Episode 8: REACHing for Vaccine Equity Holistic Approaches to Improve Health Outcomes – RAO Community Health/Carmenia Consulting, LLC

Yabo Beysolow 00:48

At the top of every episode, we really like to explore how individuals can continue to thrive, not only with the preventive power of getting vaccinated but also by adopting healthy behaviors.

Today, we’re going to be talking about how vaccination protects individuals in various communities in Charlotte, North Carolina. I want to welcome our guests, Ashley Carmenia and Chinue Hinds-Hazelwood from RAO Community Health. I’ve worked with both of you over the past two and a half years through the iReach project, and I’m excited for you to share all of the great work you’ve been doing to promote flu and COVID-19 vaccination among your communities in the Charlotte area.

So Ashley and Chinue, I’m so glad to have you on the show. Welcome.

Chinue Hinds-Hazelwood 01:33

Thank you. Thank you for having us.

Ashley Carmenia 01:35

Thank you.

Yabo Beysolow 01:36

You are so welcome. So starting with you, Ashley, can you please tell our listeners just a little bit about your organization and how RAO Community Health works to impact the lives of people in your community?

Ashley Carmenia 01:49

Absolutely. So, RAO Community Health is a local nonprofit organization. We are based in Charlotte, North Carolina. We’re in Mecklenburg County, so in the heart of the city, in uptown. Our office services patients that are living with HIV as well as providing HIV preventative support service. In 2018, we were awarded the CDC’s Racial Ethnic Approaches to Community Health grant and the REACH grant to broaden our scope of work. It’s a broader population of our priority populations here within the Charlotte area. In 2020. the pandemic hit and so then that began our supplemental work with the COVID-19 and seasonal flu vaccinations, as well as working to increase that vaccine confidence in populations that were similarly impacted by different health disparities and different social determinants of health.

Yabo Beysolow 02:24

Great. That’s a great overview of just how your program has evolved now to include work on the REACH program. Can you tell us a little bit about the cultural aspects of the community demographics, et cetera?

Ashley Carmenia 02:59

Yes. So Charlotte within itself has, is becoming extremely diverse. So particularly we’ve seen a very big blossoming of influx of people coming in. I mean, that’s a huge diversity of minorities as well. So, not just you know, black, white, also Asian American, and…but definitely an increase in the Latino/Hispanic population as well. Our primary populations that we work with in our organization are minority populations but particularly within the LGBTQIA+ communities as well. So, we are very inclusive, very diverse across the spectrum of, of patients and community members that we work with.

Yabo Beysolow 03:39

Excellent. As you work with all of your communities, are there any health inequities that you come across that face your community?

Ashley Carmenia 03:48

Absolutely. So, just within our patient population, we see a very large disparity in healthcare access, particularly inequitable healthcare access, especially in dealing LGBTQIA population. But then, just pushing it out a bit further to the broader racial groups, of course, we have the typical disparities of once again, barriers to transportation, barriers to health care access.

A great deal of our minority populations reside in zip codes that are deemed as food deserts. So, there’s an equitable access to healthy food access. As well as there being, you know, disparities in financial literacy and health literacy. So, there are multiple tiers in which we are working to really reduce those health disparity gaps increase the equitable and social awareness to resources.

Yabo Beysolow 04:41 You’ve really outlined for us, you know, some of those inequities. You mentioned access, transports, food deserts, health literacy, etc. How did you build relationships and foster partnerships in your community to promote flu and COVID vaccination? What are some of your strategies?

Ashley Carmenia 05:02

So with that, we really relied on the community, the community within itself and what the community needed and what they wanted to hear, and the methods in which would be most impactful for getting the information out to them. So, particularly within the COVID-19 and seasonal flu space, within the messaging, we really had to rely on community leaders and developing those relationships on the ground with impactful individuals that are doing the work directly in communities and have the trust of communities, you know, and then gain the trust of the communities as well. That way, I think that was a huge component in it, was putting in that quality time to build the relationships and to build the trust and to get to know our communities and then come in with more. Come in with, just more, you know, than the vaccine and just education, but let’s really hear about the disparities in which you face on a day-to-day basis because the shot is one and done, but you still, you know, could be potentially hungry. You still can’t get to work. You know, you still have a dangerous situation, you know, in which you’re living in. So how do we also work to improve your quality of life outcomes and your health outcomes outside of COVID and flu? So that’s an approach in which we adapted and began to model in with our vaccination work that we were doing out in the communities.

