The Impact of COVID-19 on the Delivery of Educational Programs in Native American Communities: Qualitative Study

"We rely on each other": A qualitative exploration of rural Eastern Region Native American experiences during the COVID-19 pandemic

Background

Native American communities suffered disproportionately negative effects during the COVID-19 pandemic, yet no research has explored the experiences of rural Eastern Region Native Americans.

Methods

Informed by the Native Reliance Model and Indigenous Standpoint Theory, we conducted a qualitative descriptive project in the Spring and Summer of 2022; data included semi-structured interviews and focus groups with 24 individuals representing five South Carolina tribal groups.

Findings

Thematic analysis yielded four emergent themes: 1) "Let's just finish the Indians off": Pandemic distrust rooted in historical and contemporary Native American experiences; 2) "We have been misled": Making sense of conflicting public health information; 3) "I'm not giving it to some innocent person": COVID-19 mitigation behaviors as Native American cultural practice; and 4) "We put the plan in place": Self-advocacy and action as a source of Native American pride and responsibility.

Interpretation

These participants demonstrated resiliency grounded in family and tribal ties, even in the face of personal losses, economic struggles, and healthcare barriers. To strike a balance between cultural traditions and public health recommendations, public health practitioners should 1) build partnerships with community leaders, elders, and tribal health authorities to facilitate the development of culturally respectful interventions that address specific health concerns in the context of historical traumas; and 2) implement alternative methods of communication and engagement to ensure equitable access to healthcare services in rural locations, such as collaborating with community organizations, deploying mobile health units, and utilizing traditional channels of communication within these communities.

Efficacy of behavioral interventions to increase engagement in sexual health services among LatinX youth in the United States: A meta-analysis for post-pandemic implications

INTRODUCTION

LatinX youth in the U.S. are disproportionately affected by HIV and STIs, commonly attributed to a lack of diagnostic testing and regular physician consultations to address sexual health. These disparities have been exacerbated by the COVID-19 pandemic. This meta-analysis seeks to assess the efficacy of behavioral interventions among LatinX youth in the U.S. that aim to increase engagement in sexual health services (i.e., STI/HIV testing, physician consultations).

CONTENT

Following PRISMA guidelines, seven electronic databases were searched. We systematically extracted data with a coding form, and effect sizes were obtained from each study on HIV/STI testing outcomes and physician consultation. Moderator analyses were run for demographic and intervention characteristics.

SUMMARY AND OUTLOOK

Of nine included studies, the interventions created a small-to-moderate effect on increased engagement of sexual health services (d +=0.204, 95 % CI=0.079, 0.329). Moderator analyses showed that interventions including the following characteristics were most efficacious at facilitating care services: community-based or online setting, access to diagnostic testing, social media/remote components, parental involvement, and longer session duration. This meta-analysis provides informative results regarding behavioral interventions that have proven efficacious in facilitating engagement in sexual health services among LatinX youth. Most prominently, interventions that are remote or through social media, community-based, and incorporated parents had large positive effects. These findings prove useful for the ongoing COVID-19 pandemic situation and provide guidance for targeting LatinX youth to engage them in sexual health services as primary and secondary STI and HIV prevention.

Innovative Strategies to Address Systemic Inequities in Youth Sexual Health Programs: A Preliminary Program Evaluation

Disparities in sexual health outcomes between racial and ethnic groups throughout the state of Washington suggest the presence of systemic inequities impeding young people's experience with and access to sexual health care and education. Emerging innovations in sexual health look to center young people, particularly those who have been historically excluded, in the design and implementation of programs that aim to serve them. The Washington Youth Sexual Health Innovation and Impact Network (WYSHIIN) and 11 grant-funded partners engaged communities of youth across the state of Washington, including Two Spirit, lesbian, gay, bisexual, transgender, queer, questioning, intersex, and/or asexual (2SLGBTQIA+) and Black, Indigenous, and People of Color (BIPOC) youth, with the goal of equitably engaging participants and stakeholders to broaden services in schools and community settings. Evaluation staff from the Washington State Department of Health conducted virtual interviews with community partners for preliminary program evaluation purposes and identified 6 strategies for engaging youth. WYSHIIN partners highlighted strategies for centering youth voice and needs at all levels of program development and implementation, embracing holistic and culturally relevant approaches, and 2SLGBTQIA+ inclusion. These themes, reflective of wisdom across multiple Washington communities, offer strategies to address systemic issues that negatively impact youth access to and experience with sexual health care.

Addressing Food Insecurity during the COVID-19 Pandemic: Intervention Outcomes and Lessons Learned from a Collaborative Food Delivery Response in South Florida’s Underserved Households

Background: The COVID-19 pandemic highlighted underlying disparities in health, healthcare access, and other social factors that have been documented for racial/ethnic minorities. The social-distancing mandate exacerbated the impact of social determinants of health, such as unemployment and food insecurity, particularly among underserved minority populations. We highlight intervention outcomes and lessons learned from the Florida International University (FIU) Herbert Wertheim College of Medicine (HWCOM) NeighborhoodHELP’s response to pandemic-related food insecurity among Miami Dade County’s underserved population. Methods: Following the stay-at-home mandate, a weekly needs assessment of program households was conducted by the NeighborhoodHELP team, during which food insecurity emerged as a pandemic-related urgent need, rising from three percent of program Households in March 2020 to 36.9 percent six months later. Consequently, the program staff collaborated with another FIU department, community partners, and a benefactor to develop a food donation and delivery project. Results: Fifteen hundred and forty-three culturally appropriate food boxes were delivered to 289 participating households, comprising 898 household members, over a 14-month period. Conclusion: This project underscores the importance of leveraging community assets to address their needs during a crisis and the significance of sustained community engagement for researchers and service providers who work in underserved communities.