2021-04-28 HELP + NACHC

Owned by Sarah Price
Last updated: Apr 29, 2021
3 min read

Date

Attendees

NACHCHELP

Kathleen McNamara (Deactivated)

Sarah Price

Caryn Bernstein (Deactivated)

Wanda Montalvo (Unlicensed)


Susan Landskroener

Jim Lavery

Karen Andes

Lee Wilkers

Agenda

  1. Facilitator Model for AA, LATIN X and Native American   reflect communities of focus
  2. Proposal for patient recruitment:
    1. Homogeneous:  Let CHC's decide "who we are most concerned about"
      1. Denominator must be consistent for analysis across the groups
    2. Heterogeneous group could be the care team staff?  
    3. Consider context
      1.  Distrust already there and address it up front (i.e. inequity, lack of access to vaccines AND information)
      2. Include rural and urban communities
      3. Who is the patient's "community", not necessarily family
      4. Where do they get the information that they TRUST?  
  3. Strategy for rollout of an iterative process to inform
    1. Site by site (UGH)
    2. Cohorts of X with high risk groups
    3. Rolling cohorts
    4. Length of time between group meetings   (Model: 3 meetings of 3 different groups X 3)  Is this correct?
    5. Setting–no mixing of venues (ONLY virtual or ONLY in person)
  4. Feedback to health centers and patients
  5. Summary document of final findings… case study or?
  6. What is the end date?  July? August?

Discussion items

TimeItemWhoNotesAction Items/Decision tree/Key areas

  1. Facilitator Model for AA, LATIN X and Native American   reflect communities of focus
Jim

Model was originally a training model, but now moving to "coaching" model.  Work with teams that will be doing the design groups and iterate them. Initial meeting (role, products),  Health center led is key–they represent the community.  This is a "thought-partnership" approach.  

  • Decide logistics of these design sessions (will HELP teams take part or just get recordings??)

  1. Strategy for rollout of an iterative process to inform
    1. Site by site (UGH)
    2. Cohorts of X with high risk groups
    3. Rolling cohorts
    4. Length of time between group meetings   (Model: 3 meetings of 3 different groups X 3)  Is this correct?
    5. Setting–no mixing of venues (ONLY virtual or ONLY in person)
Jim/Kathy/Susan

Pace and scope of rollout, initial idea was 50 centers, but is infeasible.

Set-up

  1. City focus:  Start and stay in a city until we get a good sense of best practices.  I.e. Atlanta, number of different centers.
  2. Timeframe: hold sessions over 2-3 weeks in one city
  3. Preparation:  as we hold these sessions, plan for the next city (i.e. Detroit)–documents, logistics, etc ...

Design groups

  • 8-10 patients (b/c some may not show)
  • 3 groups at a time
  • Each groups meet twice

Characteristics:

  1. Group of those who HAVE been vaccinated....what messages made them get their vaccine?
  2. Hesitant (NACHC: maybe patients who have not vaccines at ALL)
  3. Middle group–vaccine skeptical/curious-- (NACHC: maybe patients from the same family—one vaccinated, one not)

Add

4.  Consider health care team group (they are the messengers)–front desk, security, etc.. not just clinicians. Could start here, then do design groups, then go back to staff (feedback mechanism)  

Beta-Testing

  1.  Is it feasible to get these groups?
  2.  What may we learn from each of these groups and is it important to keep them homogeneous to get the results?


Patient engagement during sessions: 

  • Questions re: vaccine or other areas surrounding care
  • Health center staff can answer these on point or during second session
  • Design–Inductive content during first session, more questions/answers during second session.

Guadalupe questions:

  1.  Structural (ID, where to go, access.)
  2. Explanatory issues (pregnancy, breastfeeding)
  3. Normalizing (worries, anxiety re: info)
  4. Persuasive–specific concerns (gov't testing, etc...) ) 
  • Identify health center coordinators and "coach" them at the same time?  Ideal to have coordinators from each site within a city, and give them the scope and overview.  









  • Health centers can find this easily through data or just identification b/c they know their patients.  Can run data:  vaccines, no shows, etc... and will also recognize those patients/families by name/behaviors










  • What can we do with these questions–both on point but also later as a collective (bigger lessons learned).  
  • Health centers have a lot of this information, so may not need to develop new messaging, but rather access to it
  • Remain aware of structural racism/barriers and access to vaccines (i.e. 1) GA–went to public health, not CHCs so lack of supply/access,   2) MI–only got J&J–patients feeling like they didn't get a choice =disregard →little uptake)

Health Center engagementKathy

Propose:

  1. Create profile
  2. Ask Health Centers what THEY want to know
  3. Start with Health Care Team design session


AnalyticsJim/Karen
  • Goal is to analyze answers and see what is useful to other parts of the country
  • Develop prototypes
  • Qualitative approach–will determine when done based on patterns and saturation (when not hearing new things anymore)


What is the end date?


HELP contract is: September 29th, 2021

NACHC contract is: August 1, 2022

Products at the end:

  • Clear articulation of the model  
    • NACHC will be writing a summary and sharing
  • Demonstration of the insights gained during this time
  • What it would take to replicate this model
  • Continuity
    • NACHC contract
    • Micro-lab curriculum? (Karen Andes with Coursera)



Next steps

  • HELP team to review NACHC "ask" document



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