Yabo Beysolow 06:22

Thank you. So looking at the whole picture and not just on vaccination, so Chinue, Ashley mentioned how you’ll build relationships and foster partnerships in your community to promote flu and COVID vaccination. Did you work with trusted leaders or messengers in your communities?

Chinue Hinds-Hazelwood 06:38

We did. So, we worked with a slew of entities and organizations across Mecklenburg and Cabarrus County, but just to name a few. So we have trusted messengers with some local disc jockeys here, No Limit Larry and Burpie. They’ve been on the radio for years now here in Charlotte. So they’re like a staple in the community for what’s going on locally and nationally.

We also partnered with a local chapter of Omega Psi Phi. We did a flu vaccine there in conjunction with a blood drive, which was great to have that partnership with fraternities and sororities, which are huge here, especially in the South, and that connection.100 Black Men – another huge partnership. They do a community event every single year so we did it this year and last year, actually. And we provided flu vaccines, we had COVID, and we also had HIV testing as well, because that’s also what our organization does here at RAO. Block Love – another great organization, great lady, Ms. Deb. She’s great. She left her job full-time to use all her time to work with the transient population, so she does, like breakfast, lunch, and dinner five days a week. I believe it’s not far from us, actually like down the street from us, so we partnered there. We had, again, COVID and flu vaccines, we had breakfast. We also had goodie bags with masks and hand sanitizers. And then also with Roof Above – they’re another nonprofit here that works with the transient population. We have several organizations here that work with the homeless, and it was a great way, again, to form partnerships and to have flu vaccines on hand to provide to those that were in need. Actually, funny story, one of our trusted messengers got their flu vaccine, no, their COVID vaccine here, actually, and he recorded it on Instagram, which was great because he has a huge following. And again, he’s like…they look up to him in the community. So, I hope that inspired other people to get vaccinated as well, seeing him do it too.

Yabo Beysolow 08:37

That is wonderful. You talked about not only nationally recognized organizations serving as trusted leaders, but also local leaders as well so great overview. I know this work sometimes can be a little challenging. So, Ashley, what was one challenge you felt that you overcame in your community with regard to flu and COVID vaccination?

Ashley Carmenia 08:58

I think probably the biggest challenge was the misconception and, and the misconstruing of information around the vaccine because, around that time, we saw that there was a lot of, um, social context around the vaccination, as well as a lot of political context around it. So, really, to put our ear to the street, for a lack of a better word. To really, gather the, you know, the most common misconceptions and work to address those.

And we had to work to address those even in some of the community leaders that we work with whereas, you know, got the vaccination but weren’t really out coming with saying that they had gotten the vaccination. So, the information in which they were giving to their constituents wasn’t supportive of them being vaccinated either.

So like I said, working to kind of get over the barriers with that misconstruing of information, but then also the stigma that had come about with getting vaccinated. And that was odd to me that there was a stigma around a vaccine, you know? So the root cause of where that stigma is coming from, you know, why is there such a stigma about the vaccination?

But then also, too, even testing positive for COVID, there were people that were fearful that they had had COVID, wear a mask, you know, to be around family, you know, where is that rooted from? So, we had a few different things and a few different angles in which we had to work from and trying to put out the correct information to the public. You know, but really being able to get their ear so in a way that it caught their attention and they paid attention to it.

Yabo Beysolow 10:37

Very important. You really unearthed a lot of you know, important issues and mentioned, you know, the stigmas, for example. And I’m sure that was surprising and enlightening to you. So, I wanted to switch that around a little bit to Chinue and ask, as you work with your trusted leaders, what surprised you in a positive manner about working with them?

Chinue Hinds-Hazelwood 10:59

The fact that they were perceptive. Due to, Ashley was mentioning about the stigma, the medical mistrust, and then the political climate that we were in the social injustice, it was like a lot going on all at once during that time. And not to mention most of the organizations that we work with, they’re also African-American or black-owned. So the fact that they may have their own personal, you know, perceptions of the vaccine, not letting that, you know, get in the way. So it was, it was, it was nice, but it was really nice and well received, and we really appreciated that, and it helped support.

Yabo Beysolow 11:33

That’s right. So you mentioned, you know, importance of just developing that acceptance by the trusted leaders. So, Ashley, how have flu and COVID vaccines been accepted in your community, would you say?

Ashley Carmenia 11:44

I would say that for the most part, I think it was, it was surprising to see more people lean towards getting the flu vaccination, and that was the easier sale than bringing the COVID vaccines out to the community. We have to do a lot of talking, you know, and just conversation having and answering a lot of questions around the COVID-19 vaccination in comparison to the flu vaccine whereas people would just sit down. There was no questions asked about the flu vaccination. With the COVID vaccine. It was frowns, you know, and I’m…they’re trying to microchip me, and they’re trying to do this, and you’re going to have horns growing out your head, you know, next year.

