SARAH: This is At the Core of Care. A podcast where people share their stories about nurses and their creative efforts to better meet the health and health-care needs of patients, families and communities.
I’m Sarah Hexem Hubbard with the Pennsylvania Action Coalition and Executive Director of the National Nurse-Led Care Consortium.
As part of our special vaccine confidence coverage, we’re taking stock of how the COVID-19 pandemic has evolved. Through our series, we’re hearing about lessons learned and what some of the latest trends are as we enter the third year of this public health emergency.
On this episode, we’ll be exploring the role that non-traditional health settings and partnerships have played in recent years to promote vaccine confidence.
Joining us for this conversation are Monica Harmon and Jayatri Das.
Monica Harmon is the Executive Director at Drexel University’s Community Wellness HUB and an assistant clinical professor. She’s a public health nurse and serves as the Co-Chair for our Pennsylvania Action Coalition’s Nurse Diversity Council, in addition to being the chapter president of the Southeastern Pennsylvania Area Black Nurses Association.
And Jayatri Das is the chief bioscientist at the Franklin Institute, a science museum in Philadelphia that leads science education programming and research efforts. Jayatri has helped oversee the Franklin Institute’s involvement with a nationwide initiative called Communities for Immunity to help educate and engage the public during the pandemic.
Monica, it is great to have you back on At the Core of Care and welcome Jayatri.
MONICA: Thank you. I'm so excited to be back.
JAYATRI: And I'm so glad to be part of this conversation.
SARAH: So here we are heading into the third full year of the COVID-19 pandemic. Over the past several years, both of you have been involved in educational and public health outreach within the community. So I would love to just hear from each of you a brief recap of your efforts. Monica, what was the early COVID response like?
MONICA: It was chaotic. Early COVID response has definitely been chaotic. From what do I do? How do I do it? What do we say? Am I saying the right thing? Will the guidance change? And how quickly will it change? How quickly can we get the information out to community members, to other nurses, so that we can all be empowered for this thing. Just understanding COVID. So it's been chaotic for sure.
SARAH: And then how has your own engagement changed? Or really the educational programming at the Community Wellness Hub? How has that evolved?
MONICA: So that has evolved from just preventing infectious disease, COVID, to making sure that community members have access to testing and to the vaccines. And now, how do we continue the vaccines now that we don't have the funding from the government? But we're utilizing partnerships with a program with the Sun Ray Pharmacy and then also with the colleges within the university. And then the other piece is, now how do we say, okay, COVID vaccination is a part of routine vaccination, which is a part of preventative health.
SARAH: Jayatri, can you talk about some of the programming that the Franklin Institute has carried out over the course of the pandemic and how did the museum get involved with Communities for Immunity?
JAYATRI: In some ways, museums are really following the lead of what all of you do as nurses. We find ways to make information relevant and accessible and engaging for people. So, certainly in the early days, chaotic is a great word to describe it, Monica. You know, we were not only just trying to keep up with the information, but also trying to pivot very quickly from being a very place-based organization to suddenly thinking about how do we engage in the digital space? How do we reach our audiences and what do they want to know? So in those early days, we were really thinking of our role as that familiar translator. There were so many new voices in the space with so much information. And what we tried to do was try to consolidate what we were hearing and present it in a way that felt understandable and friendly in a time that was very stressful for everybody.
So, we started out doing live Facebook broadcasts every day at the beginning as information was just coming out in overflow. And then we started to kind of pull out, okay, what are the important things that you're hearing and how do you make sense of it? You know, I did one with my daughter who I guess she was 10 at the time, as a way to engage families with kids and letting kids have a space to ask questions. And over time, we've really tried to just help people explain the process of science because we've seen how much that lack of engagement with how science works has influenced people's perception of the vaccines.
And so knowing that we have always been this resource for understanding science, it wasn't that big of a shift to say, ‘Hey, we've always talked about how that process works, how experiments work, how we tried to prove ourselves wrong and what is the level of evidence that we need to move forward?’
And so we were able to kind of carry that story into how we engage with people about the pandemic. And this is a role that science museums have played for a long time, and recognizing the value of cultural institutions like museums and libraries. The Communities for Immunity program was a federal government program that was a partnership between the CDC and the Institute for Museum and Library Services to really think about how do we really build the capacity for these cultural institutions to become a place where people can come for health and public health information?
