4.2 Article

Centering Health Equity Within COVID-19 Contact Tracing: Connecticut's Community Outreach Specialist Program

Journal

JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE
Volume 28, Issue 6, Pages 728-738

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/PHH.0000000000001608

Keywords

community health; COVID-19 contact tracing; health equity

Funding

  1. CDC: Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC) COVID-19 Funding
  2. Connecticut Health Foundation
  3. NIH [T32GM007205]
  4. National Center for Advancing Translational Science (NCATS), a component of the National Institutes of Health (NIH) [TL1 TR001864]

Ask authors/readers for more resources

The COVID-19 pandemic has disproportionately affected vulnerable populations and those with lower socioeconomic status. In an effort to improve participation in contact tracing among these groups, the Connecticut Department of Public Health established the Community Outreach Specialist (COS) program. The program recruited workers from target communities and trained them to provide contact tracing services to vulnerable and non-English-speaking populations. The program was found to be more effective at reaching contacts than the standard contact tracing program.
Context: The COVID-19 pandemic has disproportionately impacted vulnerable populations, including those who are non-English-speaking and those with lower socioeconomic status; yet, participation of these groups in contact tracing was initially low. Distrust of government agencies, anticipated COVID-19-related stigma, and language and cultural barriers between contact tracers and communities are common challenges. Program: The Community Outreach Specialist (COS) program was established within the Connecticut Department of Public Health (DPH) COVID-19 contact tracing program to encourage participation in contact tracing and address a need for culturally competent care and social and material support among socially vulnerable and non-English-speaking populations in 11 high-burden jurisdictions in Connecticut. Implementation: In partnership with state and local health departments, we recruited 25 COS workers with relevant language skills from target communities and trained them to deliver contact tracing services to vulnerable and non-English speaking populations. Evaluation: We conducted a cross-sectional analysis using data from ContaCT, DPH's enterprise contact tracing system. Overall, the COS program enrolled 1938 cases and 492 contacts. The proportion of residents reached (ie, called and interviewed) in the COS program was higher than that in the regular contact tracing program for both cases (70% vs 57%, P < .001) and contacts (84% vs 64%, P < .001). After adjusting for client age, sex, race and ethnicity, language, and jurisdiction, we found that the COS program was associated with increased reach for contacts (odds ratio [OR] = 1.52; 95% confidence interval [95% CI], 1.17-1.99) but not for cases (OR = 0.78; 95% CI, 0.70-0.88). Rapid qualitative analysis of programmatic field notes and meeting reports provided evidence that the COS program was feasible and acceptable to clients and contributed to COVID-19 education and communication efforts. Conclusion: A COS program employing a client-centered, community-engaged strategy for reaching vulnerable and non-English-speaking populations was feasible and more effective at reaching contacts than standard COVID-19 contact tracing.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.2
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

No Data Available
No Data Available