Bull City Strong, a community-based partnership in Durham County, North Carolina will address the increased risk of contracting, being hospitalized, and dying from COVID-19 among Black, Hispanic, and other historically marginalized populations. The Durham County Department of Public Health (DCoDPH) will lead the implementation of evidence-based health literacy interventions to address disparities in health outcomes related to COVID-19, and North Carolina Central University (NCCU) will facilitate research around the development, implementation, and evaluation of interventions to improve individual and organizational health literacy in Durham County. DCoDPH and NCCU will work in partnership with LATIN-19, a community coalition established to address health disparities within the Latinx community as a result of the COVID-19 pandemic; Project ACCESS of Durham County, a community-based organization that seeks to improve the health of uninsured and underserved Durham County residents; media partners; and other community partners who employ and support community health workers to provide services related to COVID-19. The project will employ a health equity framework to formulate a disparity impact statement to monitor disparities data and guide implementation efforts. Proposed strategies include: a mass media campaign, SMS distribution of health messaging, out-of-home advertising within targeted geofencing, coordinating existing networks of community health workers, expanding peer advocacy programs to address vaccine hesitancy, outreach to address health-related misinformation, mini-grants for native content development with accurate health messages, and a digital learning community to advance organizational health literacy. Bull City Strong will provide support, coaching and education to Durham community members from historically marginalized populations to improve their access to and utilization of high-quality health care. Project aims align with
Healthy People 2030 goals to improve health communication; increase access to comprehensive, high-quality health care services; help people get recommended preventive health care services; and promote health and safety in community settings. Research on program sustainability and institutional capacity across the project aims will provide project assessment and generalized knowledge about best practices in using a health equity approach to improving health literacy.