And so the Communities for Immunity program was really an initiative that recognized that each one of these cultural institutions across the country has its own relationship with the places that they are. And so it was a great collective effort to take kind of the centralized information and disperse it to these organizations who could really tailor it and customize it to the particular audiences that they were reaching.
SARAH: Could you share some specific examples of what maybe you thought were some impactful efforts for public outreach?
JAYATRI: One of the things that we did in our project was to partner with the Philadelphia Department of Public Health. So at that time, as the project started, they were really going out to community block parties and gatherings. This was about a year, you know, once the vaccine was out, about a year, a year and a half into the pandemic. And what they recognized is that they had information, but it wasn't necessarily being presented in a way that was engaging and accessible in the environments where they were encountering people. So for instance, when you're at a block party to give somebody just an eight and a half by eleven sheet of paper that has some frequently asked questions in very scientific language, well, that's not really, interpreting the information in a way that fits the encounter.
And so we worked with them because at that point we were especially thinking about how to reach young adults as an under-vaccinated segment of the population. How do we create this information in simple language in a way that's designed to look like it's targeted to that population? And how do we fold it up in a form that, you know, somebody can get on the street and stick in their pocket instead of being an eight and a half by eleven sheet of paper that they don't know what to do with and they're just going to toss it at the next trash can. So, that sort of information design, bringing that to the actual information, that's really important in helping people digest information. So that was our project.
But there were other projects in rural areas. There were museums and libraries who had mobile vans that had vaccination clinics out in their communities. There were children's museums that designed some hands-on activities that could help kids feel comfortable getting vaccinated. So, we all really looked at our communities, looked at the partners we were working with in our communities and tried to design projects that met the needs of where we were.
SARAH: That’s great and I love speaking to how you start with the community, it's reminding me, Monica, of the listening sessions that you were hosting for us early on. I mean, any of the examples that Jayatri gave that you've seen as being impactful, either specifically with this initiative or with our other community partners?
MONICA: I think, for sure, meeting people where they were, where they are at that time, that moment in time. I think we were all trying to figure it out. You know, the one thing I think I appreciate as a public health nurse that I don't think many people did is that sometimes people won't come to your institution, or at least they won't think about your institution initially as a place for healthcare and for healthcare information. So being able to tie everything in, you know, all hands on deck. So, you know, working with Jayatri and the team, just thinking about how we get the information out using different props. We have a program I think I can share we're working on together for the Communities for Immunity with the school nurses. Because in that community, for sure, you know, the nurse is the authority on healthcare. And when COVID hit, those nurses were answering the questions for not only the families, but also the staff in the schools and trying to work within a district that was trying to develop a policy.
SARAH: These are moments when our producers will remind me that we have several episodes you could even listen to. Hearing from actually school nurses in that moment when this was all happening. Monica being one of them. And then even further into the pandemic. So yeah, definitely, were on the frontline in a lot of senses.
MONICA: The other thing though, I think what Jayatri and the team did at the Franklin Institute is that they also developed teaching modules that were in different languages. And that's so important. You know, not just the ones we think about, English, Spanish, French. But so many different ones and that's such a help, you know, when you're trying to meet the needs.
JAYATRI: And that was really something that we heard from the nurses that we were collaborating with. Again, knowing that we don't have a window into every community. We don't necessarily know what people need. It was by asking them and learning about the communities that they were working with. You know, at that point, we were able to come up with these resources and translate them into the languages that they need. And one of the things that we heard from them was that, especially in communities with a lot of immigrants, that a lot of the source of misinformation was because they didn't have access to high quality information in the languages that they were familiar with. And so, we were really glad that that was a resource that we could provide.
MONICA: So were we.
SARAH: Can you tell us about what NNCC is doing with the school nurses and the Franklin Institute?
