The Perceptions and Lived Experiences of African-American Pastors at the Onslaught of the COVID-19 Pandemic in Mississippi.

The purpose of this phenomenological study was to explore perceptions and lived experiences of African-American pastors addressing the onslaught of COVID-19 with their congregation. Thirty-seven pastors representing various denominations from across Mississippi participated in semi-structured, in-depth interviews. From the data, five themes emerged including (1) Pastors' relentlessness, (2) Pastors' adoption of new technology, (3) Maximized social capital, (4) Unintended consequences resulting from COVID-19, and (5) Unintended benefits resulting from COVID-19.

Engaging African American Pastors in COVID-19 Research During a Pandemic: Lessons Learned.

African American pastors are recognized as trusted information sources for their communities. The pastors willing to address health-related concerns such as preventing the spread of the coronavirus are invaluable for leading their congregation through relevant health programs. Underlining the importance of religion, spirituality, and faith-based leaders in addressing and furthering health promotion research, the article discusses lessons learned during the study implementation and the recommendations for engaging minority pastors in research during a global health pandemic.

The Community Health Worker (CHW) Common Indicators Project: Engaging CHWs in Measurement to Sustain the Profession.

Despite progress in documenting the outcomes of Community Health Worker interventions, the lack of standardized measures to assess CHW practice has made it difficult for programs to conduct reliable evaluations, and impossible to aggregate data across programs and regions, impeding commitment to sustainable, long-term financing of CHW programs. In addition, while CHWs have sometimes been involved as data collectors, they have seldom been engaged as full partners in all stages of evaluation and research. This manuscript details the current work being done by the CI Project, demonstrating how CHWs are able to contribute to the integrity, sustainability, and viability of CHW programs through the collaborative development and adoption of a set of common process and outcome constructs and indicators for CHW practice and CHW program implementation.

Insights on COVID-19 From Community Health Worker State Leaders.

Community health workers (CHWs) leverage their trusting relationships with underresourced populations to promote health equity and social justice in their communities. Little is known about CHWs roles in addressing COVID-19 or how the pandemic may have affected CHWs' ability to interact with and support communities experiencing disparities. A focus group with CHW leaders from 7 states revealed 8 major themes: CHW identity, CHW resiliency, self-care, unintended positives outcomes of COVID-19, technology, resources, stressors, and consequences of COVID-19. Understanding the pandemic's impact on CHWs has implications for workforce development, training, and health policies.

Addressing the Social Vulnerability of Mississippi Gulf Coast Vietnamese Community through the Development of Community Health Advisors.

BACKGROUND: Resiliency is the ability to prepare for, recover from, and adapt to stressors from adverse events. Social vulnerabilities (limited access to resources, political power, and representation; lack of social capital; aspects of the built environment; health inequities; and being in certain demographic categories) can impact resiliency. The Vietnamese population living along the Mississippi Gulf Coast is a community that has unique social vulnerabilities that impact their ability to be resilient to adverse events. OBJECTIVES: The purpose of this project was to address social vulnerability by implementing and evaluating a volunteer Community Health Advisor (CHA) project to enhance community resiliency in this community. METHODS: A program implemented over 8 three-hour sessions was adapted from the Community Health Advisor Network curriculum that focused on healthy eating, preventing chronic conditions (hyperlipidemia, Diabetes, hypertension, cancer, poor mental health). Topics also included leadership and capacity development skills. RESULTS: Participants (n=22) ranged from 35-84 years of age. Most were female (63.6%), married (45.5%), unemployed (63.6%), had annual incomes of <$10,000, and had high school diplomas (68.2%). Community concerns were crime (50.0%), volunteerism (40.0%), language barriers (35.0%), and food insecurity (30.0%). Approximately 75% had experienced war trauma and/or refugee camps, and 10% had experienced domestic violence. Scores on the Community Health Advisor Core Competency Assessment increased from pre-test to post-test (t=-5.962, df=11, p<0.0001), as did SF-8 scores (t=5.759, df=17, p<0.0001). CONCLUSION: Strategies to reduce vulnerabilities in the Vietnamese community should include developing interventions that address health risks and strengths and focus on root causes of vulnerability.

Describing Vulnerability and Resiliency through Photovoice: Generational Perspectives from the Mississippi Gulf Coast Vietnamese Community.

