Outreach Is Key To The Fresno COVID-19 Equity Project Targeting Underserved Communities
Just outside the gates on Weldon Avenue in central Fresno, a long line of vehicles wrap around the block, waiting to get inside FIRM, or Fresno Interdenominational Refugee Ministries. It’s the static testing site for the Fresno COVID-19 Equity Project, which started testing there in September.
The project combines the medical expertise of UCSF Fresno with the outreach of community based organizations like FIRM. The project’s focus is to offer free testing, making it more accessible in some of Fresno County’s most vulnerable communities.
Because of the latest surge in COVID-19 cases, FIRM is operating at max capacity - open six days a week, first-come, first-serve.
Chanedee Cha and her husband have been waiting in line since 6 a.m. By 10 a.m., their truck is still a few cars away from the entrance. She says they got lucky.
“We got here in time, because the people who were coming by and giving slips to fill out, I think they stopped about 20 cars behind us,” she says.
FIRM’s Executive Director Christine Barker says it’s normal to see cars lined up hours before the site opens at 8 a.m.
“People start lining up earlier and earlier. We let 20 to 30 cars in at a time and they leave and let in the next group of cars,” she says.
There’s a limited number of tests that can be administered per day, around 200. It’s what they can afford to do through CARES Act funding, she says.
The project hopes to reach people like Sai Soua Her and his wife. Because of their age and concerns about the virus, this Hmong couple have come to get tested for the first time.
A FIRM employee recognizes them immediately.
“Oh they’re my best friend’s parents!” she says.
A key to the project reaching its intended targets in underserved communities is employing people from those same communities. Sai Soua Her tells community health worker Vilai Yang why they came to get tested today.
“They’re afraid because there is no vaccine yet. They can only pray and hopefully God will answer their prayer and keep them safe,” Yang translates.
In addition to offering free testing, multiple languages are spoken on site. Patients might be greeted in Hmong, Spanish, and indigenous languages like Zapoteco and Mixteco. Community health worker Theodosia Anonye speaks a Nigerian dialect, Efik. She says there’s not a lot of Nigerian people in Fresno, but many of them attend her church.
“I do research, develop flyers, give it to my community and let them know this place, when they’re ready, they can come,” Anonye says.
Besides the static site at FIRM, the Fresno COVID-19 Equity Project conducts one to two remote testing sites per day. Community health worker Renata Monjaraz says she often finds more community members to connect with off-site.
“They’re surprised when we go to events and we speak Zapoteco, Mixteco, Tlapaneco. It helps them better so they can understand us too,” she says.
Christine Barker, FIRM’s Executive Director, says it takes a lot of connected work in the community to be able to untangle stigmas attached to testing.
“There’s concern that coming to the test site will expose you or that the test itself will give you COVID. There’s just a lot of misinformation and rumors,” she says.
Fresno Building Healthy Communities is another partner that’s been instrumental in outreach. Jessica Hernandez is a promotora, or community health worker, who was recruited from her neighborhood. She says most of her work happens days before a testing event even starts.
“We do canvassing before a testing event, a couple days before so that people know about it. On event day, we have specific tasks: hand out info to people, testing flyers - as they wait for their testing,” she says.
At the FIRM site, patients are given two sets of tests: a PCR, or Polymerase Chain Reaction test that gets sent to a lab with results in 2 to 3 days, and a rapid test that can be ready in minutes.
Rapid tests are processed on site. People who take the test can know within the hour whether they are positive or negative. If the results differ from a PCR test, patients are contacted for a follow up.
Back at the line of cars where Chanedee Cha waits, she offers some words of advice.
“Just be prepared, you’re going to be staying here a long time. Bring some drinks and food because you’re going to need it,” she says.
The demand for these tests is high. And UCSF Fresno’s Dr. Ruben Mora-Roman Jr. says it can be difficult to find the balance of serving those most vulnerable.
“Because we have such limited resources and limited tests, I really feel like we should really try to get people that are higher risk, or people that are showing symptoms,” he says.
Since the COVID 19 Equity Project started testing at the FIRM site in September, 7600 tests have been conducted through November 12. Of those tested, 73% were Asian and Latino.
That’s some measure of progress, according to the latest U.S. Census data, where Asian and Latino populations make up 65% of Fresno County’s demographic.
Reaching communities disproportionately affected by the virus is something state health officials are watching closely. The California Health Equity Metric, which took effect in October, measures positivity rates in disadvantaged communities of color. Showing a lower positivity rate in these neighborhoods is an indication of a county’s overall health response for the rest of the population, and can be a factor in helping a county move into a less restrictive tier.