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Communicating with Minorities and Underrepresented Groups · The SHEA Podcast

• 0:09
  SPEAKER_01: Welcome back to our multi-part podcast series, Communication in the Age of Fake News, brought to you by the Society for Healthcare Epidemiology of America, SHA, promoting the prevention of healthcare associated infections and antibiotic resistance and seeking to advance the field of healthcare epidemiology and antibiotic stewardship.
• 0:27
  SPEAKER_01: This series will focus on how to gain and maintain public trust while messaging throughout a changing health crisis, describing the impact of social media on public perception of health information and vaccine uptake and how to communicate effectively with groups of people for whom mainstream communication may not be effective.
• 0:44
  SPEAKER_01: I am Dr.
• 0:45
  SPEAKER_01: Jennifer Hanrahan, infectious disease specialist at the University of Toledo, and I will serve as your moderator.
• 0:50
  SPEAKER_01: Discussion on the podcast does not reflect Shay's perspective, but facilitates communication of multiple perspectives and experiences on a topic that is becoming more important than ever.
• 1:00
  SPEAKER_01: Shay is excited to launch the final episode of the podcast series, Communicating with Minorities and Underrepresented Groups.
• 1:07
  SPEAKER_01: Today, we're pleased to have three fantastic speakers on the podcast.
• 1:11
  SPEAKER_01: First is Marilee Santiago.
• 1:14
  SPEAKER_01: Marilee is a licensed social worker and a public health educator.
• 1:17
  SPEAKER_01: She has 10 years' experience addressing social determinants of health with diverse populations, with her specialty serving people living with HIV AIDS.
• 1:26
  SPEAKER_01: She carries a master of social work and a master of public health through Baldwin Wallace University with a focus in education.
• 1:32
  SPEAKER_01: An avid learner, she's passionate about helping improve the lives of the Latinx community where she was raised in Cleveland, Ohio.
• 1:38
  SPEAKER_01: Mary Lee provides expertise in educating the community on public health awareness and providing access to healthcare by addressing the underlying social, economic, and political causes of poor health.
• 1:49
  SPEAKER_01: She believes in having a strong commitment to community participation, providing access to economic opportunity, and education can create health equity for all.
• 1:58
  SPEAKER_01: She currently serves as the Director of Transformative Knowledge and Education for Metro Health's Institute for Hope.
• 2:04
  SPEAKER_01: In her role, she provides leadership in developing an organizational and community culture equipped with knowledge, resources, and systems inspired and empowered to address social determinants of health.
• 2:14
  SPEAKER_01: Marie Lee also manages a community partnership addressing digital literacy in a local underserved community surrounding Metro Health Maine campus.
• 2:23
  SPEAKER_01: Next is Pastor Gerard Duncan.
• 2:25
  SPEAKER_01: Pastor Duncan is a senior pastor of Prayers by Faith Ministries in Gainesville, Florida, and president of Innovative DADS Incorporated.
• 2:33
  SPEAKER_01: He has been instrumental with grassroots community engagement while developing and organizing programs for underrepresented and marginalized communities where health inequities and disparities exist.
• 2:44
  SPEAKER_01: For over the past 15 years, Pastor Duncan has served as a community engagement liaison with the University of Florida administration, faculty, staff, and students through research and pilot initiatives with the goal of revitalizing communities, creating opportunities for stakeholders and community organizations to collaborate on education and life enrichment to achieve measurable outcomes for sustainability.
• 3:06
  SPEAKER_01: Most recently, Pastor Duncan has been a community champion for assisting with the COVID-19 testing, vaccine clinics, and community town hall efforts, in which he has been greatly connecting the health department and the University of Florida Shans Hospital screen, test, and protect with local churches to ensure equitable distribution of vaccines in the most vulnerable and hesitant communities.
• 3:28
  SPEAKER_01: Pastor Duncan is a member of the Governor's Faith-Based State Community Advisory Board, former member of the United Way of North Central Florida, and a past chair of the Family Jobs Committee Gainesville for All.
• 3:39
  SPEAKER_01: In addition, he is a member of UFIFAS Extension, Alachua County Advisory Committee, the UF Strategic Jury Award Committee, City of Gainesville Strategic Planning Committee, the Department of Juvenile Justice Faith Network, Santa Fe College Community Advisory Board, and the Gainesville Thrives Board.
• 3:59
  SPEAKER_01: And finally, Sheikh Nuru Mohammed.
• 4:01
  SPEAKER_01: Mr.
• 4:02
  SPEAKER_01: Mohammed is the Minister of Religion at Alabas Islamic Center in Birmingham, United Kingdom.
• 4:07
  SPEAKER_01: He is also the co-chair and national trustee at Citizen UK, a people power alliance of diverse local communities working together for the common good.
• 4:16
  SPEAKER_01: And finally, he is a member of the Places of Worship COVID-19 National Task Force in the United Kingdom, working with the UK to develop and oversee plans to help safely reopen places of worship in the country.
• 4:28
  SPEAKER_01: Thank you all for joining us today.
