Effective COVID-19 response among refugee, immigrant, and migrant (RIM) communities requires relationships with communities. Lack of information in the community can foster distrust with the health department, lead to hesitancy to cooperate with case investigators and contact tracers, and potentially worsen health outcomes. There may be some difficulty in knowing where to start when building or strengthening relationships with a community. Effective community engagement will vary locally; however, engaging community leaders may be one of the first steps needed to identify partners who can help reach RIM communities.
Community leaders are as diverse as the number of RIM communities themselves. They may be associated with a particular RIM-serving community-based organization (CBO), ethnic community-based organization (ECBO), refugee resettlement agency, federally qualified health center (FQHC), or they could just be a well-known member of the RIM community. Engaging these community leaders, specifically regarding communications with public health authorities, will help improve the dissemination of accurate and factual COVID-19 prevention messaging, strengthening relationships with RIM communities, and ensure that public health interventions include input and perspective from RIM communities.
Engaging Community Leaders with Public Health Authorities in Utah
When the COVID-19 response began last year, Utah's Refugee Health Program began holding meetings with community leaders to help translate COVID-19 state guidance into more digestible information for RIM communities. Working with the Refugee Services Office at the Department of Workforce Services, the refugee health team hosted multiple different meetings with more than 8 ethnic communities, where the staff learned some of the cultural nuances to the state guidance. Community leaders also helped field questions from the community and helped serve as liaisons between the community and the health department. For example, the Iraqi community had questions surrounding COVID-19 precautions and guidance for the funeral process. Utah’s COVID-19 state team would answer their questions, but field a number of the questions to the state refugee health team and community leaders to help share the guidance from a trusted community source.
Additionally, Utah’s state health department conducted a COVID-19 risk assessment for each locality. This assessment included information on transmission levels, and basic information about COVID-19 such as mask-wearing and social distance measures. These messages were curated for different communities and the health department tried to push out the messages with subtitles. The RIM communities; however, had a difficult time relating to the pictures since the resources did not include members of their own community. The health department then worked to translate the videos featuring various RIM community leaders stating the COVID-19 health messages. These Multilingual Videos were widely and well received by RIM community members, with community leaders sharing these resources via Facebook, WhatsApp, and other community platforms that RIM community members actively use and trust.
Local Arizona Health Department Engages RIM Community Leaders to Distribute COVID-19 Prevention Messaging
Maricopa County Public Health Department holds meetings with RIM community leaders and stakeholders to discuss barriers and opportunities for effective COVID-19 outreach in the community. The leaders can get questions answered and clarify misconceptions and help answer questions of how to do contact tracing better, and inform ways to improve messages. The engagement process helps identify community and or other resources needed within the community. These meetings have helped the health department identify community-requested testing sites and deliver education on proper mask-wearing techniques.