Table 3.
Themes from the statewide alliance evaluation survey (n = 34) and select quotes.
| Category | Theme | Description | Exemplar quotes |
|---|---|---|---|
| Facilitators | Existing partnerships supported the rapid implementation of pandemic community engagement | Universities relied on existing and longstanding partnerships for rapid implementation in the statewide initiative. | “Because we've worked in [the} past with many of [university name] colleagues we have TRUST… this prior relationship and work experiences is the cornerstone of continued authentic, collaborative partnership.”—CBO |
| Reach to impacted communities was expedited and expanded through community partner networks | Existing trust and connections between community partners and their communities facilitated outreach to those disproportionately impacted by the pandemic for COVID-19 information, research, and clinical trials | • “Our group of promotoras who [sic] have served as trusted messengers in their community and have been very essential in terms of community outreach/engagement. We have listened through different barriers different organizations have encountered in our communities and recognized how similar barriers have affected us, and have thus taken actions (i.e., helped individuals register for the vaccine, bring mobile clinics to communities, etc.).”—CBO • “The most effective technique we used was having trusted messengers to communicate honest and transparent messaging and communication to communities around the constant changes coming out of CDC… helped establish and strengthen the trust with our community members.” —Academic |
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| Alliance brought opportunity for critical community-based funding | Community-directed funding was able to support critical community-based engagement and meet community-partner needs. | • “Most participants are small non-profits with tight budgets and anything to pay for our time is a godsend.”—CBO • “It helped to provide some amount of compensation during a time of uneasiness, fear, and loss of work for our volunteers.”—CBO • “Energized the CBOs to jump in and join in this fight and strengthen the community network for dealing with challenges in COVID-19.”—CBO |
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| Barriers | Rapid application and implementation timelines | Difficult to build community engagement infrastructure to support a statewide initiative over the rapid application and implementation timelines. | • “Lack of time to conceptualize and fulfill cross-state projects such as interventions, etc. (beyond surveys/focus groups). Minimal funding for staff. Did not have bilingual meetings for some partners. [Difficulty] keeping up to date on all the 11 teams projects/progress/next steps, including funding/budgets.”—Academic • “Time was a barrier - we had to launch project in record time.”—CBO |
| Evolving Funding and Community Priorities | Friction between national and local priorities (including pandemic challenges and community partner needs). | “[Our challenges included] Identifying and engaging virtually (!!!) community advisory board members; national focus on vaccine trial participation versus outreach and vaccination (community priority was NOT the vaccine trial); Key barrier for engaging community members was competing priorities in their own personal and professional lives as a result of the pandemic.”—Academic | |
| Bureaucracy in distributing Funding to Community Partners | Funder and university bureaucracies made it difficult to quickly disburse funds to community partners. | • “Award occurred quickly, but there was red tape getting the contracts to [Univ.] and then more red tape getting the sub-contracts to my organization, so we'd done five months of work before we got paid. We are financially stable enough to weather that kind of delay, and we trust [Univ. name] enough to perform work and believe we'll get paid later, but it would be a hard stop for some smaller organizations.”—CBO • “The original promise of having funding spurred CBO to hire, and then they were financially strapped with the costs because we couldn't get payment to them fast enough. Nearly broke them!”—Academic |
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| Perceived impact | Strengthen Partnership Building in the Pandemic | Community-academic partnerships grew because of close working relationships during the project. | • “I think we each understand more about one another due to the projects. CBOs understand who we are, and we (the university) understand more about what CBOs do and how they work. It's strengthened our partnership.”—Academic |
| • “We have taken time to get to know each partner's work in more depth. We have gained a deeper understanding, appreciation, and trust in each other's work. This has led to being able to establish a true bi-directional learning system that facilitates learning from each other.”—CBO | |||