• 4:30
  SPEAKER_01: We're happy to have you on the podcast.
• 4:31
  SPEAKER_01: We look forward to a fantastic conversation.
• 4:34
  SPEAKER_01: And I know that our listeners will learn a lot from each of you.
• 4:37
  SPEAKER_01: So to start off with, can you each provide some background of your work and experiences around communicating with different racial, ethnic, cultural groups around science, healthcare, and vaccinations?
• 4:49
  SPEAKER_01: And we'll go ahead and start with Mar Lee.
• 4:52
  SPEAKER_00: Yeah, certainly.
• 4:53
  SPEAKER_00: Thank you, Dr.
• 4:54
  SPEAKER_00: Hanorhan, for allowing us to be part of this conversation today.
• 4:59
  SPEAKER_00: I would say with the work that I have been doing as a social worker in my tenure, I have focused on ways to widen the socioeconomic gap, racism, and discrimination that contribute to inequitable distribution of health care and mental and physical health disparities among Latinos and other people of color and those that are in poverty, especially now during the time of COVID as a leader in transformative education.
• 5:27
  SPEAKER_00: And then some of the work that I have done is on a multidisciplinary team basis.
• 5:32
  SPEAKER_00: So the work that focuses on people living with HIV and serving the Latinx community, identifying some of the care gaps and providing access is key to the work that I have really contributed to.
• 5:46
  SPEAKER_00: I would say that creating that cohesive culture of health equity is another way that I have been able to educate others and work together for marginalized individuals and to ensure that each person has a fair and have an opportunity for health and wealth, as well as an equitable access to basic resources that requires the goal to achieve the best equity for individuals that may be impacted by some form of a chronic illness, such as HIV and AIDS and others like diabetes that impact highly within the Latinx community.
• 6:22
  SPEAKER_01: Thank you.
• 6:22
  SPEAKER_01: And Pastor Duncan, can you give us a little bit of your background?
• 6:27
  SPEAKER_02: Yes.
• 6:28
  SPEAKER_02: Good morning and thank you, Dr.
• 6:29
  SPEAKER_02: Haran, and greetings to everybody.
• 6:32
  SPEAKER_02: Yes, so I've been working over the last 15 years primarily inside of the marginalized communities.
• 6:40
  SPEAKER_02: Mainly, I started through community engagement outreach through my church, mission work.
• 6:46
  SPEAKER_02: And I recognize disparities within the community.
• 6:49
  SPEAKER_02: And so I've always looked at ways to provide the resources that would be able to empower the community.
• 6:58
  SPEAKER_02: And so I connected with our local higher education health department because I seen a gap in services as well as a duplication of services.
• 7:09
  SPEAKER_02: I'm a big data person.
• 7:10
  SPEAKER_02: And so when I looked at the statistics within our community, recognized that there were large proportions through minority groups, Latino and African American group, that were being marginalized and disparity gaps all across the board.
• 7:28
  SPEAKER_02: Locally, in our state, Florida, our city ranks in the top 10 as the highest disparity inequity, as well as several zip codes in our area where primarily minority population exists, where there are food deserts.
• 7:44
  SPEAKER_02: And so wherever there is poverty and food deserts, you're going to find health disparities and inequities as well.
• 7:51
  SPEAKER_02: And because I was someone who was very prone to community engagement, I seen it firsthand.
• 7:58
  SPEAKER_02: And so I opted to stop attending meetings where stakeholders were with resources, were trying to find ways to be able to go in to those communities.
• 8:08
  SPEAKER_02: And I knew that they needed liaison.
• 8:10
  SPEAKER_02: And so I developed those for relationships, organized community events for health, for food insecurities, as well as education.
• 8:19
  SPEAKER_02: And relationships began to establish through those particular organizations that had the resources.
• 8:25
  SPEAKER_02: So we realized that it was a disconnect between the organization that had resources and the community that needed the resources.
• 8:31
  SPEAKER_02: And so I was a catalyst of being able to be a grassroot leader into the community and provide a mean of trust between the community and those and those outside organizations to bring them inside the community so that we would be able to measure how we would be able to revitalize those communities and help all of our city and our county individuals that we felt was being left behind, that they would be able to be privileged or have access and inclusion to a better quality of life.
• 9:03
  SPEAKER_01: Thank you, Pastor Duncan.
• 9:04
  SPEAKER_01: Sheikh Nuru Mohammed, can you tell us a little bit about your work?
• 9:08
  SPEAKER_03: Good morning, everyone.
• 9:09
  SPEAKER_03: Thank you so much for having me.
• 9:11
  SPEAKER_03: It's indeed a great pleasure and honor to be part of this very important conversation.
• 9:16
  SPEAKER_03: As you heard, my dear brothers and sisters, my name is Sheikh Noor Mohammed.
• 9:20
  SPEAKER_03: I am the Minister of Religion at Al-Abbas Islamic Center based in the UK.
• 9:26
  SPEAKER_03: My community is mainly made up of people of Pakistani and Indian origin, and it is made up of about 2,000 members.
