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Nuño T, Sierra LA, Wilkinson-Lee A, Carvajal S, de Zapien J, Coulter K, Figueroa C, Morales M, Sepulveda R, Sepulveda R, Ingram M. The Arizona Prevention Research Center partnerships in Arizona to promote COVID-19 vaccine health equity. Front Public Health 2022; 10:944887. [PMID: 35958854 PMCID: PMC9357975 DOI: 10.3389/fpubh.2022.944887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/01/2022] [Indexed: 12/02/2022] Open
Abstract
Background Vaccine hesitancy in the face of the COVID-19 pandemic is a complex issue that undermines our national ability to reduce the burden of the disease and control the pandemic. The COVID-19 pandemic revealed widening health disparities and disproportionate adverse health outcomes in terms of transmission, hospitalizations, morbidity and mortality among Arizona's Latinx rural, underserved, farmworker, disabled and elderly populations. In March 2021, ~8.1% of those vaccinated were Latinx, though Latinxs make up 32% of Arizona's population. The Arizona Vaccine Confidence Network (AzVCN) proposed to leverage the expertise of the Arizona Prevention Research Center (AzPRC) and the resources of the Mel and Enid Zuckerman College of Public Health (MEZCOPH) Mobile Health Unit (MHU) to identify, implement and evaluate a MHU intervention to increase uptake of COVID-19 vaccines. Methods The AzVCN focused efforts on Latinx, rural, un/underinsured and farmworker communities in the four Arizona border counties that are at greater risk of COVID-19 morbidity and mortality and may have limited access to vaccination and other essential health services. The AzVCN used listening sessions to create a feedback loop with key stakeholders and critical health care workers to validate barriers/enablers and identify solutions to increase vaccination uptake emerging from the network. The AzVCN also implemented a community-based intervention using community health workers (CHWs) based in a MHU to increase knowledge of the COVID-19 vaccines, reduce vaccination hesitancy and increase vaccination uptake among Latinx rural, un/underinsured and farmworker populations in Southern Arizona. Results AzVCN outcomes include: identification of enablers and barriers of COVID-19 vaccination in the priority populations; identification of strategies and solutions to address vaccine hesitancy and increase vaccine uptake among priority population; and evidence that the proposed solutions being tested through the AzVCN contribute to increased vaccine uptake among the priority populations. Conclusion Through these efforts the AzPRC contributed to the CDC's Vaccinate with Confidence Strategy by collaborating with CHWs and other key stakeholders to engage directly with communities in identifying and addressing structural and misinformation barriers to vaccine uptake.
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Affiliation(s)
- Tomas Nuño
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
- Division of Public Health Practice and Translational Research, Mel and Enid Zuckerman College of Public Health, University of Arizona, Phoenix, AZ, United States
- *Correspondence: Tomas Nuño
| | - Lidia Azurdia Sierra
- Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, United States
| | - Ada Wilkinson-Lee
- Department of Mexican American Studies, College of Social and Behavioral Sciences, University of Arizona, Tucson, AZ, United States
| | - Scott Carvajal
- Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, United States
| | - Jill de Zapien
- Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, United States
| | - Kiera Coulter
- Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, United States
| | - Carlos Figueroa
- Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, United States
| | - Mario Morales
- Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, United States
| | - Ramses Sepulveda
- Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, United States
| | - Refugio Sepulveda
- Division of Public Health Practice and Translational Research, Mel and Enid Zuckerman College of Public Health, University of Arizona, Phoenix, AZ, United States
| | - Maia Ingram
- Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, United States
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Coulter K, Ingram M, Lohr A, Figueroa C, Coronado G, Espinoza C, Esparza M, Monge S, Velasco M, Itule-Klasen L, Bowen M, Wilkinson-Lee A, Carvajal S. Adaptation of a Community Clinical Linkages Intervention to the COVID-19 Pandemic: A Community Case Study. Front Public Health 2022; 10:877593. [PMID: 35812475 PMCID: PMC9256923 DOI: 10.3389/fpubh.2022.877593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/20/2022] [Indexed: 11/17/2022] Open
Abstract
In this community case study, we describe the process within an academic-community partnership of adapting UNIDOS, a community health worker (CHW)-led community-clinical linkages (CCL) intervention targeting Latinx adults in Arizona, to the evolving landscape of the COVID-19 pandemic. Consistent with community-based participatory research principles, academic and community-based partners made decisions regarding changes to the intervention study protocol, specifically the intervention objectives, participant recruitment methods, CHW trainings, data collection measures and management, and mode of intervention delivery. Insights from this case study demonstrate the importance of community-based participatory research in successfully modifying the intervention to the conditions of the pandemic and also the cultural background of Latinx participants. This case study also illustrates how a CHW-led CCL intervention can address social determinants of health, in which the pandemic further exposed longstanding inequities along racial and ethnic lines in the United States.
