Promoting Access to Health Care in McLennan County through Homebound Campaigns

Theoretical Background and research questions/hypothesis:

The COVID-19 pandemic presented many unique challenges to public health professionals, including the development, distribution, and administration of the COVID-19 vaccine. Reaching vulnerable population in non-emergency times has its own challenges that were amplified and worsened by the pandemic. One such population is those who are homebound. While many efforts were established to vaccinate the homebound patients known to organizations, it does not encompass the entire homebound population whose homebound status is made up of confluence of medical, functional, social, and other needs (Dar, et al., 2021). Reaching homebound individuals can present a challenge as typical outreach methods, like posting flyers in coffee shops and local places does not reach them.

This project aims to answer the following questions:

• What impact does door-to-door campaigning have on accessing COVID vaccines for homebound individuals?
• What are the most effective communication strategies for increasing COVID vaccines among homebound McLennan County residents?

Methods:

WMCPHD has implemented “at-home” COVID vaccines since January 2021 in addition to the mass vaccine clinics and mobile vaccine clinics. The eligibility requirements for a homebound visit is the participant resides within McLennan County. While initially these programs did well as the pandemic has continued vaccinations have tapered off. Mobile vaccine efforts administered 123,056 doses in 2021, 7,452 in 2022, and 837 from January to March 2023; doses include first, second, and boosters.

To better support current efforts to reach homebound individuals, the Waco-McLennan County Public Health District (WMCPHD) created a door-to-door campaign to promote homebound services. The WMCPHD staff developed an outreach plan to visit various communities and areas throughout McLennan County to promote this service. The expected results include COVID vaccine uptake and the adoption of this method for other relevant services.

Results:

This project is in progress and will be completed by the end of May 2023.

Conclusions:

This approach focuses on addressing the social determinants of health, primarily accessible health care within McLennan County. WMCPHD created the Homebound leaflets to be distributed door-to-door to residents throughout urban Waco and rural McLennan County. While this method takes a lot of time the payoff is expected to exceed the cost. Meeting people where they are to share services and support their abilities to make informed choices about their health can lead to more improved outcomes.

Implications for research and/or practice:

Accessible health care has remained a barrier within McLennan County, as there are rural areas. Creating materials that specifically outline the requirements of the Homebound Program and targeting homes throughout McLennan County, this will encourage residents to get their COVID vaccine.