• 9:35
  SPEAKER_03: I supported and helped my mosque to be the first mosque through the United Kingdom to be converted into a vaccination hub.
• 9:45
  SPEAKER_03: And really the success of this project was the communication style we adopted.
• 9:52
  SPEAKER_03: Especially me being at the helm in the Minister of Religion, people normally look up to me.
• 9:59
  SPEAKER_03: When we converted the center into a vaccination hub, there were so many conversations within the community.
• 10:06
  SPEAKER_03: Some were for it and some were totally against it.
• 10:10
  SPEAKER_03: So what I did as a minister of religion was to try as much as I can to tailor my communication to the level of my people for them to be able to grasp and understand the reason as to why we opted to convert the mosque into a vaccination hub.
• 10:30
  SPEAKER_03: Number one, I used my Friday sermon platform.
• 10:35
  SPEAKER_03: Each and every Friday, I would spend like two, three minutes and send a powerful message on the importance of health and the sanctity of health and how dangerous coronavirus is and the need to serve the wider community in trying to contribute our culture towards the fight against this pandemic.
• 10:58
  SPEAKER_03: In addition to that, we also translated the COVID-19 messages from public health England into the languages that our people are comfortable with, i.e., Urdu, Gujarati, Arabic, and other languages.
• 11:17
  SPEAKER_03: And this really helped a lot in getting people on board, in getting people approving, converting our mosque into a vaccination hub.
• 11:28
  SPEAKER_03: And that has really helped.
• 11:30
  SPEAKER_03: Number two, as you heard earlier on, my dear brothers and sisters, I'm a co-chair and a national trustee at Citizens UK.
• 11:39
  SPEAKER_03: What we did at Citizens UK was to partner with the Birmingham City Council here in the UK to record some small videos in different languages to reach out to people about COVID-19.
• 11:55
  SPEAKER_03: So we made a video in Urdu in Eritrea language because at Citizens UK we deal with people from different backgrounds, people from Jamaica, people from different parts of Africa, Nigerian languages.
• 12:09
  SPEAKER_03: So we translated so many information into these languages, and this really helped us to reach out to so many people.
• 12:16
  SPEAKER_03: And last but not least, I'm also a member of the West Midlands Combined Authority Faith Strategic Group.
• 12:24
  SPEAKER_03: And I'm the deputy of the mental health steering committee.
• 12:29
  SPEAKER_03: Mental health, according to some, which is unfortunate, is a taboo subject.
• 12:35
  SPEAKER_03: So what we normally do is to tailor our communication in such a way that people do understand it.
• 12:41
  SPEAKER_03: So at the West Midlands Combined Autology, we also translated information from the medical experts into the languages that people are comfortable with.
• 12:52
  SPEAKER_03: And that has really helped for people now to accept the reality that mental health is not a taboo, it's not a myth.
• 13:00
  SPEAKER_03: It's something which is with us, and we need to do something about it.
• 13:06
  SPEAKER_03: So, in short, I played my role as a minister of religion, as a trustee, as a coach, as a member, to reach out to people in a very simple language they are comfortable with.
• 13:19
  SPEAKER_01: Thank you so much, Sheikh Mohammed.
• 13:21
  SPEAKER_01: Thank you all for all the important work that you're doing.
• 13:24
  SPEAKER_01: I have to say I'm incredibly impressed by the breadth and wealth of experience that you all bring to this conversation.
• 13:31
  SPEAKER_01: So, Sheikh Mohammed, you certainly answered why it's important to have health messages tailored for different groups.
• 13:38
  SPEAKER_01: What can healthcare workers be thinking about as we're trying to communicate and as we're trying to provide these messages?
• 13:44
  SPEAKER_01: Pastor Duncan?
• 13:46
  SPEAKER_02: Yes.
• 13:47
  SPEAKER_02: So, you know, what is important, and I wanted to definitely make sure that on this podcast and messaging is to really make clear as relates to minority populations, primarily African-American, and really being already affected by pre-existing or underlying health issues.
• 14:08
  SPEAKER_02: So historically, we understand that minority groups, per se, the African Americans has had reason to be hesitant or full of mistrust historically.
• 14:22
  SPEAKER_02: And so when I became involved with the COVID-19 testing, I wanted to be clear that this was an epidemic or this had become a pandemic that we had to make sure that the most affected population, being African-American, would be educated and we would be as culturally sensitive but very aware of how important it would be for that population to be tested and vaccinated.
• 14:54
  SPEAKER_02: And so when I became a part of UF Health Screen Test and Protect, primarily for the faith community, I recognized that the faith community was one of the most hesitant community itself because of our faith in God.
• 15:09
  SPEAKER_02: But I realized that there was a population within the faith community that was 65 and older that, you know, was more acceptive to the opportunity.
• 15:18
  SPEAKER_02: And so working with UF Health communication teams, we had to really be able to create material where we can bring awareness.
• 15:27
  SPEAKER_02: And because I was not fearful of the COVID testing or COVID vaccine, and I know how important my voice and my influence was in the community, I became a COVID and vaccine champion.
