Latest Projects

COVID Community Partnership (CCP) Project

Project Introduction

The COVID Community Partnership (CCP) project employs community health workers (CHWs) from diverse communities throughout the state by partnering with community-based organizations (CBO) and local health departments (LHD) to incorporate CHWs into the COVID-19 response. The project aims to address COVID-19 related disparities in Utah's under-resourced communities by connecting individuals to resources, combating misinformation and supporting equitable vaccine distribution efforts.

Project Progress

The CCP project was established in May 2020 and is currently in its fourth phase contracted through June 2023. The CCP project is currently partnered with 20 CBOs and all 13 of Utah's LHDs.

Resources

How This Project Aligns With OHE’s Foundational Practices

The CCP project works to achieve the OHE foundational principles, primarily Strategy #2 of working across agencies and Strategy #3 of fostering community partnerships. Project activities and evaluated outcomes can be read in the most recent CCP report.

CCP achieves strategy 2A through collaboration with all 13 of Utah’s local health departments to advance health equity and reduce health disparities in the COVID response. CCP provides technical assistance to support contracted local health departments and tailors tools and resources as needed.

CCP achieves strategy 3A by engaging communities, as well as 3B by learning with communities. CCP conducts regular check-in calls with community health workers to provide training, support, and serve as a space to promote two-way dialogue. This allows community health workers to share experiences of community members and provide valuable feedback and input that helps to shape program activities. CCP also achieves strategy 3C, as the foundation of CCP is built upon supporting community health workers through consistent training and technical assistance. Internal infrastructure is developed through CCP, including built-in mental health resources and support of the community health worker workforce certification.

Community Health Workers

Building the Capacity of Community Health Workers (CHWs) in Utah

Project Introduction

The COVID-19 pandemic has highlighted the importance of Community Health Workers (CHWs) as essential health workers because of their connection to underserved and underrepresented communities. The Office of Health Equity (OHE) supports building the capacity of CHWs and expanding this workforce to help strengthen our communities.

Through the OT grant, OHE assisted in building Community Health Worker workforce infrastructure to address COVID-19 health disparities and advance health equity in Utah by building Community Health Worker capacity through communication, networking, training, and skill building.

OHE established a partnership with the Utah Public Health Association’s Community Health Worker Section (UPHA CHW Section) to support in the effort to start the Utah Community Health Workers Association (UCHWA) to house an independent CHW workforce organization in Utah and provide an abundance of resources to our CHWs.

Project Progress

  • Supporting CHWs and its workforce: CHWs are part of a network through the UPHA CHW Section where they are offered professional development and training opportunities to help build their CHWs skills. In this section meeting, CHWs learned different skills to put into practice when they are interacting with the clients, skills not only to put into practice for themselves but also to teach their clients to create a better environment for them and their families.

  • CHW Certification: CHWs and advocates for the initiative have worked closely with the Department of Health and Human Services and Senator Escamilla to get a bill passed for CHW Certification that provides a voluntary certification pathway to allow CHWs to signal to employers and community members they serve that their expertise and work is recognized and valued. Through this certification pathway, employers will have an assurance of the certified CHWs community connectedness and competencies.

  • Promoting healthy lifestyles and how it can make a difference in their lives and the ones around them. Things as simple as setting a weekly goal on a physical activity, starting a small exercise routine that could be a 20 minutes walk, playing in the park with their kids or dogs for 30 minutes, not forgetting that making changes in their diet is another important aspect when it comes to changing health habits, things like adding more fruits and vegetables in all our meals, eating lean protein, and decreasing the consumption of sugars and processed foods among others.

  • CHWs learn through a skills course the importance of empathy and sympathy towards others; not putting attention on people’s race, ethnicity, color, education, or where they are from. This helps them to better understand as a CHW how they can respond appropriately to certain situations.

