Community Health Worker-Led Equity Response in Orange County, California
Center for HOPES team members are working with partners in California to evaluate efforts to increase COVID-19 vaccinations among the Latinx community by bolstering a community-based workforce of outreach and health workers. This work is funded by the Health Resources and Services Administration and led by AltaMed, the nation’s largest federally qualified health center, and supported by multiple community-based clinics and organizations throughout the state, including Latino Health Access (LHA), a nonprofit community-based organization in Orange County.
LHA was founded using a promotor-driven model. Promotores – community health workers – are recruited from the communities in LHA’s service area and trained in specialized topics (e.g., chronic disease, mental health, youth engagement) to facilitate service provision. Civic participation is a core tenet of the promotora model.
Traditional mechanisms for civic participation (e.g., voter engagement, speaking at city council meetings, providing input on local budget processes) have historically excluded LHA participants by not prioritizing outreach to their communities, disinvesting from their neighborhoods, and failing to address linguistic, cultural, and socioeconomic barriers to engagement. In contrast, LHA promotores create culturally appropriate mechanisms for its participants to engage in their primary language and invests time and resources to build their skills to create and lead their own local policy advocacy campaigns and health and wellness programming.
In March 2020, LHA implemented a community-led COVID-19 Health Equity Response in Orange County, one of California’s hardest hit counties. The Response initiative integrates civic engagement as a tool for equity in COVID-19 response efforts and in preparing for long-term recovery.
Promotores, as well as community members within LHA’s participant database, provided feedback on an introductory message about the response initiative and connected to the response team to assess the effects of the pandemic in their communities. These efforts coincided with LHA’s efforts to assess its participants’ interest in civic engagement in preparation for the 2020 general election and Census participation. Preliminary findings indicate that civic engagement is a pathway to building resilience and better health outcomes in LHA communities.
Community Health Worker-Led Equity Response in Ohio
The Center for HOPES is the lead subgrantee for the Centers for Disease Control and Prevention’s (CDC) Community Health Workers (CHWs) for COVID Response and Resilient Communities (CCR) Grant to the Ohio Department of Health (ODH). The aim of the program is to reduce health disparities and improve health equity in the state of Ohio by expanding use of CHWs to address COVID-19 disparities. The Center for HOPES serves as the lead evaluator for Component B, collecting performance data throughout implementation of the grant to conduct both process and outcomes evaluations of the training and deployment of CHWs and their contribution to building community resilience. Center evaluators provide a broad range of services for community-driven work, from helping with proposal development to project and data management, and data analysis and dissemination.
The COVID-19 pandemic presents unprecedented challenges for the health of Ohio’s people and economy. The Center for HOPES is proud to serve the state as part of a coalition whose aims are to monitor the effects of the pandemic on Ohio and identify data-driven strategies for response and recovery. Together with the Department of Health, Development Services Agency, Department of Medicaid, Office of Budget and Management, Department of Administrative Services, and Job and Family Services, the Center for HOPES is leveraging a wide range of data sources to provide real-time analysis of Ohio’s economy and households. This includes analyzing unemployment insurance claims, health insurance coverage, and consumer confidence about public health and financial security. The state’s executive leadership is drawing on these insights to inform its decisions about health, safety, and economic recovery.
Ohio Economic Roundtable
In the fall of 2020, Professor Eric Seiber, Director of the Center for HOPES, accepted Governor DeWine’s invitation to serve as a member of the Ohio Economic Roundtable. The aim of the Roundtable is to convene experts from a variety of economic disciplines and get their insights on how the pandemic is likely to affect Ohio’s economic outlook in the coming years. As part of the Roundtable, Dr. Seiber will offer feedback on the Ohio Office of Budget and Management’s revenue forecasting models for fiscal year 2022-2023, which are used in the state’s budget preparation and approval process. As a health economist, Dr. Seiber is uniquely qualified to provide insights about the implications of the pandemic and concurrent recession on Ohio’s economy, programs, and people.
The Ohio COVID Survey
Center Director Dr. Eric Seiber is part of the design and advisory board of the Ohio COVID-19 Survey (OCS), a biweekly survey of a representative sample of Ohio households fielded by the Ohio Colleges of Medicine Government Resource Center (GRC). In the field since April 2020, the OCS tracks Ohioans’ health, economic, and social experiences as the pandemic unfolds. Results are used to inform health and human services decision-making in real time.
Research Update: Center for HOPES researchers have authored a research memo describing the Ohio COVID Survey (OCS) and summarizing key findings within the context of the first six months of the COVID-19 pandemic. The OCS, unique in tracking Ohio household health and economic dynamics over time, has been an important source of information to Ohio’s state leadership.
COVID-19 Analytics & Targeted Surveillance (CATS)
The COVID-19 Analytics and Targeted Surveillance system (CATS) is a syndromic surveillance system that helps schools and public health authorities work together to make data-informed decisions about learning modality (virtual, in-person, or hybrid) to prevent and control the spread of the novel coronavirus. The College of Public Health is working with school districts and public health authorities to train this system to be able to automatically send an alert once certain thresholds for the indicators are reached. The Center for HOPES is providing project management and community engagement services on CATS, managing data use agreements, memoranda of understanding, trainings and presentations, and community team meetings.
By combining monitoring and epidemiological review of school nurse visits among students, absences among students due to illness, and absences among staff due to illness with county-level data for COVID-19 case rates, CATS allows for real-time analyses of factors that can predict localized outbreaks. The CATS team seeks to improve system sensitivity (i.e., minimize false negatives) and specificity (i.e., minimize false positives) over time as we get more data and track the number of new confirmed cases. Findings from this work can inform surveillance systems for other infectious agents, like influenza or norovirus, that are also disruptive to learning environments. Additionally, the system can be deployed statewide as a means of standardizing how different districts make decisions to ultimately lower the number of cases of COVID-19 disease.