Public Health Emergency - Leading a Nation Prepared
This document includes promising practices and recommendations from several organizations working with communities affected disproportionately by COVID-19, that had success in increasing the utilization of COVID-19 monoclonal antibody treatments. These findings provide inspiration and information to those working to build treatment awareness and demand and can supplement individual plans and provide context to playbooks and planning discussions with leadership.
Communities of color and low-income communities were significantly and disproportionately more likely to be exposed to COVID-19, and more likely to experience infection, severe illness, hospitalization, and death attributable to the virus.1 This document describes the efforts of three organizations that worked to increase equitable access to COVID-19 monoclonal antibody treatment. These organizations implemented patient- and community-centered approaches to care, engagement, and problem solving. These approaches centered on compassion, deep knowledge of the communities they serve, and data-driven decision making to provide equitable access to care over the course of the COVID-19 pandemic.
Teche Action Clinics2 are a network of 16 Federally Qualified Health Centers (FQHCs) serving more than 25,000 patients across seven parishes in southwest Louisiana.
The County of San Diego3 has 18 municipalities serving many diverse communities, including more than 3.3 million residents, 18 federally recognized tribal reservations, 16 major naval and military installations, and 64 unincorporated areas.
The Black Coalition Against COVID4 was created to organize a multi-dimensional and broadly inclusive cohort of community leaders and advocates to urgently mobilize and coordinate assets to serve the Black community in Washington, D.C. and nationally.
Organizations have used the following approaches to increase access to FDA-authorized monoclonal antibodies:
Success Factors for Equitably Serving At-Risk Communities During a Pandemic
The following section provides key recommendations based on lessons learned by three organizations—Teche Action Clinics, the County of San Diego, and the Black Coalition Against COVID—as they served vulnerable populations during the COVID-19 pandemic.
Know Your Key Stakeholders and Community Gatekeepers
Stakeholders and gatekeepers are critical individuals in every community because they
serve as decision-makers and deal-breakers on behalf of specific populations. The Teche Action Clinics successfully reached high need populations in part because they
ensured that stakeholders had an opportunity to speak at critical junctures, and they consistently engaged gatekeepers like church leaders and local activists. The Black Coalition Against COVID
enlarged their community-based grassroots campaign by collaborating with trusted organizations that could speak with both compassion and scientific credibility to the Black community. These organizations included historically Black college and university (HBCU) medical schools, the National Urban League, and the National Black Nurses Association, among others.
Including Social Determinants of Health in Data-Driven Decision Making
Many organizations successfully used data to make decisions about which communities were highest risk and where to invest their limited resources. For example, the County of San Diego mapped infection rates by zip code, race, ethnicity, and age to identify where they needed to open regional centers providing easy access to mAbs treatment. This data-driven approach also informed their care practices: their treatment access centers utilized nurse triage lines, were open seven days a week, and were available to anyone regardless of health insurance, immigration status, or languages spoken.
Equitable access to care is challenging during the best of circumstances, and disparities in access to care were highlighted and exacerbated over the course of the COVID-19 pandemic.5 The practices and approaches employed by Teche Action Clinics, the County of San Diego, and the Black Coalition Against COVID were important and impactful in improving equitable access to care during a pandemic situation. However, the lessons learned and recommendations here may also apply for general provision of care in at-risk populations and communities.
All organizations highlighted in this document centered their care practices around deep-seated respect for different community cultures, norms, and perspectives.
Organizations should engage frequently and thoughtfully with key gatekeepers, focus on listening to understand pressing challenges, and keep historical context in mind as they collaborate with local leaders when they work on addressing health disparities in at-risk communities.
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