• 15:41
  SPEAKER_02: And I was able to use my face on material that I would present out to different congregations and other fake leaders that eventually they accepted.
• 15:52
  SPEAKER_02: And it was one of those things as a, well, we trust him.
• 15:56
  SPEAKER_02: So if he's doing it, you know, we'll do it.
• 15:59
  SPEAKER_02: But it did not come without a lot of you know backlash because, you know, again, African American community, you know, we we've had many reasons from the Tuskegee experiment and you know, such and so.
• 16:14
  SPEAKER_02: And that was the major focus and conversation, you know, they're trying to kill us, you know.
• 16:19
  SPEAKER_02: But then when I looked at the statistics and I seen more, you know, white Americans, you know, taking the vaccines, I was like, well, I mean, they won't be trying to kill themselves, you know.
• 16:29
  SPEAKER_02: And because I was working closely with, you know, health professionals and one, you know, Dr.
• 16:36
  SPEAKER_02: Cindy Prims and Dr.
• 16:38
  SPEAKER_02: Mike Lozato, you know, I trusted these health, you know, professionals.
• 16:42
  SPEAKER_02: And, you know, these are my friends.
• 16:43
  SPEAKER_02: And so it worked well with me to be able to be vaccinated.
• 16:47
  SPEAKER_02: Matter of fact, I was vaccinated by Dr.
• 16:50
  SPEAKER_02: Lozato.
• 16:51
  SPEAKER_02: And so I wanted to make sure that the same vaccine that he took, I ought to take it too.
• 16:56
  SPEAKER_02: And so what we did is we created material that would be relevant to the Hispanic and African American community because we recognized, you know, through statistics, that those were the population that was mainly affected.
• 17:12
  SPEAKER_02: And because we were in a pandemic, we had to create content where we were able to get that content out in a way to where it brought a light to, you know, images of different cultures and different ethnic groups that was taking the vaccine.
• 17:28
  SPEAKER_02: And as because of that, you know, I believe that we seen a large proportion in our statistics of African American and Latinos, you know, being able to take the vaccine.
• 17:39
  SPEAKER_02: But it was all through our communications.
• 17:41
  SPEAKER_02: We communicated in a way to where, you know, our team was able to create content and be able to put out a social media.
• 17:48
  SPEAKER_02: And as more pastors and leaders and community leaders became more comfortable, we began to use their image.
• 17:54
  SPEAKER_02: We began to use their face on material and we put out in the community.
• 17:58
  SPEAKER_02: And so when we went out of the community, we did pop-up clinics at churches and at community centers, people were more, you know, receptive to be able to.
• 18:07
  SPEAKER_02: And so I think telling the message, you know, through the health community, and and one of the things about it is a lot of times, and I say this with no pun intended, you know, the ad council has information out.
• 18:19
  SPEAKER_02: The American Cancer Center has information out, but a lot of the information is not culturally sensitive, right?
• 18:26
  SPEAKER_02: You can't use words as, you know, the black community, right?
• 18:31
  SPEAKER_02: And so when you put that information out, you know, it's like to an already hesitant group, it's almost like, okay, you're already marginalizing us in this material.
• 18:43
  SPEAKER_02: And is this some type of another case study?
• 18:45
  SPEAKER_02: Is this another Tuskegee experiment?
• 18:48
  SPEAKER_02: So we had to, for those of us that believe that we believed in the science, and in no way eliminated our faith in God, but we believed that God also created the knowledge and wisdom of scientists, specifically scientists who, you know, who have faith themselves.
• 19:08
  SPEAKER_02: And so when we tailored those messages, those messages, you know, through that steering committee, they were very receptive because we were the ones in the community.
• 19:17
  SPEAKER_02: We were the ones who accessed, and Sheikh Muhammad said, you know, well trusted.
• 19:23
  SPEAKER_02: We were very well trusted.
• 19:24
  SPEAKER_02: And so our voices were being heard.
• 19:27
  SPEAKER_02: And so, as we were able to be a part of the creative content, we were able to help create very culturally sensitive and relevant material to get out in barbershops and hair salons and community centers and grocery stores and churches and all of these places where our faces were on, and then people began to be more receptive because they trusted their leaders and they felt like if they received the vaccine or they took the vaccine, you know, and they're still alive and they haven't grown any wings yet or haven't grown a tail yet, then it must be fine.
• 20:02
  SPEAKER_01: Pastor Duncan, thank you so much.
• 20:04
  SPEAKER_01: What I hear you saying is that healthcare professionals should be working with a lot of other people, not just sending messages out, but actually making sure that the message is coming through community members who are trusted.
• 20:18
  SPEAKER_01: So I think that's incredibly important information.
• 20:21
  SPEAKER_01: Sheikh Mohammed, you're nodding.
• 20:22
  SPEAKER_03: Yeah, thank you so much, Pastor Duncan.
• 20:25
  SPEAKER_03: I think you've literally mentioned what really I wanted to say.
