Denise Octavia Smith, MBA, CHW, PN, is the founding Executive Director of the National Association of Community Health Workers (NACHW) . In September 2020, Mrs. Smith joined the Office of Minority Health (OMH) for a virtual symposium highlighting state, tribal, territorial, and community-based efforts to address COVID-19 among racial and ethnic minority and American Indian and Alaska Native populations.
OMH is focused on the success, sustainability, and spread of health equity-promoting policies, programs, and practices. As part of its blog series, “Advancing the Response to COVID-19,” OMH followed up with Mrs. Smith to discuss how NACHW’s strategy and efforts have evolved since her presentation in September 2020, including leveraging cultural and linguistic competency to address COVID-19 misinformation and addressing the lack of mental health resources for CHWs.
What role has cultural and linguistic competency played in the COVID-19 impact on minority communities?
We should consider that, during this global pandemic, many of the systems, sectors, and providers needed to prevent, diagnose, or treat infection were not initially designed to benefit the diverse communities now living in the United States. Thus, when we see significant disparities in COVID infections and deaths, and in the other impacts of COVID-19, such as layoffs from work, lack of internet access, food insecurity, and the rise in mental health symptoms, we understand that each of these is made worse when the systems and sectors designed to help people in a crisis are difficult to access or inaccessible due to lack of language diversity or cultural competency, prejudice, or bias.
How has NACHW addressed the lack of culturally appropriate materials and access to basic needs since you presented at the OMH Virtual Symposium in September 2020?
NACHW has a diverse membership representing many different languages, ethnicities, and cultures. When the pandemic began, NACHW recognized the need for culturally and linguistically appropriate materials. We consulted with a team of Spanish speakers from a variety of cultures and national backgrounds to review our translations and endorse them.
In the spring of 2020, with the rise of community and physical violence against Asian American and Pacific Islander (AAPI) communities, we responded by partnering with organizations representing these languages, ethnicities, and cultures to develop materials to stop AAPI hate and to provide support for these community members. In January 2022, we partnered with the White House to help roll out covidtest.gov , focusing our efforts on marginalized communities and culturally and linguistically diverse community-based organizations, including translating our website and materials into Chinese, Spanish, Haitian Creole, Arabic, and Korean languages.
How has NACHW addressed misinformation and distrust within the communities you serve?
NACHW has been on the front lines of amplifying the roles, capacity, and leadership of our profession in addressing misinformation and distrust during and before the COVID-19 pandemic. CHWs work in many different sectors and many different programs providing factual information and educating people about risk factors, diagnoses, or treatments. We regularly address the misinformation that we know the community may have based on what they have heard or read about a risk factor, disease, treatment, program, or organization. We respond with compassion, patience, and determination to provide individuals and families with the factual information they need to make decisions to protect themselves and their families.
It is because we share the lived experience, culture, faith, language, or even the same diagnosis as many of the people we serve that we have trusting relationships that help us break down barriers of communication, address stigma, shame, and low literacy, and get to the heart of the issue.
Now that vaccines are recommended for anyone age 5 and over, how have you evolved your messaging and community initiatives to ensure you’re reaching the various age groups?
NACHW is a co-founding organization of the Vaccine Equity Cooperative (VEC) , launched in October 2020, to provide access to data, strategy, and resources that are developed and endorsed by community-based organizations and workforce members.
The VEC facilitated a diverse working group of subject matter experts to produce a set of detailed recommendations for the equitable distribution of COVID-19 vaccines to children ages 5 to 11 years old . These recommendations were shared at the highest levels, with the White House and several federal agencies, and also distributed to community-based organizations and CHWs, so that they would have access to clear, actionable recommendations that they could apply to their state, county, or local levels.
What are some ways that community health workers have addressed the lack of mental health support for themselves since you presented at the OMH Virtual Symposium in September 2020?
NACHW confirmed in the early months of COVID-19 that our members were experiencing emotional burden, mental stress, anxiety, and frustration when many of the families and communities they served began to suffer from unemployment, food insecurity, threats of eviction, rising rates of domestic violence, loss of health insurance, and other impacts from COVID-19.
NACHW surveyed our national membership in 2020 to understand their mental health needs and looked across the country to identify what CHWs were doing in response. We found that CHWs were developing online support groups for themselves and their clients. They were developing training to help other CHWs recognize the signs and symptoms of stress, and how to respond to and make referrals.
In 2021, NACHW developed national learning collaboratives after consulting with our members so that CHWs could come together in different cultural, experiential, or language groups to discuss their mental health challenges and get support and strategies from mental health experts.
Watch Mrs. Smith’s original virtual symposium presentation on OMH’s YouTube Channel.
Learn more about Cultural and Linguistic Competency and the National CLAS Standards.