Though “Help Stop the Spread” messages still cling to the walls of restaurants and faded stickers encouraging patrons to stay six feet apart have become a permanent part of the floor in public places, for most, these are signs of a pandemic of the past. But, the threat of COVID-19 is not over for everyone. Many Nevadans — especially those historically marginalized — are still profoundly impacted by the pandemic.
For the last two years, UNLV School of Public Health assistant professor Erika Marquez has been on a mission to ensure every Nevadan has equitable access to COVID-19 resources and vaccines through the Vaccine Health Equity Initiative. Marquez is the co-director of the Nevada Minority Health and Equity Coalition (NMHEC). Housed within the School of Public Health, the coalition identifies community-level priorities that impact health and develops community-engaged initiatives to improve health outcomes. Addressing the inequities of access to COVID-19 resources just made sense for NMHEC.
NMHEC also is co-led by Amanda Haboush-Deloye, executive director of the Nevada Institute for Children’s Research, and Policy, and Dzé Melendrez, interim vice president of Diversity Initiatives and Chief Diversity Officer. Public health doctoral student Samantha Smith also works alongside Marquez as the project manager for the initiative.
In recognition of her work on the project, Marquez is the winner of UNLV’s 2024 Community Engagement Award for Community-Based Research, presented at this year’s Academic Achievement Awards.
The Plan
With $1.2 million in funding from the Centers for Disease Control and Prevention, Marquez works with organizations and agencies throughout the state to reach racial and ethnic minorities, sexual and gender minorities, communities with lower incomes, and people who suffer from one or more chronic conditions. The initiative began in July 2022 and will run through June 2024.
Marquez leads the charge in conducting the following activities:
- Supporting the Nevada Vaccine Equity Collaborative (NVEC) to provide an ongoing space to keep up to date on the latest information and to identify and address community barriers to vaccination
- Identifying disparities related to COVID-19 and vaccinations
- Developing tailored messaging and materials for COVID-19 vaccine education and awareness
- Supporting vaccine navigation for communities in need
- Producing geographical information system (GIS) maps that depict COVID-19 vaccination progress in Nevada
- Utilizing a community-based participatory research approach to develop engagement strategies with diverse communities
“As we head into the final year of the project, the Vaccine Health Equity Initiative has grown and changed over time,” said Marquez. “We have aimed to be responsive to the needs of the community and have shifted priorities as such. For instance, in the last year of the grant, we focused our partnerships and efforts on increasing the number of children vaccinated in the state. This shift was a result of ongoing community concerns about understanding COVID-19 vaccines in children and informed by the apparent gaps in the data.”
A Community Effort
Community partners are the backbone of the initiative. Marquez and her team worked with each community partner to develop tailored messaging and strategies to communicate information about COVID-19 and the vaccines effectively. This entailed lengthy discussions about on-the-ground needs in the community and, ultimately, what concerns each community had about taking the vaccine.
Each partner would then use the messaging materials to directly disseminate information to their communities in the way that they would best receive the information. Some communication strategies utilized to reach the diverse populations throughout the state include word of mouth, canvassing by door-knocking, phone banking, and organizing events tailored specifically to the needs of the communities.
To date, community partners of the initiative include:
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Additionally, many non-funded partners support NMHEC’s work, including state and local government health authorities and agencies. The Nevada Office of Minority Health and Equity (NOMHE), has been integral in developing community-relevant and led strategies.
“Erika is a powerhouse in the community and in public health research,” said Tina Dortch, program manager for the NOMHE. “Her expertise has made her an asset to our organization, and her work within the community space exemplifies dedication and impact. The coalition, under her leadership, stands as a paramount resource to the community, continuously driving our efforts to address health disparities in Nevada.”
The Impact
From community partners to the communities in need, everyone involved with the Vaccine Health Equity Initiatives has benefited from the program.
The goal was to ensure equitable distribution of and access to the vaccine. This included discussions with community partners on challenges in community members getting the vaccine and updating the process by which the distribution occurred to facilitate vaccination uptake. The team also closely monitored progress using state data to ensure vaccine pop-ups were deployed in socially vulnerable communities, and vaccination uptake occurred in our hardest-hit communities.
The initiative also provided the opportunity to train UNLV students and recent graduates on using a community-based participatory research approach and its practical applications to make changes within various systems to improve health. As a result, Marquez published a how-to manual that supports the training of faculty, staff, students, and community partners in the administration of such an approach. And, as an institution, NMHEC’s community work has helped build trust for state institutions, specifically UNLV.
“We have a lot of trust to build, and our work has made strides in reaching communities that are often under-accessed or resourced,” said Marquez. “Our community organizations and the communities they serve were able to directly access fact-based information in culturally appropriate methods that represented their communities and increased access to the COVID-19 vaccine.”
Additionally, the vaccine equity work and use of a community-based participatory research approach have led to peer-reviewed and non-peer-reviewed publications and presentations. In collaboration with other faculty and community partners, Marquez has published four peer-reviewed and five non peer-reviewed articles and reports. And, she has presented nearly 20 presentations, many of which were as an invited speaker to discuss the work of NMHEC.
The UNLV Office of Government and Community Engagement administers four university-wide awards each academic year to recognize campus individuals for their exceptional community engagement in the areas of service learning, community-based research, faculty/staff community outreach, and student service.