So it was a complete night and day shift, you know, between between the two. So, but that that did open up a very good gateway? Okay to have a conversation about it for me to ask the questions, you know, where did you hear that from? You know, who told you that this is going to happen to you? You know where, where are these misconceptions coming from?

And then just being able to correct it. And I think that’s where a lot of the gaps have lied is that there weren’t opportunities for conversations, for their questions to be answered. Um, Because I remember, in particular, there was an individual that called our prior coordinator that was overseeing these efforts, called him multiple times with questions and things that he was hearing about. And I think it probably took about three to four conversations before he finally came in to get vaccinated. And that was a win, though. Because it’s just like, you know, this young man, had he not had somebody that was educated in this to bounce his questions off of, to really gain their trust, he wouldn’t have gotten vaccinated, and he wouldn’t have come in, you know, for his follow up boosters in that vaccination series. I think that that qualitative component being able to add that and add that personal touch really helped and provided, you know, another layer to increase acceptance in the community. There were some, you know, that we just couldn’t talk to to get them to get vaccinated. We tried and it’s just like, well, you know, we’re here if you ever need it, we can point you to the direction to get them if you want, but, you know, if your, your convictions are your convictions and we’re not here to convince just to educate. So but like I said, for the most part, where we were able to go and we have built rapport in the communities, we’ve seen a better turnout, you know, and a better willingness of people wanting to get vaccinated. And to add as well that our staff that we sent out into the community, including our volunteers, is very diverse as well. we have, a medical provider that’s out in the field, able to answer the questions that looks like the population that they’re vaccinating. As well as the medical assistants, the nurses that we had. To add to the partnerships, we’ve worked with the Black Nurses Association here in the area. So we have, minority medical providers out in the field assisting us with this work. So, able to culturally connect on a certain level as well with the community. I think that definitely helped to provide another layer of acceptance.

Yabo Beysolow 14:46

And thank you. And again, just highlighting the importance of being available, being there for the community, building trust, and utilizing the right trusted leaders or messengers for your community. So I wanted to ask you to shed some light. I was very intrigued by a specific project. You did a video series.…if you could share some light on that for our audience?

Chinue Hinds-Hazelwood 15:09

Sure. So we did two. The Barbershop Talk, which took place in May 2022, seems so long ago, but it really wasn’t when you think about it. That was fun. We had four prominent leaders in the Charlotte community. One is executive director of a neighborhood here. One worked at a barbershop. The other was, I believe he was in charge of communications of 100 Black Man.

He also was a VP at Bank of America. We also had our trusted messenger at the radio station, No Limit Larry, as well. Um, was great conversation because even though it was about COVID and flu, it expanded; it went beyond and into so many other areas of this health in general. Also talked about the social injustice going on with George Floyd. So, I think it was great that it covered a multitude of issues that still were important and needed to be addressed in the Black/ African American community as far as health disparities are concerned. We also did one with four ladies at a gym; Charlotte Fits, also located here in Charlotte.

Um, one a therapist, the other who owned the gym. She has two gyms, actually. She let us use her space. Also, we had, uh, Miss Deb from Block Love. Miss Eugenia Grinder who is phenomenal, and the maternal health space. Again, another great conversation where it didn’t just stick within COVID because it went beyond and talked about again, what that felt like being home and how that affected business owners, how effective mothers who are pregnant it affected transit population. So it was very fruitful to hear their different perspectives and their field and how COVID affected them personally and in line of work. So we, we had a great time listening to them and hearing what they had to say.

Yabo Beysolow 16:55

It seems like that was just very, very inspiring having two different groups you’re able to talk to and get perspectives from on the ground, and hopefully, if your organization will allow, we’ll be able to share those as resources to the podcast, so we appreciate that. Anything to add on that, Ashley, those projects or any other projects in particular that you wanted to highlight?

Ashley Carmenia 17:19

I think Chinue perfectly summed up. Those were wonderful. And just really even touching on the, um, differences between the genders, you know, with talking about the, different roles, with women, you know, and how they and take care, you know, of home within work, but then just that maternal aspect added to it. And then with the men with some common misconceptions as it pertains to health care, um, with men and in their health care you know, being more reactive versus proactive and addressing, you know, some of, stereotypes and stigmas around that. But I would say, too, some other great work that we’ve done have been our community resource events – or care villages as we call them – and those are the physical culmination of a community resource after we developed underneath the core REACH work. And that community resource app is an interactive mobile application available on both iOS and Android. We went through fine tooth the resources to ensure that they were equitable but free to low costs, but then really provided educational tidbits about the resources that you can get from those resources.