MONICA: So NNCC has partnered with the Centers for Disease Control. We are working with nurses in the communities they serve to decrease vaccine hesitancy and increase confidence for those communities and for the nurses who are working with those communities. And so, we decided to partner with the Franklin Institute to deliver this information to school nurses because the CDC recognized that with the new authorization of the COVID vaccines that children, that population, would be the next to get vaccinated, so that five to 11 year-olds at that time. So, we partnered with the Franklin Institute to create education kits for school nurses with the School District of Philadelphia. I will tell you that project was so successful that the CDC said, well, who else can you expand with? And so, with two to five authorization at that time, we knew it was coming. We said, ‘Well, we need to work where two to five year-olds are. We also need to work with those nurses who work with them.’ So the Headstart programs. We also partnered with the Please Touch Museum as well early on. So we had story hour. It was a panel with myself, an author who wrote a book about her experience with her child.
And the book is called Mommy, Can I Sleep with You? The idea was that with COVID in the beginning, you didn't know, you had to be isolated at the time. And you know, children just didn't understand that. And then we had another community member, a child with special needs. And then trying to get him to work with the mask and why people are wearing masks. And if you can't see facial expressions, not knowing what people mean. So, it was all these different things we were able to talk about that helped these nurses and community members understand what's going on with COVID.
And so now with the two to five year-olds, you know, the nurses and Headstart programs, the teachers, nurses partnering with the programs as well. Because we recognize, and I think Jayatri talked about this, that children go home with the information they learn. And that's where some of our greatest public health challenges have been addressed. Whether it's recycling, you know, that started with children. You know, Mothers Against Drunk Driving. It was the mothers talking with the children, you know, about drug use, alcohol, you know, all of these things. The Great American Smokeout. It all started with children, and sometimes we say the children will lead them, you know, as well.
And you know, being able to see the world through their eyes and hear through their ears has meant so much with understanding what children need. Cause they'll tell, for sure.
JAYATRI: And I think it's a great partnership for us because when we're working with nurses, they already know the science. They're experts in the science. What we can give them is the strategies to be educators about science. Most often, nurses are working in the role of direct care. And so, they don't necessarily feel comfortable with the skillset of how do I deal with the whole classroom of kids at once or things like that. And we can give them those strategies, those tools, and really make it easy for them to be that educator in kids' lives and give them the toolkits, the communication strategies. How do you ask good questions? How do you let kids lead the conversation? These are things that we do every day on the museum floor that actually work really well when you're talking about health in any kind of a setting.
SARAH: Throughout this pandemic, we've been learning about how important it is to have that wide range of trusted messengers and messages that folks can understand. And that's been really just paramount in promoting vaccine confidence. Do you think that's a trend that we're going to see more of, you know, in healthcare at large? Monica, you want to take this one first?
MONICA: Absolutely. It's a trend that is long overdue. So I think, for sure, we will see this trend with these partnerships. You know, healthcare occurring in non-traditional spaces. These partnerships, I'm excited about this because I think museums, libraries, they're sources of information that community members trust. But health underlies everything we do. So it just makes sense.
SARAH: Jayatri?
JAYATRI: I would add that this idea of trusted messengers and communication is actually something that we've been thinking about in science communication much more broadly for a while now. Over the last 10 years, and I think particularly in thinking about climate communication, there's been a lot of research into thinking about strategies for effective communication that's been informed by the social sciences, from psychology and communications and economics, to think about how do you get through to people in a way that makes sense to them? And what are the factors that can help people change their minds about something? And the identity of who they are hearing that information from really matters because it has to be somebody that you identify with. So, that's something that has been in the science communication research for a long time.
And so I think that really informed the science communication approach to the pandemic. And I think it's here to stay for sure. You know, even from a bigger picture, more broadly I work in science education and when we think about how do you diversify what the face of science looks like in the future? The best way to do that is with role models. And so, not only is diversifying communication effective for getting messaging out, it's also effective for really showing the next generation of scientists about who's at the table.
SARAH: I love that. We think a lot about building the pipeline in nursing and certainly, you know, in all of the healthcare fields; all of the health fields, so important. Certainly, your partnership exemplifies this. But we've seen the pandemic has really required us to innovate and work with the unexpected partners. And, you know, expand into venues like museums, which, you know, from Jayatri’s perspective, of course is the norm. But you know, those of us in the nursing field, maybe that, that doesn't come to mind. To what extent do you think that those kinds of tactics are here to stay?