The Mississippi Gulf Coast's Vietnamese community (MSGCVC) has repeatedly experienced physical, psychological, and economic hardship from natural and man-made disasters and economic downturn. Literature suggests that economic strain is the greatest contributor to Vietnamese population vulnerability. Previous literature focused on the aftermath of Hurricane Katrina, BP Deepwater Horizon oil spill, and urban communities. A photovoice project was conducted to measure causes and consequences of vulnerability and social resiliency by identifying sources of health strengths and health risks among individuals, families, and the community through generational and cultural perspectives. Content analysis was conducted to identify themes associated with vulnerability and resiliency and were subsequently grouped into six main categories. Findings will aid others exploring innovative approaches to addressing vulnerability and resiliency in underserved communities and applying photovoice as a research tool.

Investing in Gulfport: Development of an Academic-Community Partnership to Address Health Disparities.

BACKGROUND: Invest Health, a collaboration between the Robert Wood Johnson Foundation and The Reinvestment Fund, selected 50 midsized cities to participate in a health initiative that encourages cross-sector alliances to think creatively about mechanisms that address barriers to reducing health disparities among low-income populations. Gulfport, Mississippi, was 1 of 50 teams chosen to participate. OBJECTIVE: To develop an academic-community partnership among the University of Southern Mississippi, Coastal Family Health Center (CFHC), Mercy Housing and Human Development (MHHD), the Mississippi State Department of Health Office of Health Disparity Elimination, and Gulfport residents to create the Healthy Gulfport Initiative, and, ultimately, the Gulf Coast Healthy Communities Collaborative (GCHCC). METHODS: A Gulfport City team was developed per Invest Health guidelines and included five individuals who represented the public sector, community development, and an academic or health-related anchor institution in the community. Several data sources were used to develop city-wide priority health outcomes. A priority neighborhood experiencing health disparities related to the priority health outcomes was identified. A community-engaged needs assessment was conducted in the priority neighborhood. Residents were engaged in prioritizing the health, education, and activity needs of their community via a participatory nominal group process and survey data collection. RESULTS: Residents in the priority neighborhood lack access to health care and healthy food options owing to transportation difficulties and proximity to resources. CONCLUSIONS: The GCHCC will be established to act as a "backbone organization," so that a common agenda can be created with an emphasis on potential for collective impact.

Increasing Research Capacity in Underserved Communities: Formative and Summative Evaluation of the Mississippi Community Research Fellows Training Program (Cohort 1).

BACKGROUND: The Mississippi Community Research Fellows Training Program (MSCRFTP) is a 15-week program conducted in Jackson, MS, USA consisting of training in the areas of evidence-based public health, research methods, research ethics, and cultural competency. The purpose of the program was to increase community knowledge and understanding of public health research, develop community-based projects that addressed health disparity in the participants' community, increase individual and community capacity, and to engage community members as equal partners in the research process. METHODS: A comprehensive evaluation of the MSCRFTP was conducted that included both quantitative and qualitative methods. All participants were asked to complete a baseline, midterm, and final assessment as part of their program requirements. Knowledge gained was assessed by comparing baseline assessment responses to final assessment responses related to 27 key content areas addressed in the training sessions. Assessments also collected participants' attitudes toward participating in research within their communities, their perceived influence over community decisions, and their perceptions of community members' involvement in research, satisfaction with the program, and the program's impact on the participants' daily practice and community work. RESULTS: Twenty-one participants, the majority of which were female and African-American, completed the MSCRFTP. Knowledge of concepts addressed in 15 weekly training sessions improved significantly on 85.2% of 27 key areas evaluated (p < 0.05). Two mini-grant community based participatory research projects proposed by participants were funded through competitive application. Most participants agreed that by working together, the people in their community could influence decisions that affected the community. All participants rated their satisfaction with the overall program as "very high" (76.2%, n = 16) or "high" (23.8%, n = 5). CONCLUSION: The evaluation of the MSCRFTP demonstrates that participants have the necessary knowledge to engage as research partners, and the pilot projects provided an opportunity for application of this objective to be realized. Overall, the MSCRFTP was an intervention that assisted community members in identifying their communities' strengths and weaknesses, interpret knowledge in a meaningful way, and create a self-reflective community of inquiry for change.

Evaluation of a Health Education Intervention to Improve Knowledge, Skills, Behavioral Intentions and Resources Associated with Preventable Determinants of Infant Mortality.

