Table 2.
Strategies for implementation of centers for disease control and prevention communication and emergency risk communication phases with vulnerable populations in the COVID-19 pandemic by a community engaged research partnership
| Communication and emergency risk communication phases | Implementation strategies by community engaged research partnership |
|---|---|
| Preparation | |
| Develop partnership | Intervention was built by an established CEnR partnership with preexisting trust and credibility within regional immigrant communities. Shared ownership of the COVID-19 risk communication project was agreed upon by community and academic task force partners.* |
| Draft and test messages | COVID-19 message maps with content from credible sources were co-created by community and academic partners. Additional biweekly “reports” and videos were developed in partnership with community leaders for distribution through several electronic mediums (Table 1). Messages were tailored to meet each language group’s needs. Beyond the main messages (Fig. 1), additional messages included situational updates and responses to frequently asked questions solicited by Communication Leaders. |
| Create plan | Dissemination plan was discussed at an initial teleconference between Communication Leaders and task force members. The plan was augmented daily via teleconferences with the task force. |
| Determine approval process | Equal decision-making on approval process of all messages by task force members. Messages were reviewed and edited by Communication Leaders from each language group before translation. Academic partners reviewing message content included an infectious diseases specialist, and messages were cross-referenced daily with CDC and regional and local health department, as well as WHO website content. |
| Initial | |
| Explain risk | Messages targeted ways to stop the spread and transmission of COVID-19. Task force subgroups focused on reaching high risk elderly populations and those with chronic conditions, while others focused on reaching youth who often expressed sentiments of lower personal risk. |
| Promote action | All messages were action-oriented with specific steps to take for COVID-19 prevention, testing, and associated socioeconomic stressors. Messages were reenforced regularly and altered in response to community questions and stated actions. |
| Describe response efforts (organization’s credibility) | The task force maintained daily bidirectional contact with Communication Leaders. In addition to teleconferences, this included individual phone calls and text messages between task force members. A participatory approach promoted ownership of the intervention by Communication Leaders and their community partners. Credibility of the CEnR partnership was perceived as critical to the intervention success. |
| Maintenance | |
| Provide background information | Initial messaging included background information about and testing for COVID-19. These basic messages were reenforced throughout the maintenance phase. |
| Explain ongoing risks | Concerns and questions brought forward by community leaders from their communities revealed the magnitude of the crisis and how communities were assessing personal risk. Most of these questions, including those about changing perceived risk, could be answered by task force partners in real time during daily teleconferences in a culturally focused manner (e.g., how to address culture-specific mourning and burial of the deceased). If not, then community referrals were initiated through existing partnership networks. |
| Segment audiences | Messages were adapted for each language group for cultural context. Messages were also adapted for youth audiences by a task force subgroup. Finally, messages were adapted for families and contacts of those who tested positive for COVID-19. |
| Address rumors | Rumors were directly addressed in real time during daily teleconferences with Communication Leaders, who curated these rumors from members of their social networks. Rumors commonly centered on home remedies for COVID-19, treatment efficacy, vaccine availability, and risk misperception. |
| Resolution | |
| Motivate vigilance | Complacency was discouraged through sustainability of bidirectional, regular task force communications and through continuous application of community engagement principles that place equal ownership of the process with community and academic partners. |
| Discuss and document lessons learned | Lessons learned were catalogued from two sources: notes from daily task force teleconferences and weekly semi structured interviews with Communication Leaders. Through rapid analysis of these data sources, messages were refined, community resources were leveraged, and concerns of immigrant communities were expressed to regional COVID-19 decision makers. |
| Evaluate and revise plans | Rapid evaluation was conducted in real time as above. Examples of revised plans that arose from these evaluations included more coordinated messaging around social and economic resources in the community, a more streamlined COVID-19 testing protocol for individuals with limited English proficiency (adapted by healthcare institution), more solution-based messages, more message repetition, and new messages of empathy and hope. |
Abbreviations: COVID-19, coronavirus disease 2019; CEnR, community engaged research; CDC, Centers for Disease Control and Prevention; WHO, World Health Organization.
*
Task force members included community and academic leaders, Communication Leaders, other volunteers and representatives from regional community-based organizations.