And so our care villages brought all of that to life. So we, you know, ask the vendors to come that are highlighted in there, but we brought like live cooking demonstrations for healthy meals and where to get those ingredients from and gave away ingredients for it. We did the gardening demonstrations.

So had one of our registered dietitians out there doing garden living in any type of situation but then also how to use SNAP benefits to purchase seeds and how to, you know, really grow your own sustainable source of food as well as providing, you know, demonstrations within my place and really just getting into other, like I said, other health disparity issues such as chronic disease and the reduction of that.

And we were able to provide sexual health education and testing as well as the COVID-19 and seasonal flu vaccinations out there. And that just brought together some great partnerships with different entities and gave us opportunities to vaccinate and to further educate as well as addressing other issues of access to pertinent resources, and then it tied back to the app. So those were some great events. And we do have a couple of those planned for this summer and gearing up for back to school and going back into flu season and now COVID season as well, with the boosters upcoming for the fall, so those will be a great time. Like I said, we have a lot planned for the summer, but I think those have been really important throughout our time as well as just doing some unconventional stuff. We were able to partner with a comedian from the series Wild ‘n Out on MTV. He did comedy show locally here in Charlotte and one of the health and wellness partners because the premise of the event was health and wellness around comedy. So, we were able to partner there and provide vaccinations at the comedy event. So that was, it was a very different experience, but really putting healthcare into, you know, the unconventional spaces and just providing access yet once again.

Chinue Hinds-Hazelwood 20:23

One last thing. Yes, so we did a campaign that utilized, uh, billboards, buzz ads, social media, and display banner ads as well. And the whole purpose of the campaign was to dispel rumors and myths surrounding COVID-19. Just an awareness campaign, educational. So we will provide what the myth was, we provide what the fact was, and of course, provide what the source where that came from. So that is educatetovaccinate.com. It is still up and live. There’s also a downloadable toolkit we put together for social media. You can post them on your platforms as well.

So we’re really proud of that campaign and just a way to just provide educational resources on hand for people. Any question that they may have regarding COVID-19 and the flu.

Yabo Beysolow 21:08

You rarely applaud all the work that you have been doing over the last 2.5 years. You really addressed not only vaccination but adopting healthy behaviors, addressing food insecurity, teaching people how to garden, etc. And then those unconventional methods that you use, like incorporating vaccines into comedy – exciting. And then the education campaign. What, if you could pick just one thing, we’ll start with you, Chinue, what will you remember most about the last two and a half years?

Chinue Hinds-Hazelwood 21:40

Honestly, it was that the pandemic was ever-changing. We were going through the unknown in real-time, which caused a lot of emotions that I think a lot of us may have experienced, if not all emotions, maybe one of them.

Isolation, confusion, anxiety, fear, restlessness, and even sadness, all the loss that came with the pandemic as well. It was a unique time we were all experiencing together, and God willing, I hope we don’t have to go through another one anytime soon.

Yabo Beysolow 22:11

Okay, thank you. And you, Ashley?

Ashley Carmenia 22:14

I would say really the same. I think the main thing with being a public health professional is knowing, you know, the good and the education of what we needed to get out to the public, but then also to dealing with it internally, you know, in-house as well trying to find out, you know, the information is as quickly as possible for you to process it, but then for you to be able, you know, to get it out to the community in a way in which you understood, you know, so even, dealing with our own, you know, sentiments and, you know, hesitancies about being vaccinated ourselves, you know, having to get out there and tell the public the benefits of being vaccinated.

But then you’re questioning too, you know, on your side, what is this? You know, what, what are we doing? So, it’s just like Chinue said, a very up and down roller coaster of emotions, you know, with on both internal and externally but then, like I said, really working to better the community, you know, to get out there and try to get the information out to the community as quickly as possible.

I think a lot of great things came out of the last 2.5 years. A lot of lead points for us now in the public health field as to where we need to go because I think we knew the gaps were there, but that pandemic really widened them. And it’s like, so now, where do you go to address these gaps that have been left, resources that were put in place but are now, you know, slowly being pulled back. How do we sustain this work? Because we can’t go backwards to where it was pre-pandemic because it was a problem there. That was exasperated when the pandemic happened.

