Refugee Health Ed Conference - Question and Answer

Transcript

• 00:00One issue that has come up in
• 00:02some of the earlier presentations
• 00:03this evening has been this issue
• 00:05of sort of digital literacy ANAN.
• 00:07Thinking about, you know,
• 00:09as you brought up Brita,
• 00:10you know with the on line vaccine scheduling,
• 00:13that's not necessarily going to be
• 00:14the ideal mechanism for refugees,
• 00:16but but for many other populations as
• 00:18well and in in my work with with sort
• 00:21of other members of the wine HH team,
• 00:23I've been really impressed to
• 00:24hear about what has been done.
• 00:26Sort of in a granular sense to try
• 00:29to reach out to folks who maybe.
• 00:31Not be the most digitally literate,
• 00:33and I was wondering if you could
• 00:35give some additional detail just
• 00:37about the phone
• 00:38scheduling and how that's been going,
• 00:40things sure absolutely.
• 00:41So, in addition to digital literacy,
• 00:42there's also the issue that
• 00:44there is a number of people with,
• 00:46you know where the English is,
• 00:48not their first language,
• 00:50and so that would also
• 00:51be very difficult to map.
• 00:53To navigate our site so
• 00:54the phone number to call,
• 00:56and I can also put it in the chat is 833.
• 01:00Ask why NHH and through that line.
• 01:02One people that live in those
• 01:05highly vulnerable zip codes are
• 01:07basically can be identified through
• 01:08our systems that they live in
• 01:11one of those areas and it can get
• 01:13prioritized for one of those slots.
• 01:15We also have a number of
• 01:17different languages that can be
• 01:19supported on the phone line,
• 01:20so that is a great way for folks to schedule.
• 01:24In addition,
• 01:25one thing I forgot to mention
• 01:27was that we have appointments
• 01:29through Connecticut 211 as well.
• 01:32And two,
• 01:32one one has access to not only
• 01:35only given appointments but a
• 01:37number of other number of other
• 01:39providers giving vaccines as well.
• 01:42And I know they have language services.
• 01:45Also community health workers
• 01:46can also schedule directly into
• 01:48our system and again for those
• 01:51highly vulnerable patients.
• 01:52So partnering with whether
• 01:55it's project access or other.
• 01:57Navigator Programs is another way that
• 01:59we can get people directly scheduled.
• 02:03Wonderful thank you.
• 02:04I just think it's amazing that
• 02:06you guys can identify somebody's
• 02:08location where they're coming
• 02:10from and actually target them for
• 02:13specifically reserved appointments.
• 02:14Technology is amazing.
• 02:17You know another question too and
• 02:19this could be for both of you,
• 02:21and since Jason you're involved at
• 02:23the state level is just in terms of
• 02:25thinking about the information that
• 02:27people need to provide when they
• 02:29are scheduling their appointments.
• 02:30I know that through the damn system
• 02:32on line you know it's it's sort of
• 02:34date of birth and maybe occupation.
• 02:36If that's your eligibility and
• 02:38Anet believe address and email
• 02:40address are part of that as well.
• 02:41I understand that when folks are signing
• 02:43up through the retail pharmacies,
• 02:45they may also have to provide
• 02:47some health information in order
• 02:49to register for the vaccine so.
• 02:50Just wondering if you guys are getting
• 02:52any feedback in terms of communities
• 02:54that may be let more reluctant to
• 02:56provide this kind of personal data to
• 02:58either the state or the health system.
• 03:00An answer.
• 03:00Any thoughts about that?
• 03:02Yeah, I'll offer a thought or two
• 03:04and then breeder can probably
• 03:06speak with more specificity at yes.
