Mayo Clinic, Jacksonville, FL, USA.
Mayo Clinic, Rochester, MN, USA.
J Prim Care Community Health. 2022 Jan-Dec;13:21501319221133076. doi: 10.1177/21501319221133076.
The COVID-19 pandemic has disproportionally affected historically marginalized populations and their access to resources and healthcare. In times of crisis, authentic community engagement is more important than ever. This study was Phase 1 of a larger 3-phase study to conduct timely community-engaged research with community members to understand the disproportionate impact of COVID-19 on historically underserved communities. The objective of this work was to conduct key informant (KI) interviews (1) to understand community organizations perspectives about the role that large academic health centers play as they interface with community organizations to support their work, (2) to leverage KI's expertise to identify needs and assets within the community, and (3) to inform both Phase 2 (focus group qualitative research) and Phase 3 (survey) of the broader study.
A total of 24 key informants were identified through purposeful sampling and one-on-one semi-structured interviews were conducted across 4 states using video conferencing.
Barriers to access and lack of transparency were highlighted as major issues requiring reform-in particular, aggressive billing practices and insurance barriers exacerbated local distrust of medical institutions. KIs recognized the health institution's support for testing and vaccination during the COVID-19 pandemic, but noted other significant gaps in care, especially regarding mental health support. Although communication with the health institution was consistent for some KIs, others experienced unsustained communication efforts that hindered cooperation and relationship building.
Leaders in the community as key stakeholders can provide unique insights into the challenges and potential solutions required to promote health equity, and foster understanding between local communities and healthcare institutions.
COVID-19 大流行不成比例地影响了历史上处于边缘地位的人群及其获取资源和医疗保健的机会。在危机时期,真正的社区参与比以往任何时候都更加重要。这项研究是一个更大的 3 阶段研究的第 1 阶段,旨在与社区成员进行及时的社区参与研究,以了解 COVID-19 对历史上服务不足的社区的不成比例影响。这项工作的目的是进行关键知情人(KI)访谈:(1)了解大型学术医疗中心在与社区组织合作以支持其工作时所扮演的角色,社区组织的观点;(2)利用 KI 的专业知识确定社区内的需求和资产;(3)为更广泛研究的第 2 阶段(焦点小组定性研究)和第 3 阶段(调查)提供信息。
通过有针对性的抽样确定了总共 24 名关键知情人,并在 4 个州使用视频会议进行了一对一的半结构式访谈。
准入障碍和缺乏透明度被强调为需要改革的主要问题-特别是,激进的计费做法和保险障碍加剧了当地对医疗机构的不信任。知情人认识到医疗保健机构在 COVID-19 大流行期间对检测和疫苗接种的支持,但指出了其他重大的护理差距,特别是在心理健康支持方面。虽然一些知情人与医疗保健机构的沟通是一致的,但其他人经历了沟通努力的不持续,这阻碍了合作和关系的建立。
作为利益攸关方的社区领袖可以提供独特的见解,了解促进公平和促进当地社区与医疗机构之间相互理解所需的挑战和潜在解决方案。