Bilingual care navigation and enhanced case management during COVID-19

COVID-19 disparities exposed health inequity across socioeconomic status, with community members of color experiencing higher rates of COVID-19 infections, hospitalizations, and death. Racial/ethnic differences were especially disparate in Benton and Washington counties in northwest Arkansas, a region in the United States that experienced high COVID-19 infection rates. To address these disparities and support families with COVID-19, the University of Arkansas for Medical Sciences and Community Clinic (a federally qualified health center) worked with the Arkansas Department of Health and community partners to develop systematic Care Navigation and Enhanced Case Management. During an initial screening process, contact tracers offered Care Navigation and Enhanced Case Management services to individuals who tested positive for COVID-19 within Washington and Benton counties. Bilingual community health navigators, social workers, and nurses began providing enhanced case management to households that accepted services. Between September 9, 2020 and June 19, 2021, 3,502 households representing ∼13,000 individuals were offered services, and 1,511 (43.1%) households requested/accepted services. Based on our experience, we provide four recommendations for practice: (a) provide contact tracing in community members' preferred language, (b) incorporate assessments into the contact tracing process to ensure community members have necessary resources for quarantine, (c) implement comprehensive care navigation and case management services for those who need additional support, and (d) integrate bilingual health navigators who are part of the target community into the process. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Perceptions of adult Arkansans regarding trusted sources of information about the COVID-19 pandemic

BACKGROUND

The United States leads the world in confirmed COVID-19 cases; Arkansas ranks fifth in average daily cases per 100,000. Historically, Americans relied on health communications from governmental sources and the news media. However, there has been a documented decline of trust in these sources. The present study seeks to understand trusted sources of information about COVID-19 to improve health messaging because research shows the level of trust is associated with adherence to recommendations.

METHODS

Data were collected using an online survey from participants (N = 1221) who were 18 years of age or older and residing, employed, or accessing health care in Arkansas. A qualitative descriptive design was used to summarize participants' experiences and perceptions related to trusted sources of COVID-19 information.

RESULTS

Two primary themes related to participants' perceptions of sources of information about COVID-19 are reported: 1) trusted sources of information and 2) distrust or lack of trust in sources of information. Several subthemes emerged within each primary theme. Results showed high trust in the academic medical center, federal and state public health agencies, and local health care providers. The study also documents diverging voices of distrust and uncertainty in making sense of contradictory information. Participants reported the main reason for their lack of trust was the rapidly changing information and the lack of consistency in information provided across sources.

CONCLUSIONS

This finding provides insight into the importance of coordination between national, state, and local communications to bolster trust. Personal recommendations and testimonies from trusted health care providers and professionals could inform public health messaging interventions to increase vaccine uptake.

COVID-19 Vaccine Willingness and Hesitancy Among Marshallese Pacific Islanders

COVID-19 has disproportionally burdened racial and ethnic minorities. Minority populations report greater COVID-19 vaccine hesitancy; however, no studies document COVID-19 vaccine willingness among Marshallese or any Pacific Islander group, who are often underrepresented in research. This study documents United States (US) Marshallese Pacific Islanders': willingness to get the COVID-19 vaccine, willingness to participate in vaccine trials, and sociodemographic factors associated with willingness. From July 27, 2020-November 22, 2020, a convenience sample of US Marshallese adults were recruited through e-mail, phone calls, and a Marshallese community Facebook page to participate in an online survey. Of those surveyed (n = 120), 32.5% were extremely likely to get the COVID-19 vaccine; 20.8% were somewhat likely; 14.2% were unlikely or very unlikely; and 26.7% stated they did not know or were not sure. Only 16.7% stated they were willing to participate in a COVID-19 vaccine trial. Vaccine willingness was positively associated with older age, higher income, and longer US residence. Health insurance status and having a primary care provider were positively associated with vaccine willingness. Findings demonstrate within-group variation in COVID-19 vaccine willingness.

Learning During COVID-19: Rapid E-Learning Transition at a Regional Medical School Campus

COVID-19 has changed the day-to-day landscape of education for students, faculty, and staff worldwide, and this is especially true for students in health sciences and medical education programs. This paper explores the effects of the rapid shift to e-learning modalities for students at the University of Arkansas for Medical Sciences Northwest, a regional medical campus located in Northwest Arkansas. A survey and open-ended written interview questions was conducted with a total of 144 student respondents and in-depth follow up interviews were conducted with 29 of those students. Utilizing descriptive statistics and qualitative descriptive analysis, the survey and interviews explored the effects of COVID-19 on the lived experiences of students as part of the transition to e-learning.  We found that 64.5% students reported satisfaction with the transition to e-learning as good or very good and the primary themes that influenced e-learning success for students were: Communication, technology, pedagogy, and community.

Factors Associated with First-Time Telehealth Utilization for Marshallese Living in the United States

Background: Mitigation efforts to prevent the spread of COVID-19 included the robust utilization of telehealth. However, racial/ethnic minority populations have demonstrated low telehealth utilization in the past. The aim of this study was to examine the first-time use of telehealth by Marshallese adults during the COVID-19 pandemic, using online survey data collected from 109 Marshallese respondents between July and November of 2020. Methods: To evaluate the relationships between sociodemographic characteristics, health care access, physical/mental health, and COVID-19-specific measures and the decision to use telehealth, we use bivariate analyses, including t-tests and chi-square analysis. Results: Eighteen respondents (16.5%) indicated they utilized telehealth for the first time during the pandemic. The number of chronic conditions reported was positively associated with the first-time use of telehealth (p = 0.013). Although not statistically significant, a higher proportion of Marshallese first-time telehealth users reported limited English proficiency, changes in health status, and changes in health insurance. Discussion: Although telehealth has been shown to reduce the absolute gaps in health disparities for minority populations, there is limited utilization by Marshallese communities. Conclusions: Significant research remains on the utilization of telehealth by Marshallese during the COVID-19 pandemic and to increase utilization in the future.

Avoiding bad connection: Orientation phone calls foster student-faculty connection in an RN-BSN program

BACKGROUND

Studies show that the primary reasons registered nurses (RNs) withdraw from registered nurse to bachelor of science in nursing (RN-BSN) programs are related to the challenge of sustaining work and family obligations while in school and having unclear expectations. It has been shown that nontraditional students facing these types of challenges benefit from programs that give strong sense of faculty connection and orient students to coursework by providing clear information.

PURPOSE

The purpose of this project was to see if conducting one-on-one, script-guided orientation phone calls with individual students provided valuable programmatic information and established a sense of connection to faculty.

METHODS

Six RN-to-BSN faculty conducted a combined 108 orientation telephone calls to individual, newly enrolled online RN-to-BSN students. The purpose of the orientation was to introduce general program expectations required to successfully complete courses, and provide students with a sense of connectedness with faculty. Faculty developed and distributed a survey (3, 6-point Likert scale response items and 2 open-ended questions) to understand the degree to which RN-to-BSN students valued the orientation phone call.

RESULTS

Ninety-four percent (n = 101) of participating students agreed that the RN-BSN program orientation phone call resulted in feeling a "sense of connectedness" with the online program faculty member. Additionally, 95% (n = 102) agreed that the orientation phone call provided them with the necessary information to support success in their first course within an RN-BSN online program.

CONCLUSION

One-on-one orientation telephone calls provided valuable program overview information and the personal conversational format conveyed to remote students faculty availability and an enhanced sense of connectedness.