The COVID-19 pandemic highlighted the staggering inequity that exists in many communities. Maricopa County has over 5620001 confirmed cases of COVID-19. COVID-19 has infected and killed racial and ethnic minorities, including immigrant, farm worker and refugee communities disproportionately. Yet, vulnerable communities have inadequate access to public health information to curb the transmission. Additionally, much of the public health advice given to stop transmission of COVID-19 is impractical for vulnerable communities. For example, isolating in a separate room is impossible for households with more residents than rooms. This project demonstrates the need to address both literacy and social needs at the source with culturally competent support. We build on a pilot that demonstrates the value of collaboration between Community Health Workers (CHWs) and safety-net providers at Federally Qualified Health Centers (FQHCs). The pilot fulfilled the objectives of improving adherence to COVID-19 public health information by delivering and reinforcing culturally and linguistically sensitive health information while simultaneously addressing social determinants of health (SDOH) such as separate shelter, food, or rental and utility needs. The pilot project demonstrated that 38% of infected patients required the model to enhance adherence. Implemented during the height of the pandemic in Maricopa County, we will expand on the pilot to reach more people in need within the community. Utilizing adaptable workflows that create a closed loop referral relationship between providers and CHWs working in the communities of need, this model addresses health literacy disparities by disseminating comprehensible content in the recipients native or preferred language in multiple modalities delivered at scale utilizing a secure SMS platform in addition to training the CHW workforce with consumable content for patient education. Our quality improvement model utilizes rapi
d cycle PDSA ramps, leveraging focus groups comprised of target segments of need within the community to assess improvement. The evaluation will be led by the Southwest Interdisciplinary Research Center, (SIRC), a foremost regional health equity research center at the Arizona State University, a minority serving institution.