Yabo Beysolow 23:55

And that’s a great segue into my next question. How is your organization planning to sustain the vaccine equity work that you’ve accomplished so far?

Ashley Carmenia 24:06

We still have continuous partnerships with the county, so actually just secured plans for the fall in regards to having the boosters, you know, and being a vaccination site for the dissemination of the COVID-19 boosters, as well as, um, the seasonal flu, of course. But then just furthering the relationship, even with our county health department around adult vaccinations in general, you know, really working in that space to, to ensure children and adults are vaccinated as they should be or on par anyway.

So those are the conversations in which we’re having um, like I said, just to ensure that us as a clinical site. That we still have the vaccinations and that we’re open and available, you know, to provide them to the community. But then also to working with the different entities that are vaccinating and ensuring that people know, you know where they can still go to get vaccines. We’ve seen media be retracted, you know, everywhere we went, it seems like two years ago there were signs up saying vaccine here, you can get vaccinated, you can get tested here, and now that’s not there anymore. So, still just providing the education to people so that they understand where to go.

But then what this will look like, you know, from insurance perspective, a cost perspective, things of that sort. So that the information, like I said, is at the forefront and that they’re just aware of where the resources are.

Yabo Beysolow 25:28

That is great. That, that focus on the importance of vaccinations, not only COVID and flu, but like you mentioned, all adult vaccinations is still paramount for your organization. So, you know, this is now our inspiration section of the podcast. You’ve all shared such great information. Chinue, we’ll start with you. What is one message or story that has inspired your own confidence in vaccines or one thing that has kept you returning to your work every day?

Chinue Hinds-Hazelwood 25:54

So for me, it’s knowing that there’s always an opportunity or a chance to spread awareness to educate someone on an issue. It’s, for me, it’s not about trying to influence someone to make a specific like choice, like you have to do this or don’t do that. It’s just arming them with the facts to make an informed decision that works best for them and their family.

And as long as I provide you information, you say yes, you say no, that’s great. As long as you have the facts to now tell someone else and correct them on actually what the truth of what the facts really are.

Yabo Beysolow 26:27

I like that, arming them with that education. Thank you. And with you, Ashley, either what is one message or story that has inspired your confidence in vaccines or one thing that keeps you returning to this work every day?

Ashley Carmenia 26:40

I would say probably the stories for vaccination. And this is just my own personal story is that, you know, when the pandemic was was really hot and heavy in the vaccinations that, out in full disclosure, I did have my own hesitancies about it. However, my entire family – so not only, you know, immediate family, parents, sisters, but then also family in Louisiana where the rest of my family is located – we all pretty much made the decision to get vaccinated together. So it was like 30 of us that all went on the same day when they had a vaccination drive, to do it, you know what I mean? So really just had a, a, family convening, you know, around the pros and cons of it, and just decided as a family, you know, this is what we’re, we’re going to do.

We’re, we’re going to go for it. So I think um, that is inspirational because I know some people, you know, may not have, That type of a structure, you know, to be able to have that type of conversation, you know, and that type of support as well to, to go and to help them make that decision around you know, something that could be fearful for them, or potentially life-altering.

So I’m thankful within that space, you know, and just really advocate for people to talk about it. You know, if you have a trusted friend. You know, a trusted messenger, you know, trusted confidant, you know, to really be open and just be willing to have the conversation because you just never know, you know, what other people are thinking.

And the one thing that keeps me returning to work daily is, is just, you know, being able to help and educate. I have a true passion, you know, for this work, being able to interact with people on a day-to-day basis out in the community, but then also being behind the desk, you know, and with other constituents, other sectors to help improve policies that will systemically help people, you know, in the long run, so I think it’s just important that there are people that are advocates of, um, populations, you know, that have disparities to be in the proper seats to really help them both short term and long term. And that’s, you know, what my goal is, is to improve both the immediate quality of life, you know, to do something that will instantaneously put a smile on their face. But then to also, like I said, be working on the back end to make a systemic change that will ultimately improve the outcomes as well.

Yabo Beysolow 29:01

This has truly been so inspiring, and just been really, really thankful to both of you, Ashley and Chinue. I’ve really enjoyed hearing about all the incredible work that you’re doing in your community with your organization and with your community to continue to build trust, to improve health. It’s been wonderful chatting with you today, and I want to again say thank you. We appreciate both of you for your time today.

Ashley Carmenia 29:26

Well, thank you.  We appreciate the opportunity.

Chinue Hinds-Hazelwood 29:29

Absolutely. Anytime. Thank you so much.

Yabo Beysolow 29:32

Thank you.