Adaptation of a Community Clinical Linkages Intervention to the COVID-19 Pandemic: A Community Case Study
AffiliationMel and Enid Zuckerman College of Public Health, University of Arizona
Department of Mexican American Studies, University of Arizona
community health worker
community-based participatory research
MetadataShow full item record
PublisherFrontiers Media S.A.
CitationCoulter, K., Ingram, M., Lohr, A., Figueroa, C., Coronado, G., Espinoza, C., Esparza, M., Monge, S., Velasco, M., Itule-Klasen, L., Bowen, M., Wilkinson-Lee, A., & Carvajal, S. (2022). Adaptation of a Community Clinical Linkages Intervention to the COVID-19 Pandemic: A Community Case Study. Frontiers in Public Health, 10.
JournalFrontiers in Public Health
RightsCopyright © 2022 Coulter, Ingram, Lohr, Figueroa, Coronado, Espinoza, Esparza, Monge, Velasco, Itule-Klasen, Bowen, Wilkinson-Lee and Carvajal. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY).
Collection InformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at email@example.com.
AbstractIn this community case study, we describe the process within an academic-community partnership of adapting UNIDOS, a community health worker (CHW)-led community-clinical linkages (CCL) intervention targeting Latinx adults in Arizona, to the evolving landscape of the COVID-19 pandemic. Consistent with community-based participatory research principles, academic and community-based partners made decisions regarding changes to the intervention study protocol, specifically the intervention objectives, participant recruitment methods, CHW trainings, data collection measures and management, and mode of intervention delivery. Insights from this case study demonstrate the importance of community-based participatory research in successfully modifying the intervention to the conditions of the pandemic and also the cultural background of Latinx participants. This case study also illustrates how a CHW-led CCL intervention can address social determinants of health, in which the pandemic further exposed longstanding inequities along racial and ethnic lines in the United States. Copyright © 2022 Coulter, Ingram, Lohr, Figueroa, Coronado, Espinoza, Esparza, Monge, Velasco, Itule-Klasen, Bowen, Wilkinson-Lee and Carvajal.
NoteOpen access journal
VersionFinal published version
Except where otherwise noted, this item's license is described as Copyright © 2022 Coulter, Ingram, Lohr, Figueroa, Coronado, Espinoza, Esparza, Monge, Velasco, Itule-Klasen, Bowen, Wilkinson-Lee and Carvajal. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY).
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Protocol for LINKS (linking individual needs to community and clinical services): a prospective matched observational study of a community health worker community clinical linkage intervention on the U.S.-Mexico borderLohr, Abby M; Ingram, Maia; Carvajal, Scott C; Doubleday, Kevin; Aceves, Benjamin; Espinoza, Cynthia; Redondo, Floribella; Coronado, Gloria; David, Cassalyn; Bell, Melanie L; et al. (BMC, 2019-04-11)Background: Latinos are currently the largest and fastest growing racial/ethnic group in the United States and have the lowest rates nationally of regular sources of primary care. The changing demographics of Latino populations have significant implications for the future health of the nation, particularly with respect to chronic disease. Community-based agencies and clinics alike have a long history of engaging community health workers (CHWs) to provide a broad range of tangible and emotional support strategies for Latinos with chronic diseases. In this paper, we present the protocol for a community intervention designed to evaluate the impact of CHWs in a Community-Clinical Linkage model to address chronic disease through innovative utilization of electronic health records (EHRs) and application of mixed methodologies. Linking Individual Needs to Community and Clinical Services (LINKS) is a 3-year, prospective matched observational study designed to examine the feasibility and impact of CHW-led Community-Clinical Linkages in reducing chronic disease risk and promoting emotional well-being among Latinos living in three U.S.-Mexico border communities. Methods: The primary aim of LINKS is to create Community-Clinical Linkages between three community health centers and their respective county health departments in southern Arizona. Our primary analysis is to examine the impact of the intervention 6 to 12-months post program entry. We will assess chronic disease risk factors documented in the EHRs of participants versus matched non-participants. By using a prospective matched observational study design with EHRs, we have access to numerous potential comparators to evaluate the intervention effects. Secondary analyses include modeling within-group changes of extended research-collected measures. This approach enhances the overall evaluation with rich data on physical and emotional well-being and health behaviors of study participants that EHR systems do not collect in routine clinical practice. Discussion: The LINKS intervention has practical implications for the development of Community-Clinical Linkage models. The collaborative and participatory approach in LINKS illustrates an innovative evaluation framework utilizing EHRs and mixed methods research-generated data collection.