April Joy Damian, PhD,MSc; Melanie Gonzalez, MA; May Oo, MPH; Daren Anderson, MD
Corresponding Author: April Joy Damian, PhD, MSc; Johns Hopkins Bloomberg School of Public Health. Email: adamian2@jhu.edu
Section: Original Research
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Background: The coronavirus disease 2019 (COVID-19) outbreak, a public health emergency of international concern, poses a serious health risk, particularly for older adults and persons with underlying chronic medical conditions. Community health centers (CHCs) serve as the patient medical home for populations that are disproportionately more susceptible to COVID-19; yet, there is a lack of understanding of the current efforts in place by CHCs working to prepare for and respond to the current pandemic. Methods: We conducted a sequential explanatory mixed methods approach, using a comprehensive cross-sectional survey and focus groups with physicians, nurses, medical support staff, and administrative leaders to understand the needs and current efforts in place by CHCs across the U.S. working to prepare for and respond to COVID-19. We applied the transcript-based analysis approach to the focus group data and derived themes using the constant comparative method. Results: Survey respondents (n=234; 19% response rate) identified guidance regarding COVID-19 infection prevention and control (76%), safety precautions (72%), and screening, diagnostic testing, and management of patients (66%) as their major educational needs. Findings from the focus groups (n=39) highlighted five key themes relevant to foundational aspects of readiness: leadership, resources, workforce capacity, communication, and formal policies and procedures. Discussion and Conclusion: The COVID-19 pandemic has exacerbated longstanding capacity issues that CHCs have faced, making it challenging for these safety-net practices to adequately respond to the current disease outbreak. Policies that promote greater investment in CHCs may strengthen these systems to better meet the needs of the most vulnerable members of society, and thereby, help flatten the curve.