• 20:30
  SPEAKER_03: I just want to add one or two things here.
• 20:32
  SPEAKER_03: You know, it's important the health messages are tailored for different groups.
• 20:38
  SPEAKER_03: And this is because health is central to our health.
• 20:41
  SPEAKER_03: Whatever we do in life, you know, it's pivotal.
• 20:44
  SPEAKER_03: Without health, we can't move, nothing will move.
• 20:48
  SPEAKER_03: And so it is important when we give messages regarding health, the aim has to be for the message to bring about change in people's lives.
• 21:00
  SPEAKER_03: When we give those messages out there and there are no positive changes, it becomes sort of a waste of time.
• 21:09
  SPEAKER_03: So, what should we be thinking about as health professionals when you go out there to give those messages?
• 21:15
  SPEAKER_03: Number one, think of people's cultural background is crucial.
• 21:21
  SPEAKER_03: Two, their religious background is very, very important.
• 21:25
  SPEAKER_03: Number three, think of their social status, crucial.
• 21:29
  SPEAKER_03: Which level of society are they and where do they live, what's happening there?
• 21:35
  SPEAKER_03: Number four, think of their financial status, that's also crucial.
• 21:40
  SPEAKER_03: And then, of course, last but not least, make sure their message is related to people because people will only accept their message and take it on board if they find it relating to them.
• 21:54
  SPEAKER_03: And how do we make sure it is related?
• 21:57
  SPEAKER_03: It is only when they see people.
• 22:00
  SPEAKER_03: Who consider them as part of them giving those messages to them?
• 22:06
  SPEAKER_03: And so it's important we consider these things that I've just mentioned if we truly want to bring it about positive change.
• 22:13
  SPEAKER_01: Thank you, Sheikh.
• 22:14
  SPEAKER_01: Merilie, would you like to give your perspective?
• 22:18
  SPEAKER_00: Yeah, I think that they've mentioned a lot that goes on hand in hand with the Latinx community, Hispanic community.
• 22:25
  SPEAKER_00: We want to make sure that we use clear and accessible messaging is really important as a first way to build that trust by using that clear and accessible messaging.
• 22:35
  SPEAKER_00: And one of the things that we did, or one of the initiatives that I took on as a leader, was making sure that we were on the forefront as a healthcare institution, that we were recognizing that the messaging that was coming across was tailored in a language that individuals that we serve understood.
• 22:55
  SPEAKER_00: And then making sure that the messaging was tailored to the health literacy that the population that we serve was understood.
• 23:02
  SPEAKER_00: So I thought that was really important and not second-guessing, but really relying on those Hispanic faith leaders and holistic leaders on making sure that we tailored the messaging appropriately and that we made sure that it was at a level where it wasn't offending individuals.
• 23:25
  SPEAKER_00: So oftentimes healthcare professionals need to understand or be clear that the information should not be in a chemical term, a form of messaging, and explain it where it's too technical because it can come off as offensive, right?
• 23:42
  SPEAKER_00: And it can be, it can minimize empathy to your patient and to your community members.
• 23:48
  SPEAKER_00: It was important for us to provide that consistency to ensure that the readers weren't confused or felt conflicted with the messages.
• 23:57
  SPEAKER_00: We provided the clarity and transparency in every messaging that we did was really, really important.
• 24:03
  SPEAKER_00: Another component that was really important for the Latino community was making sure that we met them where they were.
• 24:12
  SPEAKER_00: So during this time of the pandemic, still folks highly rely on Facebook and Facebook Live.
• 24:18
  SPEAKER_00: So we have the connection with the Mexican Consulate of Detroit.
• 24:22
  SPEAKER_00: So our window of health program, Ventanilla de Salud, has been on the forefront of making sure that each week they would invite different experts within the field of infectious disease to provide clear messaging to our audience, to the Latino community.
• 24:38
  SPEAKER_00: And that was an effective way to really get the messaging out and with factual information and minimize the misinformation.
• 24:47
  SPEAKER_00: And then another way that we leveraged the communication was addressing the digital divide.
• 24:53
  SPEAKER_00: We are working diligently in making sure that my chart and telehealth is accessible in Spanish and it is in a way where marginalized populations that may not have access to internet connectivity devices and education that we are working diligently on that.
• 25:09
  SPEAKER_00: And then I also worked with my prior connection and background in infectious disease.
• 25:14
  SPEAKER_00: I was able to leverage the healthcare experts of different providers in our infectious disease department to provide an external facing community virtual event that was recorded and then promoted on Facebook to really ensure that we were providing the right messaging and the clear messaging and show that we are an institution that cares.
• 25:37
  SPEAKER_00: So I think those are many ways that we made sure and or or that is key to the messaging within the Spanish-speaking population.
• 25:46
  SPEAKER_01: I think you have all provided so much information.
• 25:49
  SPEAKER_01: I actually feel like this conversation actually should go on for hours because it's so important.
• 25:55
  SPEAKER_01: There are a lot of things that, you know, clearly I think people are not thinking enough about.