Resources

How This Project Aligns With OHE’s Foundational Practices

Foster Community Partnerships

Community health workers are trusted health equity agents who promote and improve health and quality of life by connecting and educating individuals and their communities. The two main objectives the OHE focuses on are: Supporting the workforce development and sustainability through contracts, training and technical assistance; and developing internal infrastructure to support certification of the community health worker workforce. We have met these objectives by partnering with CHWs from Community Based Organizations (CBOs) and Local Health Departments (LHDs) throughout the state and through the Covid Community Partnership Project (CCP) and the Utah Public Health Association (UPHA) CHW Section. These are spaces where the CHWs obtain training in community health work and COVID topics, how to access resources, and how to be an advocate for their communities. OHE provides technical assistance to CHWs regarding these areas which can help strengthen our partnerships. Within the Department of Health and Human Services, OHE and Healthy Environment Active Living (HEAL) have partnered to conduct the CHW Core Skills Training which will be a part of the formal certification process for CHWs moving forward.

Alliances and networks are formed to collectively advance health equity by increasing awareness, advocating for policy change, and assuring accountability. One objective for this strategy is to support rural and urban CBOs to foster alliances and capacity to serve and reach vulnerable communities through contracts, training, and technical assistance. Through the CCP Project and the UPHA CHW Section, we collaborate with CBOs and other community partners’ CHWs to provide the resources, training, and other assistance needed to ensure they have all the tools they need to best serve their communities.

The Embrace Project Study

Project Introduction (March 2021–June 2022)

The Embrace Project Study (Embrace) is a community-based participatory research study focused on addressing health in maternal mortality and morbidity and diabetes. Embrace is developed by the Utah Department of Health Office of Health Equity and the University of Utah Health’s The Wellness Bus in partnership with community health workers from community-based organizations. This study focuses on addressing maternal mortality and morbidity and diabetes health disparities among women 18–44 years old who are Native Hawaiian and Pacific Islander, Black/African American, Hispanic or Latina, and Refugee and new American along Utah’s Wasatch Front in Salt Lake, Weber, Davis, and Utah counties.

The aim of Embrace is to reduce health disparities among Native Hawaiian and Pacific Islander women by providing culturally responsive health services for the women in this study. Embrace focuses on mental health and self-care for women so they are able to thrive for their current and future generations. Embrace also roots mental and self-care practices in ancestral NHPI cultural traditions and emphasizes culture as a source of resilience.

Through the University of Utah Health’s The Wellness Bus, a mobile health clinic which provides chronic disease screenings in key neighborhoods, the study is able to provide biometric screenings and health coaching sessions. Embrace is also partnered with five community-based organizations , National Tongan American Society, Utah Pacific Islander Health Coalition, Comunidad Materna en Utah, Project Success Coalition, and Utah Muslim Civic League, who each serve their community members. Embrace works and supports community health workers (CHWs) who are able to support and engage community members in the study.

Project Progress

Currently, Embrace has two cohorts of women who are participating in the study. Embrace began in April 2021, and is expected to end June-July 2022. The first cohort is completing their participation in the study, and Cohort 2 is expected to end during summer 2022. Analysis of all data will begin after the completion of Cohort 2.

Embrace has been accepted to present at the following conferences:

Utah Public Health Association Conference 2022
Culture of Data Conference 2022 with the Colorado Public Health Association

Association for Maternal and Child Health Programs Conference 2022

Please be on the lookout for any more reports, conferences, or other types of updates to share!

Resources

The Embrace Project Study continues and expands the work of It Takes a Village: Giving our Babies the Best Chance. It Takes a Village (ITAV) focuses on addressing health disparities in infant mortality among Native Hawaiian and Pacific Islander communities. ITAV raises awareness and educates NHPI families and community members about maternal and infant health in the context of Pacific Islander cultural beliefs and practices. For more information on It Takes a Village, please visit this link here.

