The Mississippi Recognizing Important Vaccine & Education Resources (RIVER) collaborative seeks to unify efforts to improve outcomes relating to COVID-19 in minority communities living in 11 rural counties of the Delta. Alcorn State University’s Dr. Shirley Evers-Manly, who serves on the Biden COVID-19 Vaccine Implementation Committee, will lead our quality improvement activities and program evaluation. The Town of Inverness is joined in this effort by Delta Health Alliance (DHA) - bringing 20 years of experience in these counties using community-based educators drawn from and representative of the neighborhoods they serve, the Leland Medical Clinic (LMC) - a rural non-profit approved by the state to administer vaccinations with a mobile medical unit to serve isolated communities, the Delta Ministerial Alliance for coordinating outreach with faith-based partners and the Center for Community Research & Evaluation to develop our Disparity Impact Statement. This collaborative also enjoys the sole support of U.S. Rep. Bennie Thompson, the longest-serving African-American elected official in the State of Mississippi representing Mississippi’s 2nd district.
The Delta’s rural, low-income communities faced tremendous disparities long before the pandemic. Our area is 66% African-American, 22% of adults lack basic literacy skills, 20% of adults lack a high school diploma, 19% of residents are uninsured and 40% of adults are obese and at increased risk for long haulers syndrome. The CDC has ranked our region’s average overall Social Vulnerability Index score as 0.9572 our of 1 (worst vulnerability). COVID-19 has been devastating for our communities of color, who experience double the positivity rates of our state as well as higher rates of total incidence and twice the mortality than the U.S. average. Our area also faces disparate effects of COVID’s indirect impacts including 54% more unemployment than the U.S.. Three of our counties have NO locations providing vaccinations. On March 3rd Mississippi ended our mask mandate and allowed businesses to operate at full capacity stating that the decision to practice preventative measures should be left up to individuals, making the need for health literacy more urgent than ever.
MS RIVER began with listening sessions with residents and minority outreach workers. This groundwork informed our program design, which will use a phased approach to reach increasing circles of minorities. In the first month we will complete a Disparity Impact Statement using local data and feedback to identify minority populations at greatest risk for disparities, low health literacy and lack of engagement. Educators will target employees of all partners in Phase 1, applying the evidence-based National Action Plan to Improve Health Literacy to improve the suitability, availability and use of COVID-19 information and services by minorities. Starting with a focused cohort will allow us to fine tune data systems and to test our quality improvement strategy. We will then use these findings to develop and implement a plan for Phase 2, providing services to residents with a connection to our network, including Chamber members, Alcorn students, DHA participants, LMC patients and congregations of the Ministerial Alliance. Phase 3 will expand these programs to all communities, targeting all 159,905 minorities in our rural service area.
Dr. Evers-Manly’s evaluation will utilize focus groups of minority households, businesses and churches, pre-/post- testing to assess behavioral changes in participants and data from the MS Dept. of Health. Her independent analysis will determine whether our health literacy intervention was implemented as planned, whether it reached target populations described in our Disparity Impact Statement, the impact on select HealthyPeople2030 measures and whether there were any changes in the access, use and outcomes of COVID-19 vaccination, testing, preventative behaviors and other related activities.
