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

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          Abstract

          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.

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          Most cited references12

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          Report of Health Care Provider Recommendation for COVID-19 Vaccination Among Adults, by Recipient COVID-19 Vaccination Status and Attitudes — United States, April–September 2021

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            The Neighborhood as a Unit of Change for Health: Early Findings from the East Harlem Neighborhood Health Action Center

            Place-based approaches have been promoted as one way to reduce health inequities by addressing community-level factors that shape health, such as housing quality, healthcare systems, the built environment, and social capital. In 2016–2017, the NYC Health Department’s Center for Health Equity launched three Neighborhood Health Action Centers (Action Centers), which use a place-based approach to improve health in neighborhoods with disproportionate burdens of premature mortality. We describe this approach and the genesis of the Action Centers. We then describe the East Harlem Action Center, which was the first to open, and share findings from qualitative interviews with the East Harlem Action Center’s Governance Council, a group comprised of Action Center staff and co-located partners and programs which supports Action Center coordination. Interviewees felt that collaboration, being responsive to community needs, and being community based were essential elements of the Action Center. Interviewees recognized the complex dynamic of a large city agency serving as the host for the Action Center while simultaneously aiming to establish more equitable relationships with partners. Governance Council members’ expectations and hopes for the East Harlem Action Center were consistent with the overall vision and model for the Action Centers, which may facilitate implementation.
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              Public Health Detailing: A Strategy to Improve the Delivery of Clinical Preventive Services in New York City

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                Author and article information

                Contributors
                Journal
                J Public Health Manag Pract
                J Public Health Manag Pract
                JPUMP
                Journal of Public Health Management and Practice
                Wolters Kluwer Health, Inc.
                1078-4659
                1550-5022
                March 2024
                23 October 2023
                : 30
                : 2 , Communicable Diseases
                : 168-175
                Affiliations
                Center for Health Equity and Community Wellness, New York City Department of Health and Mental Hygiene, Queens, New York (Mss Shabbat, Dresser, Petrsoric, and Bhatnagar Ansari and Dr Morse); and Harvard Medical School, Boston, Massachusetts (Dr Morse).
                Author notes
                [*] Correspondence: Nina Shabbat, MPH, Public Health Detailing Program, New York City Department of Health and Mental Hygiene, 42-09 28th St, Queens, NY 11101 ( nshabbat@ 123456health.nyc.gov ).
                Author information
                https://orcid.org/0009-0008-8339-9147
                https://orcid.org/0009-0006-4565-8553
                Article
                jpump3002p168
                10.1097/PHH.0000000000001819
                10833189
                37874972
                98ea8ad3-08bc-4ddd-a450-4b587d7ffdd4
                © 2023 City of New York. Published by Wolters Kluwer Health, Inc.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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                Categories
                Research Reports
                Practice Full Report
                Custom metadata
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                TRUE

                community outreach,covid-19 vaccination,detailing,health equity,provider education,provider outreach

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