For more information on why The Embrace Project Study was created, please look at the following two health profiles:

A Utah Health Disparities Profile Diabetes and Gestational Diabetes among Racial and Ethnic Minority Women in Utah

A Utah Health Disparities Profile Maternal Mortality and Morbidity among Utah Minority Women

Embrace in the News: 'We have to do better': Policymakers, advocates call for better support of maternal mental health (KSL, May 19, 2022)

How This Project Aligns With OHE’s Foundational Practices

Build Internal Infrastructure

The Embrace Project Study (Embrace) focuses on addressing the health disparities in diabetes and maternal mortality and morbidity impacting communities participating in the study, particularly Native Hawaiian and Pacific Islander communities. Embrace has utilized data from previous years to provide evidence to show the need of this study. Embrace will also perform further data analysis and evaluation as the study progresses and is completed in Summer 2022. In addition, Embrace has provided valuable data training to community health workers, and has provided opportunities for diversifying data collection skillsets.

Work Across Agencies

The Embrace Project Study (Embrace) would not be possible without the University of Utah Health’s The Wellness Bus and National Tongan American Society, Utah Pacific Islander Health Coalition, Project Success Coalition, Comunidad Materna en Utah, and Utah Muslim Civic League. These partnerships are vital to the implementation, recruitment, retention, and impact of Embrace for community members.

Foster Community Partnerships

The Embrace Project Study (Embrace) is partnered with five community-based organizations including National Tongan American Society, Utah Pacific Islander Health Coalition, Project Success Coalition, Comunidad Materna en Utah, and the Utah Muslim Civic League. Embrace is also collaborating with the University of Utah Health’s The Wellness Bus to engage women in the study through biometric screenings and health coaching sessions. These partnerships with community-based organizations and community health workers is key to the retention of women in the study, as community health workers are foundational for the trust with community members, and to expand the skills and knowledge of data collection for community health workers to broaden their skillset.

Expand the Narrative

The Embrace Project Study’s (Embrace) focus is diabetes and maternal mortality and morbidity health disparities among women from racial and ethnic minority backgrounds along Utah’s Wasatch Front. A unique aspect of Embrace’s curriculum is rooted in Native Hawaiian and Pacific Islander culture and traditions. One component that Embrace focuses on is mental health. Mental health is vital to the health and wellbeing of everyone, particularly among women of childbearing age in these communities. Providing education on mental health and self-care is essential for women in this study. Mental health continues to be stigmatized, and self-care is often seen through a narrow lens. This study focuses on mental health and self-care grounded in cultural practices and beliefs, reimagining and changing the narrative around what self-care should be, and expanding self-care to include everyone.

Local Health Departments

Building the Capacity for Health Equity at the Local Health Departments

Project Introduction

As part of the Strategic Plan for 2021-2023, The Office of Health Equity (OHE) has contracted with Utah’s 13 local health departments (LHDs) to strategize specific approaches and practices for each local health district to serve vulnerable populations, advance health equity, and address COVID-19 disparities. The local health departments have built out their own strategies and activities that fall under the four key strategies; 1) Build Internal Infrastructure, 2) Work Across Agencies, 3) Foster Community Partnerships, and 4) Expand the Narrative.

Project Progress

Each local health department hired a health equity coordinator and/or an epidemiologist to lead the healthy equity activities, to build organizational capacity and internal infrastructure at the department level to advance health equity (Build Internal Infrastructure). This develops practical skills to apply this understanding across all policies, programs, practices, and interventions. The health equity teams receive tailored technical assistance and trainings provided by the Office of Health Equity and its partners. Another tool the OHE partners created and provided for the LHDs is an online platform used to provide resources and sustain technical assistance as needed (Build Internal Infrastructure).

Through their contracts with OHE, many of the local health departments are focusing on health equity and finding ways to implement it into their practices, new and existing programs, and overall agency. For example, many are conducting internal building organizational capacity assessments to advance health equity by taking stock of the services and resources they offer, assessing where there is opportunity for improvement, and talking with leadership to create buy-in and organizational consensus on where to focus their efforts (Build Internal Infrastructure). Some local health departments are conducting focus groups and external community health needs assessments with stakeholders and community partners to gather information on where there is overlap in services provided and obtain feedback from the community to assess how well the LHD is doing in providing services. A few local health departments are creating coalitions and boards to strategize with stakeholders, community members, advocates, funders, government agencies, private healthcare providers, and many more, to look at existing public policy, address their region’s public health needs, and make impactful and lasting health improvements (Foster Community Partnerships).

