Abstract
Aims:
Health and social services are fundamental to public and population health, and disruptions can have devastating effects on individuals of all ages. During the first wave of the COVID-19 pandemic, the availability of health and social services rapidly changed. Existing resources experienced changes in operation and mode of service delivery, while new resources emerged to address escalating needs. Both the general public and service providers lacked access to accurate information on availability and access, and existing service directories became obsolete or unreliable. To address this gap, a committee of university students expanded its volunteer base, partnered with a local non-profit organization, and invested in maintaining a centralized, up-to-date resource directory for the region.
Methods/Results:
Student volunteers sourced and consolidated existing county-level directories to curate more than 370 resources across 12 healthcare and social care domains in a Google Sheets platform. This directory was publicly accessible, available in English and Spanish, adjustable to community feedback and needs, disseminated through the local health system intranet, synthesized into paper handouts for food pantries, and utilized to curate a directory aimed toward older adult needs. Students worked in a tiered leadership model and mobilized quickly to respond to immediate community needs.
Conclusion:
This academic–community partnership engaging student volunteers can be a low-cost, high-value resource to support public health systems meet the information needs of their community, particularly during periods of crisis or rapid changes in service availability.
Keywords
Community-based health and social services are a critical component of the public health system for supporting overall wellbeing. Service disruptions can be catastrophic for people with the greatest needs. The COVID-19 pandemic with subsequent waves of different strains and public health emergency declarations challenged common communication pathways to maintain real-time information. Service providers and the general public often lacked timely access to accurate information on available resources and services to meet health and social needs. Existing resources, such as food pantries and childcare services, shifted their operations to fewer staff, reduced hours of operations, and some transitioned to virtual service delivery. New pandemic programs also emerged, such as mobile COVID-19 testing sites and emergency financial assistance options. Keeping the community informed became a public health imperative.
Community resource directories and publicly available online information on service availability are dependent on individual organizations to manage and update their profiles. This requires resources of time and personnel, both of which are limited for non-profits even without a pandemic. The primary purpose of this article is to describe an academic–community partnership to establish, disseminate, and maintain an accurate public directory of community resources to address social, health, and healthcare-related needs during a period of rapid change. Secondarily, we evaluated the volunteers’ experience with responding to urgent public health crises, partnering with community-based organizations (CBOs), and contributing to statewide efforts to support public health needs.
Approach
This initiative extended over three phases: (1) establish academic–community partnerships to evaluate existing databases and directories of resources toward one integrated directory, (2) map additional community assets to expand and then evolve a public-facing directory, and (3) transition resource data to NCCARE360, a new statewide resource referral platform. 1 Student volunteers were then surveyed through an anonymous Google form with 10 questions evaluating their time commitment to the directory initiative and their reflections on learning and service experiences with stakeholders and other student leaders.
Partnership to evaluate databases and directories
In 2018, students from Duke University partnered with the Lincoln Community Health Center, a federally qualified health center (FQHC), to establish ‘Help Desk’ as an integrated healthcare and social care program. 2 To address patients’ health and social needs, students established a database of community and public resources and services that could be used in clinic as part of patient–provider interactions. 3 In this program, social workers screened patients for health and social needs, identified relevant CBOs, and referred patients to what was available. 4 Student volunteer community resource navigators followed up with patients telephonically after their referrals to help problem-solve barriers, identify new service options, or help make connections. 5 This internal resource directory was continuously updated by students to incorporate feedback from patients, social workers, and CBOs.
When the pandemic began, Help Desk volunteers found it difficult to maintain the accuracy and comprehensiveness of the directory and continue to support individual patients. We learned that other local healthcare organizations and CBOs faced similar challenges and had to allocate already extended staff to collect up-to-date information. Existing local- and state-level resource directories also did not have the capacity to integrate newly created services during the pandemic. In an effort to support the community, the local public health department published several resource directories from various organizations, but the information sometimes conflicted and they expressed the need to reduce duplication and effort.
Help Desk was a subgroup of a larger undergraduate health policy organization, the Duke Student Collaborative on Health Policy (SCOHP). 6 In response to the public health department’s need and request, our SCOHP student leadership, with guidance from our faculty advisor, consolidated the most comprehensive databases and resource directories to produce a single, ‘one-stop-shop’ platform. Students contacted organizations and updated resource information. This integration process occurred quickly in March and April 2020.