• 03:08And depending on the system,
• 03:10depending on how individuals
• 03:11are accessing vaccines,
• 03:12whether it's through the pharmacy clinics,
• 03:14whether it's through a health system,
• 03:16whether it's through a community clinic,
• 03:18there are different kinds of
• 03:19information required in some cases,
• 03:21part of sort of the medical prescreen
• 03:23to see whether individuals may be
• 03:25pregnant or have histories of allergies,
• 03:27things that help dictate issues
• 03:29around observation or additional
• 03:30information that might be shared.
• 03:31And also again, right.
• 03:33Some personal information to share,
• 03:34whether it's registration for email
• 03:36addresses or even at vaccination sites,
• 03:38vaccination providers can
• 03:39ask for identification,
• 03:40but it's been very clear at the state
• 03:42level and hopefully diffused all of the
• 03:44vaccination providers that they have.
• 03:46An ID can be asked for,
• 03:48but certainly 1 does not have to be
• 03:50presented and folks should not be turned
• 03:53away if they don't present identification.
• 03:55So really trying very hard to take
• 03:57down any barriers or concerns that
• 03:59might keep people away from the
• 04:01vaccination system even at the.
• 04:03I guess the theoretical expense
• 04:04that someone could could could
• 04:05could misrepresent their identity,
• 04:07and that's that's a trade off the states.
• 04:09Happy to make in order to ensure
• 04:10that folks don't feel concerned about
• 04:12privacy or personal information
• 04:13standing in the way of vaccination.
• 04:17Yeah, exactly, at least it you know Haven.
• 04:21In the scheduling process, you know
• 04:23there is some information that is asked,
• 04:26including insurance information.
• 04:27You don't need insurance to get a vaccine,
• 04:30and if people are uninsured like
• 04:33they absolutely will not get a bill.
• 04:36But if they are insured then we do billing
• 04:39administration fee to their to their payer.
• 04:42But don't ask for any additional
• 04:44money from the patient themselves.
• 04:46But yes, we also do have
• 04:49some information about.
• 04:51Allergies and other things to let us
• 04:53know how long the person needs to stay
• 04:56in the observation period afterwards.
• 04:58So certainly you know some
• 05:00of these questions,
• 05:01may you know may feel personal to some
• 05:04I have not heard of anyone being too
• 05:07like so uncomfortable with answering the
• 05:09questions that they did not schedule.
• 05:11You know,
• 05:12at least like to the call center phone line.
• 05:15Of course I have no idea if
• 05:18someone felt uncomfortable online
• 05:20and then decided not to.
• 05:21Continue on with the process,
• 05:24but from our listening sessions and
• 05:26another input from the community.
• 05:29That's not something that we've heard
• 05:31has deterred people from getting vaccinated.
• 05:36Thanks so much for that and I.
• 05:38I mean, I think it certainly is a
• 05:40credit that that there are listening
• 05:42sessions happening that there is
• 05:44engagement with the community to
• 05:46try to try to understand this.
• 05:48I see a question in the chat from Joe
• 05:50Williams saying I wonder what some of
• 05:52the educational programming around
• 05:54vaccination looks like for refugees.
• 05:56Slash non English speakers, slash,
• 05:57lower socioeconomic status communities.
• 05:59Have there been thoughts on digital
• 06:01videos or narrative storytelling to
• 06:02help these communities understand the
• 06:04importance and safety of vaccination?
• 06:08So I'll say yes, there's been
• 06:11a lot of thought around that,
• 06:14and efforts as well.
• 06:16It is certainly a challenge given the
• 06:20virtual world where forced to be in.
• 06:23So for example.
• 06:26We have developed a very simple like
• 06:29fact sheet about the vaccines using
• 06:32kind of the best evidence around
• 06:35effective communication and messaging
• 06:37about vaccination that has a version
• 06:40at like the 6th grade level and also
• 06:43a third grade level and in multiple
• 06:46languages that we hope can dispel
• 06:48some myths and misconceptions about
• 06:51the vaccine and disseminating that
• 06:54through community based organizations
• 06:56through through the state.
• 06:58Health systems and so on and so forth.
