UArizona Mobile Health Unit Outreach to Spanish-Speakers Offers Crucial Link in COVID-19 Battle

An internationally recognized program at the University of Arizona is conducting health screenings and referrals by phone and online to help vulnerable communities hit hard by the pandemic.

TUCSON, Ariz. – At a time when most of the world is on hold in response to the COVID-19 pandemic, the Primary Prevention Mobile Health Unit Program teams at the University of Arizona Mel and Enid Zuckerman College of Public Health are continuing their mission of outreach to Spanish-speaking communities in Arizona – largely by phone.

Unlimited Potential event in 2019 at South Mountain, Phoenix, with Kathleen Shurba, a dental hygienist (seated with mask) from Native Health; Dr. Eduardo Gonzalez, on right in back. (Photo: University of Arizona/Alma Ramirez)The Mobile Health Unit teams normally take vans to public events, community centers and other locales, urban and rural, where they provide basic health screenings, up-to-date health information and referrals for health care and more. Now, the teams reach out mostly by phone, text, online meetings and social media as they strive to address challenges created since the outset of Arizona’s stay-at-home orders in late March.

More recently, the units have participated in Tucson blood draws for COVID-19 antibody testing of health-care workers, first responders and UArizona students and staff still on campus. They are  expected to play an expanding role in that as the testing grows to all counties and the general public statewide.

Today, many of the Mobile Health Units’ clients are out of jobs, whether they worked in agriculture, construction, landscaping, restaurants, hotels or domestic service, noted Cecilia Rosales, MD, professor and associate dean for the college’s Phoenix programs, and associate dean for community engagement and outreach at both campuses.

“Often, with a job loss, the first expense to go is cable TV and internet, if they had it to begin with,” Dr. Rosales said. That’s because their clients often live paycheck to paycheck. Without TV, those clients become dependent on Spanish radio and social media apps on their mobile phones for news. As a result, Dr. Rosales said, her staff are battling many myths and much misinformation.

Dr. Cecilia Rosales, with Dr. Eduardo Gonzales (background), performing screenings at Arizona PRIDE Alliance event hosted by Chicanos Por La Causa at Corona Ranch, Phoenix. (Photo: University of Arizona/Alma Ramirez)

“In Phoenix, we've heard that at some point, some locutores – radio station hosts – make jokes about COVID and they don't take it seriously on their radio programs. So if they don't take it seriously, the people listening are not going to take it seriously either,” Dr. Rosales said.

One team member who frequently corrects misinformation is Teresa Lobo, a Phoenix Mobile Health Unit coordinator who has an internet radio presence at LaReynaRadio.com. In addition to  radio, Lobo has launched social media campaigns on Facebook, Twitter, Instagram and WhatsApp to promote good physicial distancing practices and provide other COVID-19 evidence-based information in Spanish.

Early in the pandemic, an absence of quality information in Spanish, and conflicting information heard on English and Spanish TV and radio, created a problem, which was made worse because Spanish-translations from the U.S. Centers for Disease Control and Prevention, Arizona Department of Health Services and health departments for Pima County and Maricopa County lagged  a few weeks, Lobo said. Now, many have caught up and are helping to flatten the curve (haga clic arriba para acceder a sus sitios en español). But it  still remains an uphill struggle.

“Sometimes older people are more reluctant to believe in those things (like COVID-19). Because they cannot see it, they feel it is not a real risk,” said Eduardo Gonzalez, PhD, a UArizona public health assistant professor and Phoenix Mobile Health Unit program manager. “I will say the same thing for younger individuals, who saw early reporting about it only affecting older people and thinking, ‘Oh, I don’t have a high risk to get this bad virus.’”

Sheila Soto making follow-up calls about COVID-19 and Tucson Mobile Health Unit client needs from home in April 2020. (Photo: University of Arizona/Sheila Soto)Sheila Soto, program manager for the Tucson unit, agreed. “For us in Tucson when we first started (talking to people by phone), it was more a sense of disbelief or them thinking (the virus) wasn't going to affect them,” Soto said of the reactions her team heard during their COVID-19 outreach efforts. “And, then, a lot of our families were let go from their jobs. Many things came into play (on perceptions) from there, too. Things would change if they were undocumented or mixed-status families; and they would also be affected if there were multi-generational homes because services and attitudes depended on so many different factors.”

