After nearly 20 months of the Covid-19 pandemic, there have been ample strategies to address the public health crisis—which responses actually worked? Advisory Board's Pamela Divack, Andrew Mohama, and Lauren Woodrow recently spoke with an organization that found success in their efforts. The organization, called Stop the Spread, was able to have an impact through solutions embedded in equity. To advance health equity during the Covid-19 pandemic and other public health responses, health care leaders need to think beyond the vaccine. They must identify opportunities to better understand their communities and improve basic health care, all while prioritizing trust and equity. That's exactly what Stop the Spread did.

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In March 2020, Stop the Spread called on chief executives and other leaders to commit to steps directed toward Covid-19 support and recovery. In just a few days, more than 1,300 chief executives signed the pledge to #StopTheSpread and #LeadBoldy. Operating as a program of ImpactAssets since June 2020, Stop the Spread developed into an organization dedicated to catalyzing both the private and philanthropic sectors' responses to the pandemic. Since January, the focus expanded to Covid-19 vaccine access, building trust and awareness, and advancing health equity in under-resourced communities, with a strong focus in New York and Los Angeles neighborhoods.

The impact of Stop the Spread's efforts

In addition to expanding access to vaccines, Stop the Spread focused on addressing underlying health needs in communities by creating access to other health care and social services. These efforts have been highly successful, and it was made possible through strategic community-based and private sector partnerships. Through partnerships with organizations such as the Community Healthcare Network, St. John's Well Child & Family Center, Unite Us, Bento, Headspace, Teen Line, and others, here are some of the achievements from Stop the Spread:

• Administer 30,000+ vaccines across four community-based sites and 80+ pop-up events in historically under-resourced neighborhoods through partnerships with churches, schools, supportive housing units and other community organization (70% of vaccinated individuals identified as Black or Hispanic);
• Launch its "Vaccine+" program connecting over 700 vaccine recipients to insurance coverage and a primary care provider in Los Angeles alone;
• Offer mental health information, tools, and services to over 4,000 individuals;
• Establish over 1,100 referrals to community-based organizations; and,
• Provide over 6,000 free and healthy meals to individuals experiencing food insecurity.

These are just some of the many impacts Stop the Spread had on various communities. What exactly were the keys to their success? There are four key takeaways for this organization's efforts, many of which can advise beyond the scope of Covid-19.

Four takeaways from Stop the Spread's successful efforts

1. Equity is not a one-size-fits-all initiative—advancing health equity is possible by developing solutions tailored to each community served.

How the concept of "community" is defined is critical for advancing health equity. Communities should be defined by neighborhoods or communities of people, rather than existing patient populations. Stop the Spread worked at this broader community level to deploy hyperlocal services tailored to the population.

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In the early phases of vaccine rollout, Stop the Spread recognized that people are most comfortable revealing their health care needs and challenges with trusted intermediaries or when their identity is protected. To better understand and address community needs, Stop the Spread held weekly meetings with community leaders and deployed anonymous in-person and virtual surveys to community members. They did this in real time, recognizing that one-off focus groups do not provide insight into evolving needs.

These efforts revealed community needs ranging from nutrition, healthy living, and access to food, support for anxiety and stress, health insurance, primary care, financial assistance, and increased loneliness. As a result, Stop the Spread was able to pinpoint and address needs as the pandemic evolved.

2. Take advantage of every free moment to identify needs.

"Any vaccination site that is not making better use of that 15-minute monitoring period is losing out on an opportunity to listen to the needs of their community," said Kimberly Chen, Health Equity Program Manager with Stop the Spread. Don't underestimate the power of 15 minutes—conversations had in this timeframe surfaced stories that helped guide important efforts. In one instance, a St. John's outreach worker asked someone sitting for the observation period, "What else do you need help with right now?" This simple question opened the door to their personal narrative, revealing they were a survivor of domestic violence, were living out of their car, and had no health insurance. This conversation allowed the outreach worker to connect the patient to critical resources to assist them in their time of need—and it only took a few minutes.

3. Meet a community's basic health and safety needs through last mile interventions—trust will follow.

In addition to setting up Covid-19 vaccination sites, Stop the Spread incorporated free non-Covid-19-related health care services into their community efforts. Access to basic services is still a challenge, so vaccination sites gave a prime opportunity to meet those community needs in a way that was easy to access, convenient, personalized, and free. Ultimately, this helped build trust in the health care system and instilled greater confidence in the Covid-19 vaccine.

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For example, Stop the Spread and Community Healthcare Network held a free, mobile HIV clinic in New York, along with a PRIDE celebration. Some patients were unwilling to receive a Covid-19 vaccine but were interested in HIV preventive care. After patients received free HIV tests and PrEP enrollment, they began to trust the health workers and became open to receiving the Covid-19 vaccine. This was a direct result of building relationships with patients and giving them a safe space to discuss their concerns. Pairing Covid-19 vaccinations with other components of primary care also helped to destigmatize transmissible infections and made it easier for individuals to access services they needed at no cost to them, regardless of insurance or immigration status. A partnership with the Clinical and Translational Science Center at Weill Cornell Medicine in New York City also enabled diabetes and health screenings and connections to follow-up care.

By leveraging other one-on-one interactions with patients, Stop the Spread demonstrated how building confidence in the vaccine can happen by building trust and caring for needs beyond just the vaccine.

4. Leverage the power of interpersonal relationships to build trust at the patient level.

Stop the Spread learned that the biggest driver of vaccine site attendance is word of mouth. As a result, Stop the Spread focused on tapping into the power of personal networks and launched a "Refer-A-Friend" incentive program for vaccinations, powered by mPulse Mobile.

During the 15-minute observation period post-vaccination, outreach workers from the community encouraged patients to text friends and family to get vaccinated. They also co-designed a Youth Ambassador program with RISE to empower young people to lead vaccination efforts in their community.

Additionally, Stop the Spread leveraged community-based outreach workers to connect with patients and discuss common concerns. Since these volunteers were from the neighborhoods they were serving, they were aware of the unique historic trauma that certain populations experienced and were able to connect with people more deeply on a personal level.

Parting thoughts

As leaders seek to take on challenges related to Covid-19, or really any public health concern, they must embed equity into every part of their business strategy. A holistic approach with equitable partnerships will not only save money and time, but it will also further advance long-term equity strategy, rather than relying on disjointed pilot programs. Stop the Spread prioritized equity in every effort, which helped them succeed in increasing both vaccinations and access to other important services and information in under-resourced communities.

The opportunity to listen, learn, and help is often hidden in plain sight. People want to be seen and heard for who they are. When we bear witness to individual life stories, we learn how to best help an entire community. Stop the Spread took that to heart.

Want to learn more about Stop the Spread? Check out their website to access their resources and tools, such as the Stop the Spread Playbook for Community-based Vaccinations and top 5 strategies to accelerate vaccine uptake. Additionally, you can sign up here for a free Technical Assistance Session before September 30.