• 07:02I think the videos and narrative
• 07:05storing it telling is also really,
• 07:08really critical and so our communications
• 07:11Department is certainly developing
• 07:13some and we try to have clips of
• 07:16especially of physicians and clinicians
• 07:19of color providing that information,
• 07:22and also especially in other
• 07:24languages besides English.
• 07:26But there are a number of resources
• 07:30with that information, you know.
• 07:32Externally as well, and that is 1.
• 07:35Nice thing about the Internet and you can be
• 07:37can be shared widely and disseminated widely.
• 07:40Whether it was, you know,
• 07:41homegrown or not.
• 07:44We've also been holding a
• 07:45number of town halls again,
• 07:47so people can kind of ask their
• 07:49questions and have them addressed.
• 07:51Although one thing I am starting
• 07:52to hear is is a lot of people
• 07:55you know can't can't make those.
• 07:57I mean, even if they are in the evenings,
• 07:59you know,
• 08:00not everyone wants to be on the
• 08:02same at 7:00 PM on a weekday.
• 08:04Or,
• 08:04you know they're tired after after
• 08:06working or busy on the weekends.
• 08:08And so that's you, know,
• 08:09a challenge,
• 08:10but we're certainly still holding
• 08:12them and trying both through
• 08:14the health system and then also.
• 08:15Through the state there is a program
• 08:18where clinicians can partner with
• 08:19leadership from a community based
• 08:21organization to hold a session
• 08:23where they can directly address
• 08:25people's questions about the vaccine.
• 08:27So those are some of the things
• 08:30I'm aware of and Jason you may
• 08:32have others as well.
• 08:34Yeah,
• 08:34similar
• 08:34things happening in terms of town
• 08:36halls and developing materials and
• 08:38recognizing the while public service
• 08:40announcement campaigns and CDC
• 08:42websites are one way to disseminate
• 08:44the kind of information that can
• 08:46correct some misperceptions that.
• 08:47Has a limited reach and trying to
• 08:50identify more tailored programs that
• 08:51are more readily identifiable and
• 08:53recognizable and and iaccessible to
• 08:55particular groups and communities
• 08:57and the concerns they may have.
• 08:59I think is is one of those really
• 09:01critical efforts as we move forward,
• 09:04I'll just add one point.
• 09:06Just very briefly.
• 09:07Is that because of the latest
• 09:09relief bill that passed through
• 09:11Congress and was signed by President
• 09:14Biden a week or two ago,
• 09:15there is a tremendous amount.
• 09:17Of additional resources flowing to
• 09:19the states imminently to support both
• 09:22the vaccination rollout and to support
• 09:24expanding the public health workforce,
• 09:26a lot of those efforts will go
• 09:28towards continuing the this.
• 09:30This,
• 09:30I think pretty difficult work that
• 09:32will lie ahead in terms of reaching
• 09:35all of our communities of reaching
• 09:37more broadly and equitable vaccination
• 09:39program by building the kinds of facilities,
• 09:42the resources, the staff,
• 09:44the personnel.
• 09:44But then I think we'll start seeing
• 09:47concrete applications of those
• 09:49additional resources long overdue.
• 09:51If I could editorialize,
• 09:52that will help again,
• 09:53support that at the state level,
• 09:55recognizing that that's one
• 09:56piece that can work in a more
• 09:58comprehensive solution to address
• 09:59address these challenges ahead.
• 10:02Wonderful, thanks so much to both of you.
• 10:05At this point, let me ask all of
• 10:07our other panelists to go ahead
• 10:09and turn your video back on.
• 10:11There's a couple of questions
• 10:12in the chat that I think would
• 10:14be good to have some discussion.
• 10:16You know, one question specifically
• 10:17to Jenny's if you're hearing
• 10:19anything about refugees.