MONICA: Well, I think, being able to expose health profession students. That it's not work in silos. You know, that was always one of my biggest challenges. I think as a public health nurse, we always work with other professionals, paraprofessionals. In acute care, not so much. And it's sad to me, but I think, those are opportunities that my discipline, nursing, hasn't always explored. But public health nurses, we've always done that in our specialty, so.
JAYATRI: I think that public health is such a great collaboration for museums because we're not really in a place where we can respond to acute crises because we're just not equipped to have that level of responsiveness. And we found that out in our collaboration as well is that we couldn't keep up that daily dose of information, because we’re not a news service, right? We're not seeing people day to day. What we can do is tell the bigger story, and that's what public health is. It's that bigger story of how do we keep everybody healthy every day over the long term, sustainably? And so that type of education I think is a great space for museums to partner with.
SARAH: Yeah, absolutely. Sort of taking a pause here to zoom out. I think we're highlighting a lot of the successes, a lot of the wins. Probably worth noting, at least as we're talking now at the end of January 2023, the climate around COVID has shifted a little bit, right? So, you know, I definitely think, we're seeing that COVID fatigue. We're seeing that the risk remains heightened and especially in certain populations. So, wanted to hear from both of you, but Monica, you run a community wellness center, you know, what are you seeing? What are you hearing?
MONICA: I'm still seeing a lot of people now saying, ‘Why do I need to get a booster of the COVID vaccine?’ You've already given me how many immunization series for this. Why am I having to take more? And that's the conversations we were always having about the influenza vaccines and to some extent, pneumonia. I think the other piece, now we're kind of moving to a tripledemic, if you will. So not only are we seeing COVID, we're seeing RSV and we're also seeing influenza, an uptick in all three of those. In addition, Monkeypox. And so as a center director, I'm thinking, okay, how do I get this information out? How do I help community members make the best decisions for their health? But then also, I'm working with different generations at the same time, so how do we have this intergenerational care, education? Working with students from different disciplines, so how do I prepare them to get these skills, this education, but be able to apply it in their future careers?
Because the future is now. We're living it. But also working within an institution as well, right? So making sure that we continue community engagement. I'm fortunate I do work for a community engaged institution. You know, that is about social justice and anti-racism, which are huge to breaking down barriers with community members, particularly, with community and academic partnerships, which can be, I'll say a challenge. But also opportunities for greater healthcare outcomes.
SARAH: And Jayatri, tell us where’s the museum now? You know, in terms of COVID protocols? Are mask requirements still in place? I mean, how does it look from your perspective?
JAYATRI: So we always take our guidance from whatever the public health guidance in Philadelphia is. So, we do not have mask requirements right now. You know, we have certainly continued our messaging around the importance of vaccination, especially through this kind of programming that we're working on with Monica and the National Nurse Led Care Consortium team. But our day to day is much less focused on the pandemic. And that's partly because, you know, of course, COVID fatigue is real. And people see the museum as a place to find joy. And we want to be that place for them in, you know, coming out of this really hard time. So, we've really focused on thinking about how do we make sure that our spaces are well ventilated? Some of the kind of behind-the-scenes ways that we can minimize risk to people, and we think that's been effective. But interestingly, what we're also seeing now is that people are looking to us to help them understand some of the long-term effects of the pandemic, particularly around mental health. So we're about to start working on a new exhibit around the human body and we just finished up doing focus groups with six groups of middle school and high school kids.
And the number one topic that came out of all of them was mental health. Because they've really been through a hard time, and I think that's changed the conversation around mental health and they're looking for ways to understand that. So that's, I think, a new piece of the conversation that we are really learning about and thinking about how do all of these pieces tie together? From the effects of the pandemic to the impact of that on these kids as they grow older.
SARAH: And so where do you see the path forward? I mean, how do we go forward with vaccine confidence? What do we even tell people about, you know, getting boosters? How do we focus? Where do we prioritize?
MONICA: I think for me, what I've seen is, from community members is this appreciation for just solid information. You know, down to how does the body develop its own immune senses and that understanding of science, but also how vaccines are developed. You know, how they come to market. And then also how is this a part of preventative health? Because I tell community members often you don't see certain diseases anymore because we have a vaccine for it. We have a vaccine for that, right. So, you know, I also talk about what those diseases look like. So Polio and you know, different ones and, you know they appreciate that understanding a bit more in plain language.
