Rural resourcefulness: How communities are innovating in the face of COVID-19

When the pandemic hit, health care professionals were faced with a new world. They set to work, mapping resources from scratch, improvising networks and procedures and nodes of communication, all to help their communities stay safe.

The Rural Health Innovation Hub collected best practices, lessons learned, and other examples of how rural communities are innovating in the face of COVID-19 to address health care and health-related concerns.

With their permission, NRHA has adapted a selection of these anecdotes to show rural ingenuity at its best. For the full article, visit ruralhealthinfo.org/topics/covid-19/innovations.

Increasing vaccine compliance rate among health care workers

Tennessee

Feb. 2021 - Bolivar General Hospital is at an 86 percent compliance rate with health care staff receiving the vaccine. Executive leaders had one-on-one conversations with employees, board members, and community members who were hesitant about getting the vaccine and answered any questions or concerns they had. The hospital leadership team and department heads were the first to get vaccinated and talked about their experiences so employees could learn more about potential side effects. In addition, the hospital offered vaccine appointments at times that better accommodated people working nights or weekends.

Source: Ruby Kirby, Bolivar General Hospital CEO

Reaching out to Black preachers and leaders to encourage vaccination

Louisiana

Feb. 2021 - St. James Parish Hospital staff noticed that the majority of people choosing to get vaccinated after seeing the hospital’s online and social media advertising were white — in a parish where almost 49 percent of the population is Black. Hospital staff reached out to Black preachers and local leaders (including a state representative) and established a phone line to spread the word about getting vaccinated. The next week, vaccination among Black community members increased from 9 percent of the total number of people vaccinated to 30 percent.

Source: Rural Hospital Remains Entrenched in Covid ‘War’ Even Amid Vaccine Rollout, Kaiser Health News

Helpline for health care workers and community members

North Carolina

May 2020 - The Hope4Healers Helpline (919.226.2002) provides resilience and mental health support to health care workers and their families experiencing stress from responding to COVID-19. This helpline is available 24/7, and callers will receive follow-up from a volunteer licensed behavioral health professional. The 24/7 Hope4NC Helpline (1.855.587.3463), previously used for hurricane relief efforts, is now available for every North Carolina county.

Source: Glenn D. Field, North Carolina Department of Health and Human Services community development specialist

Using phone trees and regional transit systems to reach individuals

North Carolina

Feb. 2021 - When CommWell Health in Brunswick County had 200 vaccine doses available, the NAACP county branch president organized a phone tree so that the vaccination event held the next day would have enough attendees. This method of communication was important in reaching individuals unable to access their usual sources of information, like churches or senior centers. In Jackson County, the regional transit system is picking up older adults and driving them to vaccination sites. These rides (in vans and small buses) are free, a small number of passengers can ride at any given time, and plexiglass separates passengers from one another.

Source: In the Rural Race to Distribute COVID Vaccines, a Piecemeal Approach, North Carolina Health News

Telephone trees and personal calls to inform community members about COVID-19

South Carolina

Oct. 2020 - Hollywood, S.C., municipal leadership shares COVID-19 information through its town website, social media, email, and press releases, but not all community members have adequate internet access to view this information. Clergy use telephone trees and personal phone calls to make sure high-risk individuals such as older adults and people with disabilities stay informed.

Source: Case Study: Rural Municipal COVID-19 Research Leadership, NRHA Rural Health Voices

Grassroots education to encourage acceptance of COVID-19 vaccination

Arkansas

Jan. 2021 - Jason Lofton, a family physician who practices in the rural community of De Queen, Ark., has noticed a trend of vaccine hesitancy in his community, which was hit especially hard by COVID-19 in June and July. To combat the issues of mistrust and lack of understanding, Lofton has taken a grassroots approach to educate his patients and members of the community using various media and meeting with local leaders. Lofton provides education on the COVID-19 vaccine as part of every patient encounter. He has discussed current issues about both the virus and vaccine on local radio, along with presenting to the area’s police department, Rotary and Lion’s Club, and public school administration — who used their new video department to record and broadcast a video. Lofton also records Facebook videos in order to inform the public, sometimes collaborating with another local physician, Randy Walker. Additionally, to aid in education of the community’s Hispanic and Marshallese populations, they have worked on bringing in Spanish and Marshallese interpreters on some of their videos.

Source: Dr. Jason Lofton, De Queen, Ark.

Vaccinating homebound individuals

Vermont

May 2021 - The Vermont Department of Health worked with local stakeholder groups to identify homebound individuals who need to be vaccinated and created a call center to find any individuals they missed. The State Health Operations Center worked with emergency medical services and home health agencies to deliver vaccines to homebound individuals. EMS agencies additionally provided vaccinations in long-term care facilities to support and augment gaps in the federal pharmacy program. In the first month, EMS vaccinated 2,625 homebound individuals and have since delivered vaccines to more than 4,500 homebound individuals.

Source: Dan Batsie, Vermont Department of Health Division of Emergency Preparedness, Response, and Injury Prevention director, via NRHA

Library increases access to internet and telehealth for community members

Texas

Oct. 2020 - Thanks to a grant, a local wireless internet service provider serving Pottsboro, Texas, has put wireless equipment on water towers, and people in low-income households with students can check out portable Wi-Fi routers from the Pottsboro Public Library. A library network funded three neighborhood access stations for the community. The Pottsboro Public Library director even let patrons use her office for telehealth sessions. With an additional grant, the library is working on launching a telehealth program, including creating a room specifically for telehealth.

Source: Commentary: Rural Public Libraries as Telehealth Providers During COVID-19, The Daily Yonder

Creating a free wireless internet service for students

Texas

Sept. 2020 - Lockhart Independent School District surveyed students’ families in March and found that at least 40 percent of students did not have reliable internet access. The school district diverted money from other projects to create a free wireless internet service. This project involved building towers, installing home routers, and installing antennas.

Source: Rural School District Creates Free Internet Service to Keep Students Connected, WRBL.com

Library increases access to internet and telehealth for community members

Texas

Oct. 2020 - Thanks to a grant, a local wireless internet service provider serving Pottsboro, Texas, has put wireless equipment on water towers, and people in low-income households with students can check out portable Wi-Fi routers from the Pottsboro Public Library. A library network funded three neighborhood access stations for the community. The Pottsboro Public Library director even let patrons use her office for telehealth sessions. With an additional grant, the library is working on launching a telehealth program, including creating a room specifically for telehealth.

Source: Commentary: Rural Public Libraries as Telehealth Providers During COVID-19, The Daily Yonder

Mobile health unit for testing and vaccines

Pennsylvania, Ohio

March 2021 - Primary Health Network, an FQHC serving 16 counties in Pennsylvania and one in Ohio, purchased a mobile health system where health care staff can travel to underserved communities and provide COVID-19 testing or vaccines. The mobile unit can be set up in about 45 minutes; this process includes powering up generators for the freezers that house the vaccines and creating negative air flow to prevent airborne spreading of the virus. Primary Health Network plans to mobilize their COVID-19 vaccination efforts once adequate supply of vaccine is available. Additionally, the FQHC is performing COVID testing from the mobile unit three to four days per week for Mercer County, Penn., residents. To address any misinformation and encourage community members to get the vaccine, Primary Health Network Chief Medical Officer George Garrow, MD, talks to organizations like farmers’ groups, trade unions, and church groups.

Source: Sara Rupp, Primary Health Network marketing director