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Creating customized approaches for communities in the fight against COVID-19

To mitigate risk of COVID-19, two University of Minnesota (UMN) researchers are analyzing factors such as race, economic stability, living environment, education, and more to get a more comprehensive, holistic picture of health. They’ll be collecting data from individuals receiving care from local clinics and hospitals, and using that self-reported data to understand hidden strengths and needs of the most vulnerable. 

Results will be shared with M Health Fairview, a local healthcare system and key stakeholder. This will help the healthcare system better respond to underrepresented, under-resourced patients during the COVID-19 crisis. Better understanding how COVID-19 is affecting patients can aid in developing personalized approaches to infection prevention and holistic health care. 

Identifying social determinants

For this project, researchers Drs. Karen Monsen and Robin Austin are using the MyStrengths+MyHealth mobile app they created. The app is designed for individuals, families, and communities to self-identify strengths, challenges, and needs. 

The MyStrengths+MyHealth app leverages the rigor of the Omaha System (Martin, 2005), a multi-disciplinary, standardized approach for addressing health across four domains with 42 discrete concepts. Using the app, users take surveys with these domains and concepts embedded. 

Surveys use terminology that’s simple and accessible to both the general public and experts. For example, when the UMN Clinical and Translational Science Institute (CTSI) supported the researchers’ efforts to use the app to address opioid use in the community, researchers refined the app to add specific questions related to opioid use and stigma. This included adjusting the survey to describe the issues in their terms. For one community, this meant describing the issue in terms of heroin or OxyContin, not opioids. They also recognized that for many communities of color, opioid issues were often considered normal, not part of an epidemic. 

They’ll use data to uncover similar community-specific nuances and perceptions with their COVID-19 project. Researchers are asking participants their zip code, how many people they may come in contact with, and how many people they live with. This data will provide insights into potential contact data. The data can then be aggregated by zip code to show community-level strengths, challenges, and needs. 

Responding to patients’ unique needs and strengths

Insights from the survey can help determine each patient’s unique needs, strengths, and assets, and be used to inform community and health system policy decisions. 

Within M Health Fairview, this information will be key to understanding the COVID-19 responses that are needed. For example, income and mental health challenges may underlie much of the risk-taking behaviors of patients amid COVID-19 pandemic, while relationships strengths may protect from risk. But most risk assessments do not assess these and other critical areas. 

Aggregate data will provide an overview of patient needs as well as their perceived strengths, while individual patient reports will be available for clinical conversations and care planning. 

Engaging communities in research

For the opioids-focused project, after communities used the app to participate in surveys, researchers presented their data to the communities who’d participated. Researchers described a common theme of adverse feelings toward opioid use, noting how communities had seen the dangers of opioids and were looking for alternative solutions. 

Drs. Monsen and Austin have similar plans to share insights and findings from their COVID-19 research, and increase knowledge about an important health issue. The researchers’ preliminary conversations with communities around COVID-19 have focused on the central role of faith communities to patient wellbeing, even while safety issues around church attendance pose challenges for community connections and must be addressed. To the researchers, it’s important to focus on the strengths in these communities, not just the challenges. 

By engaging individuals and families, they hope to facilitate deeper levels of participation in care and provide a foundation for personalized and collaborative care.

A complete data-driven picture, including community strengths, can also inform community, stakeholders, and policy decisions. This data is essential to connect individuals with vital healthcare and basic needs resources during this pandemic and inform clinical care. It can also advise policy makers about allocating essential life-protecting resources, such as PPE, basic needs, and mental health care in the community. 

Supporting underserved and vulnerable communities

Many of CTSI’s funding programs strive to foster collaboration between university researchers and underserved and vulnerable communities, and ensure they have access to information and research about important health issues.

The primary purpose of the grant the researchers received for the opioid project is to foster community-university research engagement and mutual learning to improve community health. The idea for the grant itself came from a community member who wanted Minnesotans to have more access to University researchers. With support through that program, the researchers began what would become an effective, sustainable research collaboration with the Hue-MAN Partnership, which seeks to improve health and healthcare for racial and ethnic minority communities that experience significant disparities, and Black Nurses Rock.

About two years later, the researchers pivoted to focus on using the app to confront the COVID-19 pandemic. CTSI quickly supported the effort with funding through its COVID-19 Rapid Response Seed Grant program.

By providing critical funds to the MyStrengths+MyHealth app, CTSI is supporting communities so they can tackle health issues to make a difference in their own way. Considering the growing body of evidence suggesting that underserved and vulnerable populations are more susceptible to COVID-19 infection, funding community-centric approaches has the potential to make a real impact in people’s lives.