• 10:20Skepticism about the vaccine,
• 10:21that would be good to share,
• 10:23but also for all of our panelists,
• 10:25and certainly for attendees to you
• 10:26could put answers in the chat you know,
• 10:29would love to hear more about your
• 10:31specific experiences with refugees.
• 10:32Acceptance of the vaccine.
• 10:33So I don't know if any of our
• 10:35panelists Jenny would do.
• 10:36You want to start with some comments?
• 10:38I yeah, I'm happy to start a
• 10:41few things that I have heard.
• 10:44The first being. I actually spoke
• 10:48with PAMAM our health and Wellness
• 10:50Manager earlier today about this.
• 10:53She said, you know,
• 10:55in outreach to clients about the vaccine.
• 10:58They were like, well,
• 10:59you called this a year ago and you
• 11:01told us to stay home and we've been
• 11:03staying home and we haven't gone
• 11:05anywhere and we haven't gotten
• 11:06covid so we don't need the vaccine.
• 11:09And so that's been one thing.
• 11:12An another thing is just like,
• 11:14yeah, there's some, I think.
• 11:19Yeah, some some you know.
• 11:20I don't know if you want to call them
• 11:23conspiracy theories or what, but.
• 11:25You know, like I've heard that
• 11:28this is satanic or like it's,
• 11:30you know, black magic.
• 11:32Things like that have come up.
• 11:36One thing that I haven't
• 11:39necessarily heard from any of our.
• 11:43Any of our clients,
• 11:44but something that kind of like was
• 11:47sparked by something I heard in the
• 11:49news recently was the Catholic Church.
• 11:50Kind of.
• 11:52Denouncing the Johnson and Johnson
• 11:54vaccine based on the way that it was
• 11:57developed and thinking about a lot
• 11:59of our undocumented clients and,
• 12:02you know, maybe their their
• 12:04correlation with Catholicism.
• 12:06Just being like yeah pre
• 12:09Emptive thought of mine.
• 12:11But again, not sure that that
• 12:13is like I haven't heard that.
• 12:17Personally.
• 12:19Silent that gives like a bit of a bit
• 12:21of a starting point as to what are
• 12:23some of the things going around, but.
• 12:26But I see heads nodding,
• 12:29so that's that's what you're
• 12:31describing is clearly not uncommon.
• 12:35Yeah, quickly time and saying I've
• 12:37definitely heard some of those
• 12:39things as well. Especially since the
• 12:41Janssen or JNJ vaccine recently came out.
• 12:43I guess one one piece of good news is that
• 12:46we do have really good access to other
• 12:49types of vaccines here in the states,
• 12:52so you know someone was
• 12:54really opposed to Janssen JNJ.
• 12:56It's easy for them to get Pfizer radar.
• 12:58No, I do think it's important,
• 13:01you know, to to counter those things,
• 13:03but maybe not quite as critical.
• 13:06As far as the not needing the vaccine,
• 13:09because you know,
• 13:10staying at home or you know you've been
• 13:13asking for so long and haven't gotten that,
• 13:16that is something that we hear.
• 13:18Also, there's a contingent of folks
• 13:20that don't don't believe the severity
• 13:22of of COVID-19 either as another
• 13:24key group that doesn't see the
• 13:26importance of getting vaccinated.
• 13:28And I think for for those folks,
• 13:31I think understanding that well,
• 13:32you don't know what they want
• 13:34to stay in their homes forever.
• 13:37Anything for doing it for a year but
• 13:40but the vaccine is sort of the way out,
• 13:43kind of back towards normal life
• 13:46and trying to communicate.
• 13:47You know the concept of herd immunity
• 13:50or community immunity as a way that
• 13:52we can you know collectively kind
• 13:54of get back towards normal life
• 13:57is usually fairly effective.
• 14:00Just very briefly, I'll jump in on that one,
• 14:02particularly around the
• 14:03Johnson and Johnson vaccine,
• 14:04and I'll put it in the chat momentarily.
