NYC Community Engagement Alliance (NYCEAL) Against COVID-19 Disparities

BCR Study Design and Methods: To incorporate adequacy and plausibility, approaches in public health research often move beyond randomized trials to better support evaluation and public health decision-making, while being responsive to the three hallmarks of sound study design: minimizing selection and information bias, controlling confounding, and ruling out chance. BCR will leverage a quasi-experimental approach to evaluate the impact of the proposed intervention on participating NYCEAL CBOs' CHWs. The researchers will employ a pre-post non-equivalent waitlist control group design to proactively minimize logistical barriers, maximize feasibility of implementing the intervention, and reduce ethical concerns of depriving communities of beneficial interventions. The waitlist control sites (the second cohort of CBOs receiving the educational workshops) are expected to have similar sociodemographic characteristics and health burdens as the intervention sites. Data collection in the second cohort of sites will allow the researchers to examine whether observed changes in outcomes are attributable to the intervention and ensure that all of the partnering CBO sites have access to BCR educational workshops for CHWs and frontline workers. The researchers will assess impact using an outcomes survey co-developed with NYCEAL CBO partners (not individuals receiving the intervention). The researchers will conduct surveys via RedCap at pre- and 6-month post-intervention timepoints with CHWs at BCR sites (for both cohorts). The primary outcome for the CHW intervention is burnout (Mini-Z burnout scale), which is closely linked to workforce retention, work quality, and client interactions. Secondary outcomes include validated measures for resilience, stress, worker wellbeing, and job satisfaction. BCR intervention sites were chosen based on interest, history of collaboration, readiness, capacity and interest in promoting resilience, and consequently overall good health at the organizational level, and as they serve priority populations in high disparity neighborhoods (and the wellbeing of these sites is important for continuing the work of supporting local communities).

The BCR educational workshops will take place over two years, with two cohorts of six CBOs each (12 CBOs total). Both cohorts will be recruited simultaneously, with the second cohort serving as a waitlist control group during the first year. To improve CHW resilience and wellbeing, during each BCR cycle, the 6 participating CBOs will send groups of four to six CHWs to participate in the program (48-72 CHWs over the 2 cycles). Each cohort will receive six virtual, hour-long, evidence-based interactive workshops, delivered once per month over a six-month period. The first cohort will receive the intervention in year 1, while the second cohort will receive the intervention in year 2.

Topics include: 1) realistic optimism ("Build Your Hope"); 2) active coping and facing fears ("Face Your Fears"); 3) self-care ("Mind Your Body"); 4) social support and networks ("Mind Your Circle"); 5) building our "why" ("Mind Your Purpose"); and 6) addressing social justice ("Mind Your Community"). DePierro and an experienced social worker will co-facilitate the interactive, skills based workshops. They will include information in lay format about the importance of resilience factors and activities that result in the development of resilience plans. For example, activities to support the development of "utilizing social support networks"include building/mapping a social support network tree that allows people to take stock of the areas of support needed to further cultivate, and develop action-oriented SMART goals that address specific needs. Workshop participants will also have free access to a mobile app (Wellness Hub) that was developed by DePierro they can use to reinforce these topics through maintenance activities.