“A lot of collaboration,” Garcia Rico said with a tired laugh. “It’s hard to list them all and to mention everyone.”
To reach residents, the Department of Health and Human Services used some familiar tactics: There were bilingual ads on TV, radio and social media, virtual town halls, posting on Facebook Live.
But it also did something more creative.
A DHHS project, called Healthier Together, paid community health workers in each of North Carolina’s 100 counties to get the message out. Those boots-on-the-ground workers built on their existing relationships, in this case their relationships with Latino residents, to improve the group’s access both to information about the vaccine, and to the shot itself.
Garcia Rico, and others in the field, attribute much of the credit for the group’s high vaccination rate to these community health workers.
“We started the initiative to support organizations on the ground that were already doing a lot of work,” Garcia Rico said. By tapping into existing community networks and providing local people already in positions of trust with the money and logistical support to help residents learn about vaccines and schedule appointments, the agency was able to avoid wasting time and duplicating resources.
And that resulted in more shots into more arms more quickly.
Also, almost half of the community health workers are bilingual, which Garcia Rico said proved to be critical.
Norma Martí is the co-leader for the Latinx Hispanic Community Response Team, a project of the North Carolina Community Engagement Alliance funded through the National Institutes of Health. One of the group’s end goals is to improve vaccine equity in the state. Martí has worked closely with DHHS throughout the pandemic to distribute supplies and information to the state’s Latino community.
“Getting the messaging out was probably the hardest thing, because with social media, people get all this … misinformation,” Martí said. Part of the challenge, also, is that much of North Carolina’s Latino community lives in rural areas. Hispanic residents make up between 16 and 23 percent of the population in Duplin, Sampson, Lee, Greene and Montgomery counties.
In June 2020, DHHS announced it would award $100,000 each to five different organizations that worked closely with Latino residents in different parts of the state. That project, in many ways, laid the groundwork for the partnership with community health workers.
The NIH approved funding for Martí's group in the winter of 2021. She and the other leaders looked across the state, aiming to ensure each region was represented, and brought 10 Latino North Carolinians together. They began strategizing on how best to reach people in different parts of the state.
“Their position was, ‘We need to talk about the myths. We need to do some mythbusters,’” Martí said. “People are hearing this, and you’ve got to tell them, ‘No, this isn’t right.’’”
So, Martí and the other leaders went to work.
Over the last year, the group has created animated myth-busting videos in English, Spanish and Zapoteco, an indigenous language spoken in Mexico. They seem to have been effective, and the group is working on creating a Mayan language version.
‘Win the confidence’
Martí believes that general barriers to care can help explain why there was a lag in vaccine uptake at the beginning by Latino residents.
“We don’t have access, as a people, to health systems,” she said. “Latinos are the least insured in the state.” According to the Census Bureau, about 31 percent of Latino residents in North Carolina do not have health insurance.
“When we heard about vaccines, we’re like, ‘Well, it’s not for us because we don’t have health insurance …,” Martí said. “It took a lot of time for those community health workers to get into those communities to get the word out to, to win the confidence again.”
Martí and Garcia Rico both said there’s no silver-bullet reason for why the vaccination rate of Hispanic residents looks as good as it does now.
It’s the result of lots of work and lots of investment that has built up over the months.
“I do think, really, truly in my heart, it was that combination of collaboration,” Martí said.
Clarissa Donnelly-DeRoven, writes for North Carolina Health News. This story comes through our partnership with the Solutions Journalism Network, a nonprofit organization dedicated to rigorous reporting about social issues. It originally appeared online here.