Expand and evolve public-facing community resource directory
In May 2020, SCOHP partnered with the Community Empowerment Fund (CEF), a local social services non-profit organization, and together they recruited student volunteers across both organizations to advance these efforts that centralized accurate up-to-date information on local health and social services during the COVID-19 pandemic. We aimed for the directory to be on a platform that was (1) publicly accessible, (2) available in English and Spanish, (3) open to public community feedback through a comments feature, (4) updated weekly, and (5) tailored to community needs.
To create the public-facing directory, we first combined SCOHP’s and CEF’s databases in May 2020. With input from community partners and coalitions, we identified other directories and resource lists. From June 2020 to August 2020, we consolidated 32 other existing county-level lists to expand our centralized directory to 370+ resources across 12 healthcare and social care domains. Housed on a Google Sheets platform, the centralized directory was organized such that each tab represented 1 of 12 service domains. These included medical care, prescription medications, behavioral health and crisis support, food, housing, communication and technology, employment, financial aid, transportation, early childhood and childcare, criminal justice aid, and legal assistance services. Each resource had a minimum of the following information: name, target recipients, purpose, description, website links, contact information, language access, status during COVID-19, and the date last updated by a volunteer.
To maintain the directory, student volunteers were organized in a tiered model – 3 student leads oversaw the entire volunteer team and liaised with community partners; 1 student led a Spanish translation team of 5 volunteers; 12 students led individual resource domain teams of 3–5 students (e.g. food resources team) (Figure 1). To ensure accuracy, volunteers updated resource information at least weekly by calling or emailing services and monitoring their websites and social media. Furthermore, students regularly monitored the directory ‘comments feature’, in which the public could suggest edits and recommend new resources to be added. Students also regularly attended community health coalition meetings to source additional resources.
Tiered student volunteer leadership model used to maintain directory
In addition to being a public-only directory, we used several strategies to disseminate updated resource information. CEF operated a 40-hour/week hotline to provide directory navigation support. The web link to our directory was shared and posted on trusted local government and CBO websites, social media, and email listservs. The local health system incorporated the directory on their intranet. Consolidated resource lists were prepared in English and Spanish as paper handouts for distribution directly to providers, patients, and CBO clients. Subgroups of resources were curated for population-specific needs including one to support a coalition for older adults and individuals with disabilities.
Transition to a statewide referral platform
Prior to the pandemic, the state public health department had committed to establishing a technology platform, NCCARE360, to support health and human service collaboration for coordinated care. 7 Although the need increased in 2020, onboarding community resources had slowed due to the lack of capacity within service organizations to provide information, train, and integrate the platform into their day-to-day practice. Our volunteer team was well positioned to support community organizations in fall 2020 as we observed personnel continued to be stretched thin and there were fewer operational changes (and updates) to local resources for the centralized directory. We partnered with the local public health department and Unite Us to accelerate the evaluation of NCCARE360 for our region and to identify resource gaps and organizations that were in our directory but not yet in NCCARE360. This comparison of our locally managed directory with the statewide platform continued for 12 months. Student volunteers also supported the onboarding and platform training process for new CBOs and assisted platform-active CBOs in navigating NCCARE360 use and troubleshoot barriers.
Key Findings on Volunteer Experience
Student volunteers reported a strong connection with CBOs and the local community during the emergency crisis. Working closely with CBOs through regular contact primarily by phone enabled students to be directly involved with COVID-19 response efforts and allowed for remote volunteer engagement from out-of-state. Utilizing a large volunteer workforce ensured flexible and manageable time commitment and fostered a close connection with many organizations involved with local and state public health efforts. In a survey with 13 respondents of 24 invited to participate, 61.5% of students reported working 1 h per week, 30.8% reported working less than 1 h per week, and 7.7% responded working 3 h per week on resource information updates. Volunteers reported that the tiered team structure per resource domain increased a sense of teamwork and leadership in troubleshooting difficulties and navigating positive relationships with CBOs. Enabling supports included strong relationships with community partners, defined student operational structures, and faculty guidance.
While our directory initiative was originally developed as a short-term solution to fill an immediate gap, volunteers were able to contribute to long-term efforts to integrate medical, public health, and social services beyond the pandemic.
Conclusion
The COVID-19 pandemic highlighted the need for collaboration among service providers across healthcare, public health, and social services and the value of volunteers to expand the capacity of community organizations to improve the accuracy and availability of service information. Student volunteers can be a low-cost, high-value resource that can be quickly mobilized to support cross-sector linkages.
Footnotes
Conflict of Interest
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