Due to the COVID-19 pandemic and with the funding provided by OHE, LHDs have reached out to their existing community partners and created new partnerships, community coalitions, to collaborate and coordinate efforts and resources for their communities. Many LHDs have ambitious goals to integrate health equity in the work they do. A majority of the LHDs report a good connection with community-based organizations (CBOs), with several of the LHDs reporting a good connection with racial/ethnic minority communities. Additionally, the majority of the LHDs are utilizing community health workers (CHWs). This illustrates the importance of coordinating with stakeholders, local organizations, and community members to extend health services to populations in need of assistance (Foster Community Partnerships).

Resources

Health Equity Conferences

The Office of Health Equity has a valuable partnership with the Utah Association of Local Health Departments (UALHD). With the help of UALHD, the local health departments will host a series of regional Health Equity Conferences in the spring of 2023 to reveal their plans for sustainability in their respective regions, share their stories of successes and challenges throughout the project, and celebrate their hard work and accomplishments with each other. The Utah Association of Local Health Departments is an essential partner in coordinating efforts with the Boards of Health for each health department. Their health equity team serves as liaison between all the health officers and health equity teams across all the health departments and is a crucial component to helping facilitate the integration of health equity efforts (Foster Community Partnerships and Expand the Narrative). https://ualhd.org/

Bridging Communities and Clinics Project

Status: Completed

Bridging Communities and Clinics (BCC) is a community-based outreach program developed by the Office of Health Disparities (OHD) that was successfully piloted in 2012 through outreach conducted in four Wasatch Front counties. The BCC outreach model was designed to address known inadequacies and inefficiencies of the “traditional” health fair approach to community health outreach.

Between April 2012 and July 2015, BCC focused on outreach among populations affected by significant health disparities and communities historically identified to be at high risk for obesity, diabetes, cardiovascular disease, and barriers to healthcare.1 During that period, the Bridging Communities and Clinics model provided over 2,800 screenings through over 130 outreach events coordinated through a dynamic network of 13 referral clinics and 25 community partners in Salt Lake, Utah, Summit, Weber, and Grand counties.

In August 2015 and, because of federal requirements to address geographic disparities, OHD re-engineered BCC to focus on improving access to both medical and oral health services in two of Utah’s most underserved communities: the neighborhood of Glendale and the city of South Salt Lake. Since 2015, BCC has focused on outreach among populations affected by significant health disparities and residents of Glendale and South Salt Lake are no exception as they face considerable barriers to accessing medical health services and oral health services. In these two communities, BCC aims to (1) increase the number of people with a usual primary care provider and (2), increase the number of children, teens, and adults who used the oral health care system in the past year.

Moving beyond distribution of brochures and basic health screenings, the BCC approach employs evidence-based best practices to address themes of access to health services, preventive wellness promotion, and cultural competency by (1) partnering with community-based organizations to coordinate community events and mobilize community members; (2) assembling a diverse Outreach Team made up of trained outreach assistants and licensed oral health volunteers; (3) providing clinically relevant screenings for blood glucose and cholesterol, blood pressure, and oral health at no cost; (4) employing a secure data collection tool to identify community members’ social determinants of health needs; (5) offering appropriate referrals to free, reduced-cost, or income-based primary care and oral health services; and (6) working with a network of organizations to deliver individualized post-screening follow-up to help participants with signing up for medical insurance, finding a primary care provider, scheduling medical and dental appointments, etc.

Since September 2015, the redirected Bridging Communities and Clinics model has provided more than 2,700 encounters through outreach events coordinated through a dynamic network of over 20 partnerships including community-based organizations, oral health systems, referral institutions, and community partners.