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Affiliation(s)
- Kiera Coulter
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
- *Correspondence: Kiera Coulter
| | - Maia Ingram
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Abby Lohr
- Department of Community Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Carlos Figueroa
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Gloria Coronado
- Yuma County Public Health Services District, Yuma, AZ, United States
| | - Cynthia Espinoza
- Yuma County Public Health Services District, Yuma, AZ, United States
| | - Maria Esparza
- Yuma County Public Health Services District, Yuma, AZ, United States
| | - Stacey Monge
- Pima County Health Department, Tucson, AZ, United States
| | - Maria Velasco
- El Rio Community Health Center, Tucson, AZ, United States
| | | | | | - Ada Wilkinson-Lee
- Department of Mexican American Studies, University of Arizona, Tucson, AZ, United States
| | - Scott Carvajal
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
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Lohr AM, Alves SS, Coulter K, Redondo-Martinez F, Coronado G, David C, Espinoza C, Ingram M, Carvajal SC, Wilkinson-Lee A. Community Health Worker-Led Community Clinical on the U.S. / Mexico Border: Lessons Learned. Prog Community Health Partnersh 2022; 16:93-103. [PMID: 35342114 PMCID: PMC9359453 DOI: 10.1353/cpr.2022.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Community-clinical linkages (CCLs) connect public health organizations and health care providers to better support patients. Community health workers (CHWs), representatives from priority populations with special connections to their community, can lead CCLs. OBJECTIVES Our objective was to learn about how to conduct a CHW-led CCL from the perspectives of those implementing the intervention. METHODS We conducted focus groups with CHWs and their supervisors and regularly consulted community partners while coding and analyzing data. RESULTS We learned that CHWs thrive when supported by peers, supervisors, institutions, and researchers. Supervisors- who are new to the CHW role-should consider seeking training in CHW professional development and performance evaluation. Focus group participants agreed that by balancing the strengths and weaknesses of their organization, CHW-led CCLs benefit patients because the collaboration helps them to better manage their health. CONCLUSIONS Future CHW-led CCL practitioners should consider how to best institutionally support CHWs to maximize benefits for patients.
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Affiliation(s)
- Abby M Lohr
- University of Arizona, Mel and Enid Zuckerman College of Public Health, Health Promotion Sciences Department,Corresponding Author, Abby Lohr, current affiliation: Postdoctoral Research Fellow, Mayo Clinic in Rochester, ; Affiliation during the research: University of Arizona, Mel and Enid Zuckerman College of Public Health, Health Promotion Sciences Department
| | - Sophie S. Alves
- University of Arizona, College of Social and Behavioral Sciences, Mexican American Studies Department
| | - Kiera Coulter
- University of Arizona, Mel and Enid Zuckerman College of Public Health, Health Promotion Sciences Department
| | | | | | | | | | - Maia Ingram
- University of Arizona, Mel and Enid Zuckerman College of Public Health, Health Promotion Sciences Department
| | - Scott C. Carvajal
- University of Arizona, Mel and Enid Zuckerman College of Public Health, Health Promotion Sciences Department
| | - Ada Wilkinson-Lee
- University of Arizona, College of Social and Behavioral Sciences, Mexican American Studies Department
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Lohr AM, Van Gorden N, McClelland DJ, Dubinsky E, Gerald LB, Wilkinson-Lee A, Carvajal SC. Updating search strategies for literature reviews with OUR2D2: an open-source computer application. J Med Libr Assoc 2021; 109:317-322. [PMID: 34285675 PMCID: PMC8270383 DOI: 10.5195/jmla.2021.1105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: While writing a scoping review, we needed to update our search strategy. We wanted to capture articles generated by our additional search terms and articles published since our original search. Simultaneously, we strove to optimize project resources by not rescreening articles that had been captured in our original results. Case presentation: In response, we created Open Update Re-run Deduplicate (OUR2D2), a computer application that allows the user to compare search results from a variety of library databases. OUR2D2 supports extensible markup language (XML) files from EndNote and comma-separated values (CSV) files using article titles for comparisons. We conducted unit tests to ensure appropriate functionality as well as accurate data extraction and analysis. We tested OUR2D2 by comparing original and updated search results from PubMed, Embase, Clarivate Web of Science, CINAHL, Scopus, ProQuest Dissertation and Theses, and Lens and estimate that this application saved twenty-one hours of work during the screening process. Conclusions: OUR2D2 could be useful for individuals seeking to update literature review strategies across fields without rescreening articles from previous searches. Because the OUR2D2 source code is freely available with a permissive license, we recommend this application for researchers conducting literature reviews who need to update their search results over time, want a powerful and flexible analysis framework, and may not have access to paid subscription tools.
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Affiliation(s)
- Abby M Lohr
- , Health Promotion Sciences Department, PhD Candidate, University of Arizona Mel and Enid Zuckerman College of Public Health
| | - Noah Van Gorden
- , MCS Student, Arizona State University, School of Computing, Informatics, and Decision Systems Engineering
| | - D Jean McClelland
- , Health Promotion Sciences Department, Program Director for Community Based Health Information Resources, University of Arizona, Mel and Enid Zuckerman College of Public Health
| | - Ellen Dubinsky
- , Office of Digital Innovation and Stewardship, Scholarly Communication Librarian, University of Arizona Libraries
| | - Lynn B Gerald
- , Health Promotion Sciences Department, Professor, University of Arizona, Mel and Enid Zuckerman College of Public Health
| | - Ada Wilkinson-Lee
- , Department of Mexican American Studies, Associate Professor, University of Arizona, College of Social and Behavioral Sciences
| | - Scott C Carvajal
- , Health Promotion Sciences Department, Professor, University of Arizona, Mel and Enid Zuckerman College of Public Health
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