Using Public Health Detailing to Increase Access and Confidence in COVID-19 Vaccines and Reinvest in Disproportionately Impacted NYC Communities.

CONTEXT: COVID-19 vaccination rates in New York City (NYC) began to plateau in the spring of 2021, with unacceptable inequities in vaccination rates based on race. PROGRAM: To address racial inequities in vaccination rates and COVID-19 health outcomes, the New York City Department of Health and Mental Hygiene adapted a preexisting provider outreach and education program for public health emergency use with the goals of community reinvestment and increasing patient confidence and access to the COVID-19 vaccines. The Vaccine Public Health Detailing (VPHD) program was delivered as part of a larger community outreach initiative and brought timely updates, materials, and access to technical assistance to primary care providers and staff in NYC neighborhoods experiencing COVID-19 health inequities. Outreach representatives also collected feedback from providers on resource needs to inform the agency's response. IMPLEMENTATION: Sixteen outreach representatives were rapidly trained on COVID-19-related content and strategic communication techniques and launched a 3-wave campaign across targeted neighborhoods throughout NYC. The campaign ran from May 2021 to March 2022 and was conducted in coordination with other community engagement initiatives aimed at the general public to promote greater collective impact. EVALUATION: In total, 2873 detailing sessions were conducted with 2027 unique providers at 1281 sites. Outreach representatives successfully completed visits at more than 85% of practices that were in scope and operating. Approximately 20% (285) of the sites requested a referral for technical assistance to become a COVID-19 vaccination site or enroll in the Citywide Immunization Registry. Qualitative information shared by providers offered a more in-depth understanding of vaccine-related sentiments and challenges faced by providers on the ground. DISCUSSION: VPHD is an effective method for supporting community providers, gathering feedback on resource needs and practice challenges, and increasing health systems efficacy during a public health emergency while also prioritizing racial equity and community reinvestment.

Public health detailing of primary care providers: New York City's experience, 2003-2010.

OBJECTIVES: We evaluated the effectiveness of the Public Health Detailing Program in helping primary care providers and their staff to improve patient care on public health challenges. METHODS: We analyzed reported changes in clinical practice or behavior by examining providers' retention and implementation of recommendations for campaigns. RESULTS: During each campaign, 170 to 443 providers and 136 to 221 sites were reached. Among assessed providers who indicated changes in their practice behavior, the following statistically significant increases occurred from baseline to follow-up. Reported screening for clinical preventive services increased, including routinely screening for intimate partner violence (14%-42%). Clinical management increased, such as prescribing longer-lasting supplies of medicine (29%-42%). Lifestyle modification and behavior change, such as recommending increased physical activity to patients with high cholesterol levels, rose from 52% to 73%. Self-management goal setting with patients increased, such as using a clinical checkbook to track hemoglobin A1c goals (28% to 43%). CONCLUSIONS: Data suggest that public health detailing can be effective for linking public health agencies and their recommendations to providers and influencing reported changes in clinical practice behavior.

Public health detailing of primary care providers: New York City's experience, 2003-2010.

BACKGROUND: Given evidence of widespread underuse of recommended clinical preventive services and chronic disease management, New York City developed the Public Health Detailing Program, a primary care provider outreach initiative to increase uptake of best practices on public health priorities. PURPOSE: The goal of the study was to evaluate the effectiveness of the Public Health Detailing Program in helping primary care providers and their staff to improve patient care on public health challenges. METHODS: An analysis was conducted of reported changes in clinical practice or behavior by examining providers' retention and implementation of recommendations for campaigns. RESULTS: During each campaign, 170 to 443 providers and 136 to 221 sites were reached. Among providers who responded to questions on changes in their practice behavior, the following significant increases occurred from baseline to follow-up. Screening for clinical preventive services increased, including routinely screening for intimate partner violence (14%-42%). Clinical management increased, such as prescribing longer-lasting supplies of medicine (29%-42%). Lifestyle modification and behavior change, such as recommending increased physical activity to patients with high cholesterol levels, rose from 52% to 73%. Self-management goal-setting with patients increased, such as using a clinical checkbook to track hemoglobin HbA1c goals (28% to 43%). CONCLUSIONS: Data suggest that public health detailing can be effective for linking public health agencies and their recommendations to providers and influencing changes in clinical practice behavior.