The spread of COVID-19 has exacerbated existing health inequities nationwide and in Michigan in particular. In a state where African Americans make up 14% of the population, they experienced a 40% higher overall case rate and 30% higher cumulative death rate than Whites. Similarly, Latinx have contracted the virus at a rate 70% higher than their White counterparts. Addressing these inequities requires a more robust understanding of the experiences and insights of people living in areas hardest hit by COVID-19.
A model was needed for conducting research among minority groups and communities of color. The usual approach of a ‘clinical study’ with professionals from outside the communities was not a suitable approach as research has indicated . A community-based participatory research (CBPR) approach was adopted as partnering with these minority groups and communities is required for improved understanding of social situations and finding ways to bring change. Communities coalesce and practice certain behaviors, identify with certain belief systems, and understanding of that context is required to understand and adapt to the educational and engagement needs, and use that information to plan social goals. Research in this context is not separate from social practice, since each community is unique in their given spaces.
With Michigan CEAL – the approaches were planned using the title “The Fierce Urgency of Now”: Communities Conquering COVID to conduct interviews and focus groups among affected minority communities. In 2021, between January and April we conducted forty, one-hour interviews, and between April and June we plan on conducting 16 focus groups with African American and Latinx individuals living in four Michigan counties – Kent, Genesee, Washtenaw, and Wayne since these were the counties with significant disparities in COVID-19 morbidity and mortality. This research is being conducted as part of the National Institutes of Health Community Engagement Alliance (CEAL) Against COVID-19 initiative.
To recruit community members/participants for the interviews and focus groups the during COVID-19 pandemic, we used a CBPR approach, developing research questions, interview protocols, data collection, and analysis in partnership with our “Communities Conquering COVID” Steering Committee comprised of 16 leaders from 15 community-based organizations.
Interviews were conducted virtually in English or Spanish. Inductive analysis is being conducted to identify themes within the data allowing for a broader understanding of the experiences of African Americans and Latinx individuals.
Another focus for the Michigan CEAL project was to promote education and awareness of clinical trials since participation of minorities in clinical trials was required for equity and vaccine safety testing. Michigan CEAL engaged and collaborated with National Groups including COVID-19 Prevention Network (CoVPN) and Collaborating Network of Networks for Evaluating COVID-19 and Therapeutic Strategies (CONNECTs). These networks, along with the 16 member Michigan CEAL Steering Committee, helped us focus and expand on community outreach and to establish communication networks.
Thus far, we’ve identified broad themes including vaccine hesitancy, support for public health mitigation strategies, and facilitators and barriers to testing and trial participation. More in-depth results will be presented/posted here.
The outcomes from this study are informing public health measures, communication strategies, and research agendas to address the impact of the pandemic.
Through this project we’ve also reviewed the needs, themes, and developed a process by which community-academic partnerships were rapidly able to be mobilized to garner perspectives from marginalized populations in an evolving crisis.
In addition, we are able to better garner African American/Black and Hispanic/Latinx community perspectives on COVID-19, its mitigation strategies, vaccines, clinical trials, information sources, and the impact of the pandemic.
Holkup, P. A., Tripp-Reimer, T., Salois, E. M., & Weinert, C. (2004). Community-based participatory research: an approach to intervention research with a Native American community. ANS. Advances in nursing science, 27(3), 162–175. https://doi.org/10.1097/00012272-200407000-00002