1Including the uninsured/underinsured, low-income populations, African Americans, Hispanics/Latinos, Native Hawaiian/Pacific Islanders, refugee communities/recent immigrants, etc.

2013-2014 Legislative Report
This legislative report outlines BCC efforts for the first three years of implementation.

Bridging Communities & Clinics Pilot Outreach Program 2012
This report outlines the successful outcomes of OHD's innovative new outreach strategy.

It Takes A Village Project

Status: Completed

Background

Utah Native Hawaiians/Pacific Islanders (NHPI) experience significantly higher rates of infant mortality compared to the Utah population overall. However, no health promotion interventions exist in Utah or the U.S. tailored to Pacific Islanders to address this and other birth outcome disparities.

Since 2012, the Utah Department of Health and Human Services Office of Health Equity (OHE) in collaboration with health care professionals and community partners have been working to address this issue. The final product of these efforts is the It Takes a Village: Giving Our Babies the Best Chance (ITAV) Project. The ITAV Project raises awareness and addresses birth outcomes disparities in the context of Pacific Islander cultural beliefs and practices. From May 2017 to February 2018, the OHE conducted the final implementation and evaluation of the ITAV Project.

173 NHPI community members participated in the project over three phases. Post-intervention, awareness about NHPI infant mortality disparities increased on average by 57 %. On average, knowledge increased for all topics: infant mortality (70%), preconception health (29%), prenatal care (22%), initiating prenatal care (28%), and birth spacing (70%). Additionally, all average self-efficacy measures improved. Adaptations to the curriculum based on qualitative data from reiterations of the program lead to increased community engagement and improved cultural relevance. In the final phase, 100% of participants reported the program was culturally appropriate.

Results demonstrate the cultural appropriateness of the ITAV project at effectively raising awareness, improving knowledge, and increasing self-efficacy. The results establish the project's need and promote widespread dissemination and appropriate adaptation among organizations working with the Utah NHPI communities and for NHPI communities across the nation. Finalized project content was released online in April 2018 during Minority Health Month.

History

In 1997, the Federal Office of Management and Budget (OMB) revised the standards for collecting race and ethnicity. The Utah Department of Health (UDOH) was one of the first agencies to change all of its surveillance systems to collect data according to the new standard. To put this into perspective, the 2000 U.S. census was the first census that separated out Asian and Pacific Islander populations; prior to that, in 1999, UDOH was already collecting disaggregated data for Asians and Pacific Islanders.

Utah’s practices with data disaggregation and the subsequent data-driven projects for NHPI communities including the 2011 statewide Pacific Islander Health Survey and It Takes a Village project were cited as key examples leading to California, Governor Brown signing a health data disaggregation bill in September 2016 empowering the CA Department of Public Health to separate specific Pacific Islander group data from the broader "Asian-Pacific" category.

The Office of Health Equity (OHE) is able to identify and monitor birth outcomes disparities among Utah's Native Hawaiian/Pacific Islander communities because the Utah Department of Health and Human Services practices data disaggregation for Asians and Pacific Islanders. OHD produces reports on Utah's health status by race and ethnicity every five years.

Visit the It Takes a Village: Giving Our Babies the Best Chance Curriculum webpage by clicking here.

Implementing It Takes a Village

Implementation Guide

The DHHS Office of Health Equity (OHE) developed an ITAV Implementation Guide for organizations. It includes a readiness assessment with questions regarding support, experiences, resources, and plans for sustainability.

Recruitment Packets

The OHE created instructions with templates and examples for recruitment packets. Organizations may modify and use them to recruit facilitators and participants.

Facilitator Training

The OHE provides training for ITAV facilitators and created the ITAV Facilitator Training Preparation Checklist to complement the training experience.

Facilitator Manual

This document includes information for NHPI facilitators about how to prepare for and implement the workshops in the NHPI community.