• 26:00
  SPEAKER_01: And thank you so much all for sharing this information with us.
• 26:03
  SPEAKER_01: And Marilee, you actually just mentioned one of the significant barriers, I think, in communication, the digital divide.
• 26:11
  SPEAKER_01: So how do we go about overcoming some of these things?
• 26:15
  SPEAKER_01: Shaykh Mohammed, can you comment on that?
• 26:18
  SPEAKER_03: Yes, thank you.
• 26:19
  SPEAKER_03: Definitely the first barrier is language.
• 26:22
  SPEAKER_03: It's very, very important.
• 26:24
  SPEAKER_03: And we've seen it during this COVID-19, that the general population, when you go to them with the language, they understand, they find it appealing and they take it very seriously.
• 26:34
  SPEAKER_03: They may understand English, they may speak English.
• 26:37
  SPEAKER_03: Some of them may be working using English.
• 26:40
  SPEAKER_03: So first significant barrier is language.
• 26:43
  SPEAKER_03: Second significant barrier is to assume that whatever we put on our website is read and understood by all at the expense of other very important social media platforms, like WhatsApp.
• 26:58
  SPEAKER_03: We've not used WhatsApp the way it's supposed to be used in disseminating important messages.
• 27:05
  SPEAKER_03: Those spreading fake news, most of them are using WhatsApp.
• 27:09
  SPEAKER_03: And we are using our website, you know, Instagram, you know, Twitter.
• 27:14
  SPEAKER_03: Majority of our population are not on these platforms.
• 27:18
  SPEAKER_03: And so I found just focusing on some social media platforms without making the best out of WhatsApp is a big barrier.
• 27:30
  SPEAKER_03: And we need to do something about it.
• 27:32
  SPEAKER_03: We need to have WhatsApp platforms as health professionals.
• 27:36
  SPEAKER_03: If you truly want to reach to the wider society or reach out to the wider society, and another barrier to me, really, which is significant, is to allow only and only professionals to do the talk, or if you like, the elite to do the talk.
• 27:55
  SPEAKER_03: You know, if you look go to the wider communities, they've got their hierarchies there.
• 28:00
  SPEAKER_03: It's important we sort of give these hierarchies information, such as pastors, such as the leaders of their community, educate them a little bit and let them do the talk.
• 28:11
  SPEAKER_03: People will find it more appealing.
• 28:15
  SPEAKER_03: And so this is what I thought I should add here.
• 28:19
  SPEAKER_01: Meriley, did you want to add anything about barriers in communicating to different groups?
• 28:25
  SPEAKER_00: Yeah, definitely.
• 28:26
  SPEAKER_00: I think that as I mentioned, the digital divide is significant, one of the highest on the end of the digital divide here in Cuyahoga County.
• 28:35
  SPEAKER_00: So there is a large effort among hundreds and hundreds of stakeholders that and funders that are seeing this as being a priority, especially during this time of COVID, where we need to really uplift our communities of color by providing them with access.
• 28:52
  SPEAKER_00: And I think access is truly key in supporting that access.
• 28:55
  SPEAKER_00: As healthcare professionals, I know that oftentimes we can be exhausted, but it is critical if you are feeling frustrated on why your patients are not coming in here or may be hesitant on receiving the vaccine.
• 29:11
  SPEAKER_00: We want to make sure that our local leaders in our health institutions are being intentional about providing COVID vaccine access in settings such as community events, different church settings at local and community schools, because that is really where we're going to be effective and then do that hand in hand with providing low-cost internet.
• 29:34
  SPEAKER_00: It should be just viewed as a utility for us at this point because it is a necessity on our day-to-day.
• 29:42
  SPEAKER_00: And it is really important that we truly find, you know, those trusted messages in the community on how we can best serve and be effective in addressing the communication barriers that we are coming across with marginalized groups.
• 29:57
  SPEAKER_01: Thank you.
• 29:58
  SPEAKER_01: Pastor Duncan, what is your take on the barriers in communicating?
• 30:02
  SPEAKER_02: Yes, I found it very interesting at the height of the COVID vaccine vaccinations that as population and demographics begin to change as it relates to the white Americans and African Americans, I seen a stagnant number in Latino.
• 30:24
  SPEAKER_02: In our area, we have migrant workers.
• 30:28
  SPEAKER_02: And migrant workers who have really been marginalized themselves in rural areas.
• 30:37
  SPEAKER_02: And so I had a concern about being able to see those numbers change because I started seeing African-American numbers turn when it came to receiving the vaccine.
• 30:45
  SPEAKER_02: And so the Hispanic numbers didn't change.
• 30:48
  SPEAKER_02: And so one of the barriers was engagement for the migrant community.
• 30:52
  SPEAKER_02: We are a welcoming city, but there's still some hesitation as it relates to, you know, documentation.
• 30:59
  SPEAKER_02: And so we had to make sure that we created some type of content and reach those particular migrant workers with our mobile outreach clinic.
• 31:09
  SPEAKER_02: Many of those rural areas don't have access.
