Ukrainian Refugee Crisis Response: Actively and Authentically Engaging Communities in Outbreak Response Activities

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As one of the largest destination states for United for Ukraine arrivals, Washington Department of Health (WA DOH) has implemented programs and community outreach strategies during the COVID-19 response aimed at engaging Russian and Ukrainian speaking communities, and have also been able to effectively pivot in response to the larger Ukrainian refugee crisis.  Recognizing the barriers to vaccination for the community, they developed best and promising practices to address these challenges.

Three keys to engaging Ukrainian and Russian speaking communities include:

Identified barriers to vaccination include:

  • Care: Lack of culturally and linguistically appropriate care from health care providers.
  • Language: Lack of translated or trusted public health materials.
  • Trust: Lack of existing and continued relationships to public health and health care organizations, which results in community members interpreting that public health decisions are being made without their input.

These barriers have extended beyond the scope of COVID-19; addressing these barriers is critical to the larger public health response to the current war in Ukraine and refugee crisis. 

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Establish funding for full time staff at each local health jurisdiction, and strongly recommend that jurisdictions hire from the community.

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Leverage Community Coordinator contacts to mobilize volunteers, recruit participants for events, and grow the network.

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Intentionally build relationships with community members, recognizing that establishing trust and strengthening relationships takes time.

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Engage long term with the community through personal relationships, finding shared vision and interests, and collaboratively working towards mutual goals.

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Elevating the role of community members

It is important to elevate community members into decision-making roles in order to further the impact of public health efforts. Community members can drive public health program development as well as the creation and dissemination of health education materials.

Culturally relevant messages that are relayed by community leaders and those individuals with shared cultural experiences are better received and trusted by community members.

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Moving beyond COVID-19

With staffing and leadership in public health, WA DOH facilitated the establishment of a work group and outreach group who regularly meet to plan outreach and messaging. Initially created in response to COVID-19, these groups now respond to other community needs, such as the war in Ukraine and subsequent refugee crisis.

Remember: It’s important to humanize public health by “putting a face” to the work, and engaging long-term with the community.

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In learning from others that have implemented this model for their communities, WA DOH  provided resources for community leaders to establish a health board consisting of community leaders, public health practitioners, and health care providers.

This board, called Nashi (“our community”), serves as a trusted source of information for the community. Because community members do not typically use the WA State DOH website, the Nashi Immigrants Health Board has created a website with easily accessible information around services needed by the community (i.e. legal counsel, housing support, food, etc).

Recruiting members for a Community Health Board

The formalization and recruitment of the community health board was a multi-step, multi-year process, integrating both funded and volunteer staff from the community in addition to public health and heath care providers. To begin, the WA DOH established a funded work group, which comprised of a growing network of community leaders. They ultimately worked together to form an outreach group, consisting of Community Coordinators hired through local health jurisdictions. A few community leaders with health care and public health backgrounds served as founders of the Nashi Immigrants Health Board. This non-profit operates independently but with support from the WA DOH. 

Looking towards the future

The success of the Community Health Board lies in its grounding as a community-driven effort to provide culturally and linguistically needed resources to the community. Through grassroots efforts, the work group evolved into an outreach group that included founding members of the community health board, which is able to pivot and address other priority health conditions of concern beyond COVID-19. Future efforts of the board will include the building a community advisory board that will, in turn, provide feedback to WA DOH on community public health priorities and needs.

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  • Media and messaging (DH, Within Reach)
  • Russian and Ukrainian language Newspapers, Radio, podcasts, social media
  • Local health departments
  • Community and faith leaders (e.g. pastors)
  • Health care leaders from community (e.g. Washington Chapter of the American Association of Pediatricians, WSMA, local providers)
  • Ethnic and community based organizations (CBOs)
  • Refugee resettlement agencies

Reaching a larger audience

Through these partnerships, WA DOH is able to disseminate accurate, linguistically and culturally relevant information to larger audiences than they would on their own. These partnerships also allowed for community input in DOH’s decision-making efforts and established relationships with leaders in the community.

Building trust by identifying shared values

Given the existing distrust of the government, the efforts to build trusting relationships with community leaders has been a challenge for WA DOH. However, over time, finding leaders that had shared values and were like-minded provided opportunities to engage.

Some keys to success for WA DOH were approaching the relationships with these considerations in mind:

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Partnerships take time. Several of these partnerships took years to establish.

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Find organizations already serving the community. Start with reaching out to organizations that have similar existing relationships with community partners.

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Be mindful about how you disseminate information. It can be counterproductive for government/DOH to publicize or widely announce partnerships with certain community partners as this may undermine the trust they’ve built with their community group.

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Trust and respect others' perspectives or beliefs. This is especially true when working with faith leaders.

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Provide data. Having data to support the situation you are trying to address in the community can help build a shared understanding with community leaders and help justify why you are looking to partner with them. 

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Be intentional about establishing an authentic relationship with community members. Some community partners have felt that past relationships with government/DOH were not reciprocal, and more extractive. Community leaders were asked to provide help, feedback, and input without any obvious return or benefit to their communities. Do your best to find answers to community questions or concerns even if it goes beyond the scope of project or funding mechanisms.

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Give people the tools they need to carry out the work. WA DOH also conducted outreach and developed a training for health care providers on how to counsel the community around vaccinations. By giving community partners the resources they need, including training and an online toolkit, you can set them up for success.