The families often are close-knit, Dr. Rosales said, with grandparents babysitting grandkids whose schools are closed, and parents struggling to make ends meet. And stress only complicates chronic health issues such as diabetes, hypertension, cardiovascular and other  diseases, as worry extends to getting medications and finding follow-up treatment.

If a person in a household is experiencing COVID-19 symptoms, Mobile Health Unit staff refer them to a Federally Qualified Health Center (FQHC), most of which are providing consultations by phone or telemedicine. The 187 Arizona FQHCs are community-based organizations that provide comprehensive primary  and preventive care.

For most, though, the health issues are minor or related to common chronic conditions. Mobile Health Unit staffers may ask online to find rubbing alcohol for diabetics to disinfect fingers for periodic pricks to test blood sugar levels. Solutions for issues indirectly related to health may be as simple as a referral to a local food bank or free meal pickups at schools for their children.

Andrea Contreras (promotora), Eddie Vargas (student) and community volunteers Tanya Gonzalez and Tania Felix at the Arizona Bilingual Annual Back to School event, July 2019. (Photo: University of Arizona/Sheila Soto)

Other issues are more complex, however. Soto, a Gates Millennium Scholar and doctoral student in Public Health Policy and Management at the college, recalls spending hours helping one 70-year-old woman with a health condition submit an application for U.S. Small Business Administration payroll protection funding through the Coronavirus Aid, Relief and Economic Security (CARES) Act. She also referred her to a small business assistance program at Pima Community College, but not before making sure they could help her.

“We have one rule,” Dr. Rosales said. “Check the referral before you refer. You want to make sure the people you’re recommending a client contact actually can help them. So many times, it’s just one call in a chain of calls to the actual number where someone can help them.”

“That's what we do. We connect. We are – somos el fuente – the bridge between the community and organizations,” Lobo added. “Whatever it may be, if they need us, we're there.”

Additional information on this story and more of the college’s activities regarding the COVID-19 pandemic are at this link.

The UArizona Health Sciences COVID-19 Resources webpage can be found here.

For the latest on the University of Arizona response to the novel coronavirus, visit the university's COVID-19 webpage.

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A more in depth story on this topic can be found at the UArizona Mel and Enid Zuckerman College of Public Health website.

NOTE: Photos available here - https://arizona.box.com/s/0fg62fqhiaojzjgvzlgvpv3ukvh27a7j

About the University of Arizona Mel and Enid Zuckerman College of Public Health
Established in 2000, the Mel and Enid Zuckerman College of Public Health at the University of Arizona Health Sciences is the first nationally accredited college of public health in the Southwest. Today the college remains the only accredited college of public health in the state of Arizona, with campuses in Tucson and Phoenix. The college enrolls more than 1,100 students per year across degree programs at the bachelor's degree, master's degree and doctoral levels. Through research, education and community engagement, the UA Zuckerman College of Public Health continues to find solutions to public health problems in Arizona, the Southwest and globally. For more information: publichealth.arizona.edu (Follow us: Facebook | Twitter).

About the University of Arizona Health Sciences
The University of Arizona Health Sciences is the statewide leader in biomedical research and health professions training. UArizona Health Sciences includes the Colleges of Medicine (Tucson and Phoenix), Nursing, Pharmacy, and the Mel and Enid Zuckerman College of Public Health, with main campus locations in Tucson and the Phoenix Biomedical Campus in downtown Phoenix. From these vantage points, Health Sciences reaches across the state of Arizona, the greater Southwest and around the world to provide next-generation education, research and outreach. A major economic engine, Health Sciences employs nearly 5,000 people, has approximately 4,000 students and 900 faculty members, and garners $200 million in research grants and contracts annually. For more information: uahs.arizona.edu (Follow us: Facebook | Twitter | YouTube | LinkedIn | Instagram).