• 31:13
  SPEAKER_02: So we had to meet them where they were.
• 31:15
  SPEAKER_02: Another barrier was when we began to start registering groups for the vaccine, there was an overwhelming amount of Hispanic community members that were contacting me.
• 31:25
  SPEAKER_02: They had no English.
• 31:27
  SPEAKER_02: And so I had a hard time trying to find someone who could be able to help.
• 31:31
  SPEAKER_02: And so we were able to find someone who were able to digitally just through cell phones, you know, text the information to where we were able to register them.
• 31:41
  SPEAKER_02: So there are quite a bit of barriers, even with the Haitian community.
• 31:45
  SPEAKER_02: We have an Asian community as well.
• 31:47
  SPEAKER_02: We had to create content for the Haitian community as well, because there were a large proportion of Haitian community members themselves that didn't know English.
• 31:56
  SPEAKER_02: And so we had to create content for them as well.
• 31:58
  SPEAKER_02: So those barriers, community engagement, is also the digital vibe, and even the mobile devices is something that we had been working on in order to make sure that everyone throughout our community had equal access to the vaccine.
• 32:13
  SPEAKER_01: Thank you.
• 32:14
  SPEAKER_01: How has COVID-19 revealed the communication disparities among these different groups?
• 32:19
  SPEAKER_01: And what should we be learning from this pandemic as it pertains to communication?
• 32:24
  SPEAKER_01: Marilee?
• 32:26
  SPEAKER_00: I think what's really brought that technology is a modality of communication that we truly need to leverage in order to ensure access.
• 32:38
  SPEAKER_00: So it needs to be considered as a social determinant of health, right?
• 32:42
  SPEAKER_00: So we can really change policy and push for change of policy so that everyone has equitable access to technology.
• 32:50
  SPEAKER_00: So individuals of all sorts can access their health care through telephone and or virtual care, but also understanding that this population may not want to use virtual care as their primary way of getting health, right?
• 33:05
  SPEAKER_00: So we can't just assume.
• 33:07
  SPEAKER_00: We want to make sure that we are asking the question of how would you like your visit to be.
• 33:12
  SPEAKER_00: And if transportation is a barrier, then we can then tailor the conversation to then drive them, if they're hesitant of receiving their health care virtually, we want to make sure that we're tailoring it so that we can try to get the communication so they understand and they feel empowered where they can truly access this resource and they're not pushing back necessarily because there may be some fear around that.
• 33:38
  SPEAKER_00: Also, too, with the hesitancy of the vaccine and tailoring that communication is again being transparent, being concise with how we're messaging to our patients that we're incorporating their religious beliefs, we're incorporating their holistic healing measures.
• 33:56
  SPEAKER_00: So for instance, in the Latino community, we are really big on certain concoctions that we put together, we consider as a way that it brings kind of healing to whatever pain or ailment that we have going on, such as VIX or an alcohol-based product that is used for like headaches or when you're not feeling well.
• 34:16
  SPEAKER_00: So as healthcare providers, we want to make sure that we're not debunking those holistic measures that our patients are presenting as part of their treatment plan, right?
• 34:27
  SPEAKER_00: So we want to make sure that we're incorporating that.
• 34:29
  SPEAKER_00: Whether if it's a hot water with lemon or having a tea that is a concoction of lemon, onion, and ginger and garlic that I've heard that makes folks feel better, but it's also making sure that they know that that is not the cure to COVID, but it could be incorporated along with other public health measures as a primary form of prevention, such as the vaccine.
• 34:53
  SPEAKER_01: Thank you, Marilee.
• 34:55
  SPEAKER_01: Pastor Duncan, can you tell us what you think about how COVID-19 has revealed communication disparities for different groups?
• 35:02
  SPEAKER_02: You know, as we talked about in the age of fake news, even now we're seeing in Florida, we have one of the highest, you know, variant rates in the country, right?
• 35:12
  SPEAKER_02: And so being able to really, you know, now, you know, communicate in a way to the hesitant group that are saying, well, we thought if you got vaccinated, then you wouldn't, you know, test positive, right?
• 35:26
  SPEAKER_02: And so, you know, I find myself now, and and Sheikh Muhammad says as well, if you're not an expert, you know, you shouldn't be speaking on these things.
• 35:34
  SPEAKER_02: But as much as I know as it relates to the vaccine and the effect it had on my life and those close to me, I believe that the COVID-19 revealed communication disparities among groups, specifically within the vaccinated group now and the vaccinated group now.
• 35:53
  SPEAKER_02: So now you're having the vaccinated group now being very, you know, concerned or cautious as it relates to the information that they're giving to the hesitancy group that question why they got the vaccine.
• 36:08
  SPEAKER_02: And so now, you know, we're seeing vaccinated people, you know, saying, well, I'm not even sure because I tested positive.
• 36:16
  SPEAKER_02: So I think COVID-19 really revealed, you know, communication disparities first amongst different ethnic groups, but more or less now amongst vaccinated groups.
