Miguel Rodriguez recalls passing out educational fliers about the COVID-19 vaccine in Camden, NJ. He was approached by an individual who was curious about the vaccine but hesitant to get it after hearing misinformation. One question from Miguel — “What are your fears?” — resulted in the person getting vaccinated within the hour.
This interaction is an example of the many that occurred as a result of the Camden Coalition’s Community Ambassadors program, which has played a key role in educating Camden and South Jersey residents about various public health concerns.
Community Ambassadors are conduits between health officials and community members, relaying essential information about best practices to lead a healthy life. The Ambassadors understand what community members face and address their concerns with empathy and education.
Lessons learned
Those considering a peer-to-peer model to address community health can learn from our work over the past two years.
Build a community outreach program before you need one.
It shouldn’t take a crisis to develop a similar community outreach program. Having a model for community engagement in place, including trusted relationships with community members and partners, allows for a rapid and effective response to public health crises like the pandemic to systemic issues like lead in homes.
Strong community relationships have been a mainstay for the Camden Coalition. In 2014, the organization launched the Community Advisory Committee (CAC) to formalize these interactions and provide a way for committee members — most of whom are current or former patients — to improve the health of the city in which they live. Our Community Ambassador program grew out of the CAC early in the COVID-19 pandemic.
“The Camden Coalition wouldn’t have been able to start the Community Ambassador program if not for years of relationship-building with our Community Advisory Committee members,” says Senior Program Manager Evelyne Kane. “We began by building trust with people and co-designing the program alongside those with lived experience to ensure it is authentic and truly reflects the values of the community.”
The work and relationships extend beyond the COVID-19 response to address other issues of importance to Camden residents.
Victor Murray, the Camden Coalition’s Senior Director of Community Engagement & Capacity-Building, emphasizes trust as a starting point. “You can only move at the speed of trust,” he says. “Sometimes that’s overlooked, particularly during a crisis where things are happening quickly. Having those trusting relationships allowed us to accelerate the work and have honest conversations with our community and partners when things were not working well.”
Train Ambassadors about behavior change and health issues to improve effectiveness.
Community-building requires people-building. Ambassadors received ongoing training in motivational interviewing, up-to-date information about public health concerns, and were provided with resources to share with community members that would help them stay healthy. Onboarding guides with videos and educational materials help Ambassadors get up to speed quickly on different public health issues.
“Just one word makes a world of difference when you’re talking to people in the community,” says Maritza Gomez, a Program Manager at the Camden Coalition. “You must know how to engage with them and how to read their body language, too. Our training helps our Community Ambassadors feel comfortable with motivational interviewing and relaying the right messages to residents.”
Ambassadors are compensated for their time, effort, and expertise. Those involved stress the flexibility of the program for Ambassadors, many of whom manage their own complex social needs.
“Something special about this program, compared to community health worker and peer specialist programs, is its flexibility,” says Evelyne. “It is not a full-time job or part-time job because a lot of people with complex health and social needs have health or life constraints. This flexibility is essential to partnering with those with lived experience in a formalized, compensated way.”
This model is just one iteration of what the future public health workforce might look like: representatives of the community, invested with training and education, compensated appropriately, building long-term relationships with their neighbors.
Recruit Ambassadors who reflect — and are trusted by — the community they serve.
The Community Ambassador program sees strength in common experiences. The Ambassadors represent different demographics and face similar needs as the individuals in the community they are trying to reach, which allows them to create authentic relationships.
Camden city is home to a majority Black/Latinx population, and the demographics and lived experiences of health officials and leaders do not always reflect those of the community. Those impacted by systemic racism can often be rightfully distrusting of systems of care, which is why a peer-to-peer outreach program can be an effective rapid response to a crisis.
Miguel, an Ambassador who experienced homelessness, recalls his outreach efforts. “At first, people didn’t really trust us. When I was homeless, people told me things and I’d listen, but I wasn’t going to do them,” he says. “Now I remind them that we are from the same place, the same community. That shared experience helps me communicate better with them. I know what to say, how to approach them, and what questions to ask.”
Focus on trust as the foundation of any Ambassador’s program.
Trust is a must for any outreach program, particularly when building relationships with individuals mistrustful of a system that has exploited and harmed so many. As persuasive messengers, Ambassadors were able to use their lived experiences and trusted relationships to address misinformation, myths, and fears about COVID, and educate those they encountered about masking, social distancing, and vaccines. Ambassadors continue to apply that framework to providing support and education in other areas including ortho virus (mpox), lead in households, and colorectal cancer.
The Ambassadors are a bridge in both directions, from the grassroots of the community to the largest systems and institutions in the city, county, and even state. Local officials and leaders, such as the department of health and regional partners, rely on the Ambassadors to share honest, on-the-ground feedback in an official capacity, greatly value their perspective, and are willing and able to make changes based on their insights.
For example, COVID testing sites initially required proof of residency status. Ambassadors realized from conversations with community members that this policy excluded people experiencing homelessness and those without documentation. The Camden Coalition relayed this barrier to officials who changed the policy so all residents could access testing regardless of proof of identification.
Ambassadors also help get the word out on behalf of the partner organizations, such as myths and misinformation about COVID.
This bi-directional approach creates long-lasting partnerships built on strong foundations. Kathleen Noonan, President and CEO of the Camden Coalition, says, “When you’re dealing with complex public policy issues, there are going to be bumps in the road. It’s a long-term agenda. There’s a lot to negotiate and everybody has to trust each other.”
Meet community members where they are to educate and engage
Ambassadors frequently hit the streets, sidewalks, and boardrooms, depending on the need of the day. They participate in community meetings and events, and canvass door-to-door to provide information and engage directly with their neighbors. Additionally, they attend regular meetings with the Camden Coalition and the New Jersey Department of Health to ensure community feedback is shared and addressed.
During the pandemic, the Ambassadors worked both in person and virtually. Community Engagement Program Assistant Taylor Brown says, “If you can, host meetings online or in a general location that people can easily get to. The more things are tailored to the community, the more they’re going to want to be involved. Their feedback is so important, and they bring up so many things we would never know.”
Camden City’s public health efforts are not possible without the invaluable work of the Ambassadors. We hope that others considering developing or enhancing a peer-to-peer outreach program can apply these lessons in their communities.