Across the nation, health care organizations are exploring ways to partner with patients and communities of color to identify and reduce health disparities. Meaningfully engaging patients can address systemic power imbalances, build trust within communities, improve understanding of cultural preferences and community needs, and inform health care organizations’ policies and practices. Community-based organizations often serve as linkages for health care systems to build relationships with community members and collaboratively address health-related social needs. In many communities, faith-based organizations — trusted entities with long-standing neighborhood roots — are valuable partners for health care systems.
The Center for Health Care Strategies (CHCS) recently spoke with Jacqueline Nelson, president of the National Association for the Advancement of Colored People (NAACP) Rome, New York, and Patricia Charvat, senior vice president of marketing and strategy at Mohawk Valley Health System in Utica, New York, to explore their recent partnership. Ms. Nelson cultivated relationships between the health system and local faith-based organizations to spearhead the Healthy Heart Church Tour, informational sessions and presentations in churches about cardiovascular health and preventive care. The tour has gone to six churches, one African American association, and a woman’s faith group, reaching about 250 people thus far. Two more sessions are scheduled for fall 2022 and there are more in discussion, with potential expansion into barber shops. Both Ms. Nelson and Ms. Charvat participate in Engaging Patients of Color to Advance Health Equity, a CHCS-led initiative supported by the New York Health Foundation that is bringing together New York-based health care organizations to strengthen their capacity to engage with patients and communities of color to advance health equity.
Why should health care organizations and community-based organizations work together to engage patients?
J. Nelson: Health care systems have resources to support residents. We were very lucky that Mohawk Valley was willing to listen and learn about the challenges in the community. It is not all roses navigating these relationships. There are difficult conversations, but these partnerships need to exist to meet the needs of the community.
P. Charvat: No one can do this alone. Stakeholders need to work together to build trust, but the reality is that health care organizations have not been good partners to communities. Collaborating with community-based organizations, especially faith-based organizations, helps to repair broken trust between health care systems and community members.
What needs did you see in the community that led to this partnership with local faith-based organizations?
J. Nelson: We want to make our community healthier, and we have to be innovative and creative to make this happen. For example, there was an older gentleman who did not want to get vaccinated. His son, a doctor, tried to persuade him but his dad was still not interested. The son pleaded with his father’s pastor to convince his dad to get vaccinated, and then he finally got the immunization. Seeing how much the older gentleman trusted his pastor shows the opportunity health care organizations have to better engage with faith-based organizations.
P. Charvat: Our lack of partnership with the community was very visible during the heightened times of COVID-19 when we saw disparities amongst people of color and people with low incomes. We realized that we could support residents by providing education and administering vaccines. Community members listen to their church leaders, so collaborating with faith-based organizations helps to build these trusting relationships.
How do you engage patients and community members in the Healthy Heart Church Tour?
J. Nelson: You have to be culturally sensitive and attuned to the needs of the community. For the initiative, we have health care providers facilitate a presentation about heart disease prevention and then we provide a healthy meal for church members. As a long-time resident of Rome, I am well-connected with church leaders and familiar with the meals that churches serve. We could not completely scratch out their meals because they were not healthy. If we did, no one would participate. We had to think about how to make their favorite meals healthier to keep them engaged.
P. Charvat: Having someone who represents and looks like the community that you are trying to serve is critical. Jackie’s input while partnering with the churches was really valuable. We learned that certain churches did not allow members to wear jeans or pants, so we were respectful of that culture, and made sure health care providers were aware. If we can find providers who speak the same language as the congregation or interpreters, we make sure to reach out to them for their participation, as well.
What is the hardest thing about engaging with community members? How do you navigate this challenge?
J. Nelson: Communication, collaboration, and coordination are key components of this work. For example, the New York Department of Health wanted to support older adults getting vaccinated in Rome and established a vaccine clinic at a local community college on a Sunday. Unfortunately, buses do not operate on Sundays, so a couple of colleagues and I had to drive and pick up the seniors from their homes to get them to the vaccination clinic. The event was advertised as a drive-through clinic so we assumed that the older adults would be able to get vaccinated in the car, which would make it easy for those who have limited mobility. But we quickly learned that the seniors had to go into the building for the vaccination. I called the sheriff’s office to see if they could help us to get the seniors into the building. Thankfully, they were extremely helpful. Because there was not much communication and collaboration between the state officials and the local community, there were challenges that could have been avoided. Working together is critical.
P. Charvat: Having enough staff to accommodate all the events has been a challenge. We have community health nurses and navigators but are also reaching out to volunteers to support this work. We don’t want to turn down an event because of capacity, so we are focused on creating a bigger army of people who can help. We also believe that this is not a competition, and that joining forces with other organizations to meet community needs is important.
What impacts on health equity have you seen through this work?
J. Nelson: The communities that we work with are frequently forgotten and disenfranchised. We get phone calls from people thanking us because they finally feel seen, and they are getting needed resources. For example, one of the church members received a blood pressure screening and learned that his blood pressure was high. The nurse connected him to a primary care provider. The following week, he went to the physician and was diagnosed with high blood pressure. He received medication and was so grateful that he attended the informational session and presentation – he had no idea that he had this condition. We know that the tour is having a positive impact in the community, and we are grateful for the partnership we have with Mohawk Valley Health System to make this a reality.
P. Charvat: Knowing what the community needs helps us to be strategic. Currently, we see an opportunity to work with our rural populations and migrant workers who have health challenges. Utica has a large population of refugees and immigrants. We work closely with The Center, a resource center for refugees that provides resources and support to this population, such as adult learning classes, employee and workforce development, immigration and citizenship assistance, and health care education.
There are documented instances of marginalized communities experiencing racism by health care systems, which creates mistrust. What advice would you give to health care organizations to better build trust and ensure that patients’ voices are valued and integrated in systemic change?
J. Nelson: Health care organizations need to be sincere in this work, because once they lose trust with the community, it is very hard to get it back. When one patient has a bad experience, it spreads like wildfire through the community. One way health care organizations can help to build trust in the community is developing patient and family advisory councils. These councils can help bring community voice into health care settings to strengthen relationships between residents and the health care organization, which can be a very helpful strategy to better engage with patients.
P. Charvat: Partnership is key because community-based organizations know their residents and how to navigate challenges. Health care organizations need training and education about diversity, equity, and inclusion. We also have to do a better job in making sure that our staff resemble the population that we are serving. Navigators and bilingual speakers are critical – even promotional materials should be culturally appropriate. We have an obligation to keep the community healthy, and that is what health care organizations should strive to do every day.