo, Latino immigrant peers in Philadelphia, completed a 16-hour virtual training designed to increase knowledge regarding COVID-19, strengthen skills to disseminate accurate information, and link community members to local care services. After the training (Phase 1), these community leaders will engage in outreach and education activities for a 9-month period to reduce the effects of COVID-19 on their social networks (Phase 2).
Relevance To examine the feasibility, acceptability, and short-term efficacy of the CRiSOL Contigo training for Latino immigrant peers (Phase 1).
Methods Training participants (N=14) completed pre/post questionnaires on COVID-19 knowledge, behavioral skills, and satisfaction with the training (only post-test). Descriptive analyses and non-parametric tests for paired samples were conducted.
Results Attendance reached 100%. The average satisfaction with the training was 19.21 (SD=1.48), on a 20-point scale. Participants showed statistically significant improvement in knowledge (Z=-2.989, p=0.003) and behavioral skills (Z=-2.796, p=0.005) following the CRiSOL Contigo training. Knowledge and skills median scores improved by 42% and 8%, respectively.
Conclusions The adaptation of the CRiSOL Contigo training to address COVID-19 in Latino communities was feasible, achieved a high acceptability among participants, and was associated with significant short-term improvements in both knowledge and behavioral skills relevant to mitigate COVID-19 impact.
Administer health education strategies, interventions and programs Conduct evaluation related to programs, research, and other areas of practice Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Protection of the public in relation to communicable diseases including prevention or control Public health or related education
Abstract
Stress and well-being among community healthcare workers and providers serving socially vulnerable populations during the COVID-19 pandemic
Alice Villatoro, PhD1, Nelly Salgado de Snyder2, Marisol McDaniel, DrPH3, Sofia Ocegueda4, Deliana Garcia3 and Deborah Parra-Medina, PhD, MPH, FAAHB5
(1)Santa Clara University, Santa Clara, CA, (2)Instituto Nacional de Salud Pblica, Mxico, Ciudad de Mexico, Mexico, (3)Austin, TX, (4)The University of Texas at Austin, Austin, TX, (5)University of Texas at Austin, Austin, TX
APHA 2021 Annual Meeting and Expo
Background: Increased workload, lack of PPE, and high-risk of exposure to COVID-19 have elevated stress and burnout among healthcare workers and providers (HCWPs) worldwide. Few studies have examined the impact of the pandemic on the well-being of HCWPs in community clinics. This study examined levels of stress, mental health, and coping behaviors of HCWPs serving immigrants, people living in poverty, and other vulnerable populations in the U.S. during the pandemic.
Aims/Hypotheses: We expect HCWPs in community clinics to demonstrate high levels of stress and mental health burden during the pandemic.
Methods: We conducted a cross-sectional web-based survey of stress and well-being among HCWPs (July-September 2020). 403 affiliates from two national organizations of HCWPs at federally funded or community safety-net clinics. The majority of HCWPs were Latino/a (74.6%) and worked as a community health worker (46.9%). We examined levels of stress, anxiety and depressive symptoms, and coping behaviors. All estimates are age-adjusted.
Results: HCWPs experienced high levels of personal and job-related stress, anxiety and depressive symptomology. Major stressors included sleep disturbances, family problems, long working hours, lack of PPE, and fear of contracting the virus and infecting their families. Most HCWPs engaged in proactive coping behaviors. While <10% sought professional mental health support, most engaged in self-care behaviors aimed at enhancing their well-being, like meditation and exercise.
Discussion/Conclusions: HCWPs working with vulnerable populations urgently need specialized interventions that bolster their well-being in the workplace. We recommend implementing initiatives that encourage their involvement in restorative activities for themselves and their families.
Administer health education strategies, interventions and programs Public health or related public policy Social and behavioral sciences