Participant Workbook

The participant workbook is for community members who are participating in the ITAV project, to help them gain a better understanding of the cultural concepts and health issues being discussed. It also provides some critical thinking skills as participants record their answers, notes, thoughts, and questions throughout the workshops.

Documentation and Evaluation

In spring 2015, OHE in collaboration with the MAHINA (Maternal Health and Infant Advocates) Task Force conducted a pilot project, consisting of six workshops for 23 members of NHPI communities to raise awareness about birth outcomes disparities.

After evaluating the pilot project, OHE created a Native Hawaiian/Pacific Islander (NHPI) Birth Outcomes Advisory Committee to revise and expand the pilot project and create video production. In spring 2016, phase I of the It Takes a Village: Giving our babies the best chance (ITAV) project was implemented among 80+ NHPI community members along the Wasatch Front.

After phase I, OHE focused on developing a promising practice, by conducting focus groups and a quantitative analysis of vital records to inform final revisions of the curriculum. OHE also hired a project assistant from the NHPI community to help ground the curriculum in NHPI culture and tradition. Between May 2017 and March 2018, OHE conducted a second implementation and evaluation of the ITAV project, which reached 63 NHPI community members.

MAHINA Pilot Program: Raising Awareness about Birth Outcomes Disparities Among Pacific Islander Communities in Utah

This is a summary of OHE's collaboration with the MAHINA (Maternal Health &#38 Infant Advocates) Task Force on a pilot project to raise awareness about birth outcomes disparities among Utah Native Hawaiian/Pacific Islander communities.

Phase I Implementation: February 2016 - December 2016

This report is a summary of the activities and outcomes of the first phase of the ITAV project.

Phase II Implementation: May 2017 - March 2018

This report is a summary of the activities and outcomes of the second phase of the ITAV project.

Informative Studies

Since discovering the birth outcomes disparities faced by Utah’s Native Hawaiian/Pacific Islander (NHPI) communities, OHE has worked in collaboration with community partners on several studies to better understand the community’s experiences, socio-cultural context, and perspectives.

Pacific Islanders' Point of View: Perspectives and perceived control about addressing infant mortality disparities

This report shares findings from facilitated community discussions on infant mortality and the community's scope of engagement for prevention.

African American and Pacific Islander Postnatal Interview Study: How the Rest of their Lives Affects Pregnancies of Pacific Islanders and African Americans in Utah

Utah's first-ever qualitative study with Utah African American and Pacific Islander mothers who have experienced an adverse birth outcome; this study focused on identifying social determinants of health factors.

Developing a Multilingual Questionnaire and Surname List to Sample Utah Pacific Islanders

This peer-reviewed article explains the methods and implications of the 2011 Pacific Islander Study. Journal of Public Health Management &#38 Practice: March/April 2013 - Volume 19 - Issue 2 - p E25-E31 doi: 10.1097/PHH.0b013e318252ee60

Utah Pacific Islanders Community Perspectives

This report outlines an in-depth conversation with local Pacific Islanders about perspectives surrounding birth outcomes from the results of two surveys and five focus groups.

Utah Pacific Islanders 2011

The first statewide health survey conducted in three languages, interviewing 605 adult Utah Pacific Islanders in English, Tongan, and Samoan.

Logo History

The It Takes a Village (ITAV) Logo was designed and created by a local Pacific Islander to demonstrate the deep cultural meaning behind the project.

One community member commented: “The logo represents a family that is encircled by a tānoʻa (kavabowl), a kaliloa (headrest), and a village/fonua (three fales). In ancient times, the kavabowl and the headrest were the two sites for learning Indigenous knowledge and history. The logo conveys the idea of the fonua (placenta, land and its people, ecology), or the environment that nurtures and nourishes people. The vā, socio-spatial relations between people and their fonua are symmetrical, harmonious, reciprocal, and above all, beautiful in the performance of fatongia (communal responsibilities). I love the idea of honoring our forebears and ancestral knowledge/praxis."