• 14:06That issue about about some Catholic
• 14:07Bishops that have raised concerns
• 14:09about the the cell lines in which the
• 14:11vaccines were tested has certainly
• 14:12created some confusion, but it's been.
• 14:14It's been quite clearly to the
• 14:16extent that you may hear this.
• 14:18Elsewhere that it's been quite
• 14:20clearly even by the by the Catholic
• 14:22Bishops of Connecticut released
• 14:23a statement a few weeks ago from
• 14:25with respect to Catholic doctrine,
• 14:27Catholic teaching,
• 14:27saying that any of the three
• 14:29vaccines are acceptable in the
• 14:31Catholics in good faith can choose
• 14:32any of those available vaccines,
• 14:34so that's an important message
• 14:36that absolutely has has gotten,
• 14:37I think,
• 14:38confused by some of the voices from
• 14:40some Catholic leaders in that regard.
• 14:46Thanks, Jason, that's a really
• 14:48important important point to bring up.
• 14:50I'm wondering if if Julia or Trisha,
• 14:53or certainly Camille Ouranian clinic.
• 14:55If anybody else has had heard anything
• 14:58different from what Danny has already shared.
• 15:02I just wanted to make one point.
• 15:04I think it's sort of interesting
• 15:05that you expect refugees who come
• 15:07some various degrees of you know,
• 15:09conflict an have often been persecuted
• 15:11by their own governments, at least from
• 15:13from the refugees that I have seen.
• 15:15And it's probably not as broad as what Jenny,
• 15:17because Jenny works with a lot more people.
• 15:20I only see my patience,
• 15:21but I haven't really encountered
• 15:23this mistrust necessarily.
• 15:23That, like it's a bad thing and that
• 15:25like there's something wrong about the
• 15:27vaccine being developed by the government,
• 15:29it's more like what Jenny was saying, like.
• 15:32We're fine, we're healthy,
• 15:33like why would we need this like
• 15:35we've been doing fine so long?
• 15:36I don't think we really need this.
• 15:38And in general,
• 15:39refugees do tend to be not that
• 15:41great about preventive care,
• 15:42even though they usually majority
• 15:43of them have had their childhood
• 15:45vaccinations except travelling.
• 15:46Typically they're not.
• 15:47They're not, you know,
• 15:48the best for preventive care,
• 15:49and I feel it falls more.
• 15:51Perhaps under that umbrella.
• 15:52And like Britta said,
• 15:53like maybe lack of sort of understanding
• 15:55of what sort of population helped
• 15:57us and what like herd immunity's
• 15:58and those kind of things.
• 16:00It's just interesting to me that those
• 16:02are the barriers more than I think like.
• 16:04Specific mistrust of what's happening.
• 16:09I would agree with any.
• 16:11I haven't had a lot of mistrust,
• 16:13but I think like you know we have such a
• 16:16variety of families coming in with ideas
• 16:18that we haven't been able to pinpoint.
• 16:21Any you know, I don't think we can make
• 16:24generalizations about the population.
• 16:25We've had families who very excited
• 16:27and feel that it's a privilege to have
• 16:30American health care that they wouldn't
• 16:32be having at home that they have access to
• 16:35all these things here that they wouldn't
• 16:37have at home to families who once again.
• 16:40I don't want to get anything that
• 16:42isn't absolutely necessary and
• 16:44and I think there is.
• 16:45As everyone has said,
• 16:47a lot of misunderstanding of
• 16:48you know that they they are.
• 16:50They are healthy and that they don't
• 16:52need to to have the vaccination.
• 16:55But I would fall away from making
• 16:57any generalizations because I feel
• 16:59every family is very different.
• 17:00When I've been having conversations
• 17:02with them about the vaccines.
• 17:08Great, thank you so much chamelon honey.
• 17:10I see that we are getting to
• 17:12the end of our of our times.