• 36:27
  SPEAKER_02: And I believe that through the pandemic, what we should learn is, you know, how to be able to make clear, accessible information and education.
• 36:39
  SPEAKER_02: We have to educate, specifically with this new variant.
• 36:43
  SPEAKER_02: We have to educate.
• 36:44
  SPEAKER_02: I found myself the other day, someone was asking me a question about now, you know, who was hesitant for the last couple of months.
• 36:52
  SPEAKER_02: Now they want to be vaccinated and say, well, where do I get vaccination at?
• 36:55
  SPEAKER_02: You guys still doing vaccination?
• 36:57
  SPEAKER_02: And so I'm trying to call around, like, where to go at, right?
• 37:00
  SPEAKER_02: And so I think the COVID-19 it changes as you relate.
• 37:05
  SPEAKER_02: Do I go to CVS?
• 37:06
  SPEAKER_02: Do I go to Walgreens?
• 37:07
  SPEAKER_02: Do I go to Walmart?
• 37:08
  SPEAKER_02: And when you call these places, they're not doing walk-ins.
• 37:13
  SPEAKER_02: It's by appointment.
• 37:15
  SPEAKER_02: So I think a lot is changing, but where is this information centralized, you know, through a place where people can go and you can call, or if you have access to electronics, you could be able to, you know, reach the area of the place that you can get vaccinated or even get tested.
• 37:33
  SPEAKER_02: Right now, what we're doing now is there is a company that we're working with that's doing mobile testing.
• 37:39
  SPEAKER_02: They will come to you to get tested.
• 37:41
  SPEAKER_02: And so I think that the COVID-19 really revealed a lot of miscommunication amongst different groups, but now it is more highly amongst the vaccinated that they're confused about, you know, taking a vaccine.
• 37:56
  SPEAKER_02: But again, what we learned that even in the midst of it, of those who were vaccinated, just because you were vaccinated doesn't mean that you shouldn't still wear masks.
• 38:05
  SPEAKER_02: Didn't mean that.
• 38:06
  SPEAKER_02: So I think there's a lot of more communication and information that needs to go out.
• 38:10
  SPEAKER_02: And what we learn from it is we need to do more townhouse.
• 38:14
  SPEAKER_02: We need to do more education.
• 38:16
  SPEAKER_02: People need to be educated because there's still questions, and now I have questions that I'm concerned about that I want to be able to be ready to defend why I receive the vaccine and why, you know, I will even encourage those who are hesitant to receive the vaccine as well.
• 38:35
  SPEAKER_01: Yeah, you bring up a lot of important points, Pastor Duncan.
• 38:38
  SPEAKER_01: Sheikh Mohammed, what do you think we should be learning from this pandemic as it pertains to communication?
• 38:44
  SPEAKER_03: Yeah, I think the pandemic has really exposed the miscommunication that has been happening for many years, in the sense that if you look at our communication tools prior to the pandemic, we realized that it was only benefiting a few groups and not the wider groups.
• 39:03
  SPEAKER_03: And we've realized and seen this during this pandemic.
• 39:07
  SPEAKER_03: And I think the cause for this really is lack of balance between digital and in-person communication.
• 39:15
  SPEAKER_03: It is of great importance that in going forward we take these lessons that we've learned from this pandemic seriously, that in-person communication is equally important as digital communication.
• 39:43
  SPEAKER_03: So, therefore, for me, if you ask me what should the expert do, I will say to them humbly, do not underestimate in-person communication.
• 39:55
  SPEAKER_03: Go to people, have a webinar, talk to them, give them opportunities to ask whatever question they want to ask.
• 40:03
  SPEAKER_03: By so doing, you'll be appealing to their heart and they will be taking you seriously.
• 40:09
  SPEAKER_03: Before COVID, we were all in our comfort zones, if you like, and just tweeting and updating our website and thinking that people were getting it COVID as exposed to that.
• 40:23
  SPEAKER_03: That indeed there is communication inequality, and we cannot afford to go back to where we are.
• 40:32
  SPEAKER_03: So, in short, there must be a balance between in-person and digital communication.
• 40:39
  SPEAKER_01: Thank you so much.
• 40:40
  SPEAKER_01: Unfortunately, we don't have time to go through all of our questions.
• 40:44
  SPEAKER_01: I think you've all given us fantastic information.
• 40:47
  SPEAKER_01: Thank you, Marile, Pastor Duncan, and Sheikh Muhammad, for such a great conversation.
• 40:52
  SPEAKER_01: It was such a pleasure having you all on the podcast today.
• 40:56
  SPEAKER_01: As a reminder, this is the final episode of the series.
• 40:59
  SPEAKER_01: We hope you have enjoyed the conversations and taken away a lot of information that will help you with communication moving forward.
• 41:05
  SPEAKER_01: You can find more educational content like this podcast on Shay's online education center, Learning CE, at www.learningce.shayonline.org.
• 41:16
  SPEAKER_01: This concludes the final episode of the communication in the age of fake news series.
• 41:21
  SPEAKER_01: Thank you for tuning in.