| Ability to leverage the statewide community-academic network to advocate for policy change | The network of universities and community partners could advocate for key policy changes in addressing COVID-19 inequities. | • “[The Alliance] allowed for strong network communication, and new connections with policymakers, agency contacts (public health, etc.) on a local and statewide level to share research and policy recommendations! We were able to have conversations across community, academic, and policy/government in real-time for working through on-the-ground information, research, and policy needs… who [in turn] put plans in place to help mitigate barriers.”—Academic • “We participated in several statewide and national meetings in which we argued for the need to recognize the different experiences in rural areas.”—Academic • “Helped us to get on the radar of [local county health department] to disaggregate data further.”—CBO • “Tackling a pandemic requires an equity-based approach, and I have appreciated there being a space for our community to have their voices heard, especially at an institutional level… By giving our community a space to center their hesitancies and concerns, it has given us space to advocate their voices throughout the city.”—CBO |
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| Mutually-beneficial resources and problem-solving | Bi-lateral sharing of resources for rapid turnarounds and outreach: (a) community partners provided community expertise for informing and tailoring interventions, (b) academics provided expertise for COVID-19 information, vaccines, and the latest research. | “The statewide collaborative has been extremely beneficial in harvesting experiential learnings within the state teams and sharing them in order to strengthen local team activities… added value of being a space for joint problem solving and resource sharing.”—CBO “[The Alliance] has provided the funding and knowledge necessary to educate our communities on accurate information pertaining to COVID-19 and the vaccine. Additionally, it has provided a supportive community of professionals who have served as a supportive group working towards the same age–a–to stop the propagation of COVID and increase the number of those vaccinated.”—CBO | |
| Lessons learned | Cultural tailoring | Community partnerships were key for tailoring strategies and resources for a diversity of local populations. | “Among the highest incidence of death from COVID are farmworkers… we are saving lives by providing reliable information in the languages that farmworkers understand through [CBO] a trusted messenger which is a Latino grassroots roots non-profit… we are on the air 24/7 with live radio shows and recorded messages educating our audience about COVID, prevention, protocols, and up to date best practices.”—CBO “Not only increased outreach and strengthened partnerships, but increased and strengthened cultural/community tailoring of information…we can say we increased engagement across the board and our work allowed for broad and diverse engagement and exposure to many communities, and more than ever before…”—Academic |
| Need to address social determinants of health | Inequity in social drivers (housing, healthcare, employment, and education) remains and leads to disparities in vaccination, testing, and clinical trial participation. | • “Economic need for higher minimum wage, housing burdens in the LA area increased by the pandemic, support for caregivers, long-COVID impacts, additional vaccine outreach, potential for boosters, changing CDC/local guidelines and outreach, mental health, rebuilding community/personal bonds.”—Academic | |
| • “While food and rent assistance has been provided to community members due to COVID-19, this continues to be a major issue. Unfortunately, our communities were greatly affected and a month of assistance (which is what most families receive) simply isn't enough.”—CBO • “The collaborative can successfully address misinformation and hesitancy. However, the underlying disparities within housing, healthcare, employment, etc., need to be addressed on the policy level.”—CBO |
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| Community engagement is critical throughout the process | Community priorities and needs change as the science unfolds and pandemic socioeconomic effects deepen. Consistent feedback and co-learning is essential to appropriate and resonant COVID-19 response | • “Continued partnership for work allows community voices to be heard; Understanding how residents are thinking and making choices helps us all do better in communicating out the public health messages that resonate with concerns community residents struggle with.”—CBO • “The challenges were… the lack of appropriate outreach and educational material. Material was not published in enough languages, and the material was not relatable to many community members. Targeted communities need to be involved in the development of educational and outreach materials from the beginning.”—CBO |
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| Longitudinal academic-community partnership, funding, and collaboration is needed to sustain efforts | Sustainment of trust and partnership between the medical, science, and public is needed | • “Program recommendations are for continued collaboration by educational institutions, NIH, with authentic grassroots organizations who are trusted messengers among vulnerable populations; it should not be only during a pandemic.”—Academic • “For the community to trust the academics, a single project is not enough. The researchers have to come several times with several projects for the community to believe in them. It is important to know the culture and language of the communities.”—CBO |
CBO, Community-based organization; NIH, National Institutes of Health; COVID-19, Coronavirus Disease 2019.