Mississippi has the highest rate of infant mortality in the nation (9.3 infant deaths for 1,000 live births). A health disparity exists between white infants (6.2) and black infants (13.0). This project reports on the effectiveness of a pilot educational program, Healthy Moms and Healthy Babies, which sought to improve knowledge, skills, behavioral intentions and resources related to preventable determinants of infant mortality. A curriculum was developed and piloted with women who were currently pregnant, thinking of becoming pregnant or who had an infant <1 year old. Local Head Start Centers offered recruiting assistance and meeting space for the sessions. Six content areas were developed which addressed pre- and postnatal nutrition and physical activity, smoking, breastfeeding, maternal mental health and safe infant sleep. Sixteen objectives were evaluated to determine intervention effectiveness. Participants were very satisfied with the program overall. Fourteen of sixteen objectives were met. Unmet objectives were gaining the skill of interpreting a nutritional label (Objective 75.0%, Observed 71.4%) and being able to name five health benefits of breastfeeding (Objective 85.0%, Observed 81.0%). Future programs will incorporate participant feedback which included allowing more time to learn about interpreting food labels and addressing financial stress. Reducing preterm birth is a national public health priority. Addressing knowledge gaps through risk-reduction education may reduce behaviors associated with determinants of infant mortality such as low birth weight and preterm birth. Head Start Centers are convenient locations that can serve as hubs of education for the entire family. Addressing knowledge gaps through risk-reduction education and providing adequate resources for smoking cessation and lactation support may increase knowledge and skills and reduce behaviors associated with determinants of infant mortality such as low birth weight and preterm birth.

Addressing Breast Cancer Health Disparities in the Mississippi Delta Through an Innovative Partnership for Education, Detection, and Screening.

Projects to reduce disparities in cancer treatment and research include collaborative partnerships and multiple strategies to promote community awareness, education, and engagement. This is especially needed in underserved areas such as the Mississippi Delta where more women are diagnosed at regional and distant stages of breast cancer. The purpose for this project was to increase the relatively low screening rate for African American women in the Mississippi Delta through a partnership between the Mississippi Network for Cancer Control and Prevention at The University of Southern Mississippi, The Fannie Lou Hamer Cancer Foundation and the Mississippi State Department of Health to decrease health disparities in breast cancer through increased awareness on self-early detection methods, leveraging resources to provide mammography screenings, and adequate follow-up with services and treatment for abnormal findings. Through this collaborative effort, over 500 women in three rural Mississippi Delta counties were identified, provided community education on early self-detection, and given appointments for mammography screenings within one fiscal year.

Developing an evidence-based public health informatics course.

OBJECTIVES: This study assessed the need to develop a public health informatics (PHI) introductory course and determine contents of such a course. METHODS: Community assessments employing focus group interviews and an online survey were utilized to determine course need and content. RESULTS: Results revealed a need to provide PHI training to graduate public health students and suggested broad course content requirements. Results indicated lack of awareness of libraries and librarians as sources of public health information. CONCLUSIONS: A graduate PHI course was developed and delivered. Additionally, implementation of a subject guide increased the library's profile.

Community health workers then and now: an overview of national studies aimed at defining the field.

This article compares and contrasts 3 national studies of the US Community Health Worker (CHW) field spanning 15 years. Findings cover 4 areas of overlap among the 3 studies: CHW Demographics, Core Roles and Competencies, Training and Credentialing, and Career Advancement and Workforce Issues. Implications for the future development of research, practice, and policy are discussed. Authors observe that while health care reform has the potential for increasing funding and recognition of CHWs, it is essential that policies support the full range of CHW roles, including CHWs role as change agents, so that CHWs achieve their full potential to improve health outcomes, reduce health disparities, and work for social justice.

Getting on Target with Community Health Advisors (GOTCHA): an innovative stroke prevention project.

Health disparities along with insufficient numbers of healthcare providers and resources have created a need for effective and efficient grassroots approaches to improve community health. Community-based participatory research (CBPR), more specifically the utilization of community health advisors (CHAs), is one such strategy. The Getting on Target with Community Health Advisors (GOTCHA) project convened an interdisciplinary team to answer the call from 10 counties in the rural Mississippi Delta area of 'The Stroke Belt' to meet the region's identified health needs, and to impact the health of a disparaged state. This article explores this CBPR project including the community involvement strategies, innovative CHA training curriculum, evaluation plan, and implications to healthcare professionals, particularly nurses.

The community health advisor program and the deep South network for cancer control: health promotion programs for volunteer community health advisors.

The Community Health Advisor program is a proven, community-driven health promotion program that identifies and trains natural helpers who then seek to improve the health of individuals and their communities. This article details the basis of the Community Health Advisor model and describes early pilot programs in the Mississippi Delta. Also described is the formation of the Community Health Advisor Network, which provides technical assistance to Community Health Advisor programs and the proliferation of Community Health Advisor programs nationally. Specifically, details are presented of the modification of the model for the Deep South Network for Cancer Control and of early findings showing a decrease in health disparities in Alabama.