• 17:14I just wondering if any of our
• 17:16panelists had any final comments
• 17:17that you wanted to share with the
• 17:19audience before we we end our session.
• 17:22Yeah, I just wanted to note that.
• 17:26You know so much for the
• 17:28refugee of the interventions,
• 17:29health interventions for our various
• 17:31refugee populations really turn on.
• 17:33Volunteer support,
• 17:33making up for gaps within Systems an
• 17:36all sorts of systems failures that
• 17:38an incredible cadre of volunteers and
• 17:40dedicated staff find a work around
• 17:42for and it doesn't take that much to
• 17:44disrupt these very delicate systems.
• 17:46And then people spend a lot of time
• 17:49than trying to find new work arounds.
• 17:51And I think an ongoing question
• 17:53that I have for this particular
• 17:55vulnerable population.
• 17:56Then I'm sure for others,
• 17:58is what can we do to systematize some
• 18:01of these will always need creative
• 18:03problem solving in this work,
• 18:06but the it's.
• 18:08I feel like we're not truly
• 18:10addressing these health disparities
• 18:12when they fundamentally turn on
• 18:13people going above and beyond,
• 18:15or thinking about how to extend
• 18:17themselves in ways that seems to
• 18:19me like a very precarious way of
• 18:21getting access to basic health care.
• 18:23For a lot of people,
• 18:25although although I see Jennifer
• 18:26I see Jennifer pondering that,
• 18:28maybe that's just the nature of the work.
• 18:30I I don't know what people think.
• 18:38I, I think that's a very fitting way to sort
• 18:41of move towards the end of the discussion.
• 18:45Why? I think absolutely,
• 18:46I mean, refugees have just one
• 18:49group of vulnerable people.
• 18:50There are so many other groups of
• 18:53vulnerable people that are, you know,
• 18:56in very fragile health care systems that
• 18:58you know when there is something like this.
• 19:02Like the pandemic,
• 19:03everything is exacerbated and comes to light.
• 19:06But they are always there and
• 19:08always underlying the work we do
• 19:10and where exactly what you said.
• 19:12We're always overextending ourselves
• 19:13trying to individually create solutions,
• 19:15but I think a lesson we should take away not.
• 19:18I think everybody here,
• 19:20I think is well aware of this,
• 19:22but a lesson just.
• 19:24For for the larger systems,
• 19:26I think is just.
• 19:27How can we improve this going
• 19:29forward all the time and not
• 19:30just when there's a pandemic
• 19:32and when there's emergency?
• 19:34You know medical care.
• 19:37That's a great point on it,
• 19:39so maybe what we can end with is,
• 19:41you know, the fact that we have so
• 19:43many folks like like our panelists here
• 19:45today as well as so many of the people
• 19:48who joined us for the conversation.
• 19:50Who really are thinking
• 19:51deeply about this community?
• 19:52And then there are others who
• 19:54are thinking deeply about other
• 19:55communities that are marginalized
• 19:56and vulnerable in different ways.
• 19:58And so as long as there are people who
• 20:00are continuing to be invested in in
• 20:02making sure that our most vulnerable
• 20:04are getting the access that they need.
• 20:07You know, then.
• 20:08Then we can.
• 20:08Then we can continue to work towards
• 20:11actually fixing this system so we
• 20:13don't need to keep doing this,
• 20:14so alright.
• 20:15So with that I will thank all of our
• 20:17panelists again for joining us this evening.
• 20:20This was a wonderful session.
• 20:22So glad that we were able to
• 20:24do this this year.
• 20:25And thank everybody who joined us from
• 20:27from home or whatever wherever you were.
• 20:29And for my final slide just to show thank
• 20:32you so much for joining this conversation.
• 20:34We look forward to seeing you next year,
• 20:37hopefully with an even bigger.
• 20:38Celebration and maybe even
• 20:40in person at that point.
• 20:41So thanks so much everybody take
• 20:43care and have a wonderful evening.