Mayo researchers, community leaders develop new pandemic playbook in helping immigrant groups
Key to the approach was involving community leaders.
ROCHESTER — In March 2020, when the coronavirus pandemic began spreading through the U.S., Mayo Clinic health experts and community leaders faced a daunting public health challenge: How to fashion an outreach effort that targeted immigrant and refugee communities, which were disproportionately affected by COVID-19.
One of their first decisions was to throw away the old playbook.
Instead of a top-down communication strategy that relied on telling these communities what they needed to know and do, a framework was built premised on listening to residents' needs and concerns.
The result, say Mayo and community leaders, was a community-based intervention that in its first nine months of the pandemic reached an estimated 39,000 members of the immigrant and refugee populations.
“Rather than just a big messaging campaign, this is a ground-up approach where messages are co-created in real time based on both facts on the ground but also what people are hearing in their networks,” said Dr. Mark Wieland, a Mayo internal medicine physician.
The results were recently published in Public Health Reports, a peer-reviewed publication that publishes original research and commentaries related to public health practice.
A commitment to two-way communication, to listening to the concerns and anxieties of immigrant communities, doesn’t just happen.
“It’s a lot of work,” said Miriam Goodson, a leader in Rochester’s Hispanic community.
Thankfully, they didn’t have to build the framework from scratch.
The table, so to speak, was already set by the Rochester Healthy Community Partnership, a community-academic research program formed in 2004. That table was expanded to include more voices, including Somali, Hispanic, Cambodian and other representatives.
From these sessions emerged a multi-pronged communication strategy based on an understanding of the institutions these communities trusted, the social media platforms they used and the rhythms of their lives.
In the main, they built trust.
Regional studies have shown that immigrant groups are disproportionately impacted by COVID-19, including lowered testing rates and higher infection rates.
Early on in the pandemic, Wieland said, it was clear that the messages being pumped out by the Centers for Disease Control and Prevention and Minnesota Department of Health were not reaching area immigrant communities.
Adding and contributing to their susceptibility to COVID-19 was their limited English proficiency, low access to health care and fear of legal repercussions.
What’s more, a disproportionate number of immigrants worked in jobs deemed essential and didn’t have the option of working remotely. Consequently, they were more exposed to COVID-19 prior to the development of vaccines.
Yet, the context in which they existed was no different than the native born, as disinformation about COVID-19 and vaccines spread through their communities.
Another complication: During a pandemic, people couldn’t meet face-to-face.
Yet, the two-way communication model made the network aware of the struggles immigrant communities were going through in terms of food insecurity, sickness and lost employment.
From this understanding, action plans were developed.
“There were a lot of phone calls,” Goodson said. “We had a team of connectors claiming (these communities) weren’t all well off. Everybody was trying to help each other. Everybody was trying to give.”
One byproduct of this collaboration was the creation of weekend vaccine clinics at school sites. They came about from the realization that many immigrants were unable to take off time from their jobs to get vaccinated. They were, moreover, reluctant to go to health clinics to get the jab. But they did trust the schools that their children attended.
The network also became attuned to these communities' social media usage, Goodson said. They weren’t into Facebook and Twitter, but they were heavy users of WhatsApp.
“WhatsApp was the way we were able to pass a lot of social media information to them,” she said.
Wieland said the lessons learned from the project will apply in a post-pandemic world. But it requires work and motivation that he believes can be sustained.
“That’s a challenge," he said, "but also the promise of community-based participatory research."