A COVID-19 vaccination clinic held at Temple University.
Ryan S. Brandenberg

As COVID-19 cases alarmingly continue to rise again throughout the country, Temple University is undertaking a comprehensive community initiative designed to address vaccine hesitancy in underserved populations across Pennsylvania.

Temple's COVID-19 Trauma-Informed Workforce Initiative Fund is focused on improving health outcomes among racial and ethnic minority groups, English language learners, and vulnerable populations, including older adults, adults with intellectual and other disabilities or chronic conditions in communities throughout Pennsylvania. The fund is supported by a $5.5 million grant from the Health Resources and Services Administration (HRSA), part of the U.S. Department of Health and Human Services.

"We've been hearing a lot about vaccine hesitancy locally and nationally. The country has hit a plateau in terms of the number of people getting vaccinated," said Link Martin, Director of Temple University Harrisburg Campus. "With the Delta variant and potentially others that may arise down the road, we knew Temple could help."

According to Martin, when he, Shirley Moy, Executive Director of Temple's Lenfest Center for Community Workforce Partnerships, and Kathleen Reeves, MD, Chair of the Department of Urban Health and Population Sciences at the Lewis Katz School of Medicine and Director of Temple's Center for Bioethics, heard about the available federal funds, "we thought that this may be an opportunity to address issues in micro-communities that have been overlooked or have not had access to the vaccine or perhaps just have not been addressed in a way that will overcome their hesitancy."

"We saw that this funding seemed very flexible and would allow us to do some creative things in a very short period of time," he said. "We put together a concept, submitted it and, luckily, they thought our concept was worth funding. I think it is one of 10 or 12 projects nationally being funded."

Moy, Reeves, and Martin are overseeing the COVID-19 Trauma-Informed Workforce Initiative Fund at Temple. The fund will "prioritize communities that have endured long-standing systemic health and social inequities, such as those who have limited access to healthcare, face discrimination, live in crowded conditions and poverty, experience education, income, or wealth gaps, and work in settings that put them at higher risk of COVID-19 exposure," said Moy.

"The idea behind is that there are populations of people that have either decided not to get the vaccine in addition to a group of people who are considering getting it or simply haven't decided. For people that are hesitant, we want to be able to help them make an informed decision about whether getting any of the vaccines is right for them," she said. "One way we want to make sure we can give them the information they need is having credible messengers — people in their communities whom they trust — receive training and correct information about the vaccines that they can impart within the community."

In our local communities "there are a number of skilled individuals who have the credibility to engage with their neighbors, ensuring accurate information about the vaccine is shared so people can make the best decision on the vaccine," said Dr. Reeves.

"Additionally, the program helps to build transferable skills for these community members that will benefit their potential for career growth in the years to come," she said.

Community, Moy said, "is not necessarily defined by geography."

"It could be defined by other characteristics, such as language — people might not be receiving the information they need to make an informed decision because of communication barriers. Community could be defined as shared life experience. For example, someone working with people who are homeless are in a better position to share information with that population," she said. "The idea is that people who are representative of a particular community are in a better position to talk with community members about their concerns, about the real facts around the COVID vaccine. Maybe it is as simple as determining where to go to get the shot or it could be that where they've been told to go is not accessible to them and they need help determining an alternative."

According to Martin, $3.5 million of the funds will be allocated to community partners. Thirty-four such partner organizations have been approved across the state.

"We reached out to a wide range of community organizations and agencies and asked for concept papers on what they can do between now and November — how could they have an impact on their target communities," he said. "Dr. Reeves, will be overseeing the trauma-informed training. Temple University Harrisburg Campus is overseeing the virtual Community Health Worker training program. We're also managing the professional development components that are being created — in-service training around COVID vaccine hesitancy and some trainings that will be developed with this micro-community focus."

Training will be conducted "to help people understand how to engage community members in a way that is culturally appropriate and sensitive in addition to trauma-informed training to recognize that these folks that we're mostly dealing with or want to impact are people that are vulnerable," said Moy.

"We sought non-profit organizations that have credible and trusting relationships with the communities," she said. "Ultimately, the goals are to prevent COVID-19 transmission, increase vaccine access and decrease vaccine hesitancy, by supporting a community-based workforce that is able to address concerns, build vaccine confidence, and help make the vaccine readily available."

Moy said Temple is "excited about the model that we have developed and the response we have received so far."

"For us, it's about barrier removal. Community organizations are tapping into our barrier removal fund by going into Cousins Supermarket in North Philadelphia to make the vaccine shots available when people are shopping," she said. "These initiatives are designed to be very community-oriented and centered on helping people make an informed choice while reducing the barriers to getting the vaccine."

At selected nonprofit partner organizations, the funding will support a staff position, or positions, "that will devote their time over the next several months toward engaging their community around vaccine hesitancy; developing projects, which could be anything from a street fair or talks in community groups or churches," said Martin.

"It's about reaching out in a way that's appropriate for that target community. That allows these community groups to have people paid for through this grant who will be trained by us to become community health workers armed with knowledge about vaccine hesitancy and trauma-informed approaches," he said. "We're seeing that in some communities both individuals and groups of people may be hesitant about vaccines because of personal trauma or community trauma related to the medical establishment."

In November, according to Martin, Temple will host a conference that will invite all the partner agencies to share what they have learned — "what we can do better, not only for this pandemic, which of course is not over, but for future pandemics."

"Our anticipated outcome is that we will have around 70 individuals based in community agencies that have gotten this intensive training over the next few months. They will be working in their communities and we hope to see vaccination rates increase in these locations — the ultimate outcome is that we reduce the hesitancy around COVID-19 vaccines," he said. "One of the unique things about this project is we intentionally chose rural counties and counties within the urban Philadelphia area so that we can compare and contrast results. With our various locations — Temple Main Campus, Harrisburg, Ambler, Center City — we are in a unique position to provide resources to communities throughout the state."

Visit there for more information about the COVID-19 Trauma-Informed Workforce Initiative Fund.