JAYATRI: I think that's absolutely right. I mean, that's one of the things that we've seen through our children's vaccine education project with the nurses is, you know, we're very open in giving nurses the resources to share with families. That when they're doing these programs about vaccines in school, it's really just sharing about the science of the vaccine and what we hear from the nurses is that that kind of information first approach opens a door to a lot of conversations. And I think the other thing that we've learned that really resonates with how we do things in museums is that I think we have to continue to just think about how that messaging about vaccination and preventative healthcare and really just caring for each other is in a way embedded into a lot of different things we do, rather than just being kind of like one message that we're beating people over the head with, because there's no one thing that is necessarily going to change someone's mind. It's exposure to that message in different places from different people. And how can we be creative in giving people organic spaces to kind of think about it and counter it. Maybe think about it some more. Go look something up and, and make that journey on their own.
SARAH: Thank you both so much. I mean, I think, I have to actually just say that even hearing the energy here, because I know that, you know, many of the people that we've been talking to, even in this sort of mini-series, you know, you've been there, you've been doing this work for the last couple of years. And so, just thank you for continuing to bring that energy and creativity and solutions focus. I'd love to just hear, you know, any final thoughts that you would want to leave our listeners with as we wrap up today.
JAYATRI: I'll say that I think one of the things that I have loved, particularly, working with school and community nurses who work with kids is hearing from them how much kids can advocate for their own health. And then taking that message home to their families. That's been really inspiring to me because we work with kids all the time, but before this, we hadn't really thought about how do we empower kids to go through that decision making process about themselves. And so that's, it makes me think back to, you know, when I was a kid, I remember my older sister coming home with information about the Great American Smokeout and that kind of public health campaign that really embraces kids as messengers of health. And I feel like that's another opportunity that we're really leaning into right now.
MONICA: I think for me, I just appreciate the collaboration and how it just jumpstarts so many other avenues for care, and for community engagement. You know, all of the things that we need to do. I also appreciate just the different perspectives. I think of Jayatri and the other scientists, too. What they bring to the table in terms of education and how I can use that information and translate it so that it makes sense for community members. Right now, I'm preparing for story hour with some two to five year-olds. So I'm nervous.
JAYATRI: It’s going to be great!
MONICA: Thank you. I need all that positive energy. But I think, you know, what the team has provided me with is you know, how do you teach this lesson? How do you keep the attention of children? But then also, how can I make it so that it's at a level that they would understand and they can take home to their families, too. So, it's just exciting, those kind of partnerships because, without any one part, this wouldn't work. And so that's what I hope to see more of for the future. And I would like to leave, if organizations are thinking of doing this or not, they should be. And then also that we need to get some funders as well, to continue this work because sometimes it's rough, but we make it happen with the resources that we do have. But overall, it's been an exciting ride.
SARAH: Well, whoever's listening, you heard her. It’s great work.
Thank you again both so much for making time to join us on At the Core of Care.
MONICA: Thank you.
JAYATRI: Thanks so much for having these conversations.
MONICA: Absolutely.
CREDITS
SARAH: Our special Vaccine Confidence series was funded in part by a cooperative agreement with the Centers for Disease Control and Prevention or CDC. The CDC is an agency within the Department of Health and Human Services also known as HHS. The contents of this resource do not necessarily represent the policy of CDC or HHS, and should not be considered an endorsement by the Federal Government.
Stay tuned for more episodes in our vaccine confidence series. We’ll continue talking to health care professionals and frontline workers who are promoting vaccine confidence and addressing ongoing issues.
You can find our most current and past episodes of At the Core of Care wherever you get your podcasts or at paactioncoalition.org.
And for more information about related upcoming webinars, COVID-19 resources, and upcoming trainings for nurses to obtain continuing education credits, log on to nurseledcare.org
You can also stay up to date with us on social media by following @NurseLedCare.
At the Core of Care is produced by Stephanie Marudas of Kouvenda Media and mixed by Brad Linder.
I’m Sarah Hexem Hubbard of the Pennsylvania Action Coalition.
Thanks for joining us.
