Collaborative CBPR Partnerships and Healthcare Workforce Task Shifting An Equity Strategy to Enhance Control of COVID-19 Outbreaks in Homeless Shelters

Abstract

COVID-19 is can be particularly devastating for people experiencing homelessness (PEH) who suffer disproportionate death and disease and cannot self-isolate due to living in congregate shelters. In response to the pandemic, a multisector partnership in Albuquerque, New Mexico mobilized under the name of “Corona Crushers” to reduce COVID-19 risk for PEH as a health equity initiative. In the context of shared leadership and partnership built on dialogue and trust, the multi-sector collaboration was able to use existing data on COVID-19 to take action to rapidly adapt evidence-based interventions from the literature and innovate to improve COVID-19 patient outcomes including expedited COVID-19 testing, quality improvement to improve adherence of PEH to quarantine and isolation; and a 75% reduction in outbreaks in the largest homeless shelter in Albuquerque, New Mexico. These pandemic interventions, however, placed a significant burden on already under-resourced shelter and healthcare staff and systems. In this paper, we describe the partnership’s ability to decrease COVID-19 outbreaks by task shifting interventions traditionally done by health professionals, such as COVID-19 testing and screening, quality improvement, and triage by supporting healthcare workers with less training including community health workers, medical students, and shelter staff. Task shifting not only enhanced the quality of our equity intervention, but it has the potential to expand the healthcare workforce to be able to address future inequities.