Public Health in Practice: Durham Health Ambassador Program Gets Us “Back on the Bull”

In the spring of 2020, Durham Mayor Steve Schewel invited local scientists to meet with him and share their thoughts as to how the community could endure the health and economic stresses of the emerging COVID-19 pandemic.

“People were fearful of going out, businesses were struggling and trying to implement best practices, and there was a lot of concern about COVID-19 risks as well as the economic health of essential businesses,” says Kurt M. Ribisl, PhD, Chair and Jo Anne Earp Distinguished Professor in the Department of Health Behavior, who attended the meeting.

A few months later, the mayor asked Ribisl if the department would get involved with Durham’s Back on the Bull campaign, where businesses could publicly share their health and safety practices in hopes of reassuring a wary public that they were safe places to visit. Ribisl turned to Master of Public Health student Marlyn Pulido to partner on the project, hiring her full-time to lead the work upon graduation.

"Helping these businesses weather the economic storm was one big win, and reaching parity in vaccinations — to get to where almost all the groups had the same vaccination rate — was the other big win."

— Kurt M. Ribisl, PhD

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Working with Patsy Polston, PhD, assistant professor of health behavior; Yesenia Merino, PhD, then-director of inclusive excellence and training; and a team of master’s students, Pulido and Ribisl led a phased, community health-based plan focusing specifically on assisting Black-owned and Hispanic-owned businesses in Durham. Partnering with local nonprofit El Centro Hispano and using grant funds from the city, they hired and trained 14 local multilingual, multicultural community members to become Durham Health Ambassadors.

“We were really looking to gear up a community health worker-based program,” Pulido says. “Things were just starting to reopen, and we wanted to offer in-person support to help local businesses figure out what they needed, not just to comply with quickly changing mandates but also to stay safe and be successful.”

Whether sharing information on the latest mandates and best practices, to leveraging the University’s ability to order personal protective equipment when it was in short supply, to personally ordering and delivering masks and hand sanitizer, the ambassadors worked closely with local businesses throughout the next several months to reduce their risks and stay open for business. 

When COVID-19 vaccines began to be distributed, appointments were extremely difficult to come by — and Black, Latinx and Indigenous populations already had disproportionately higher rates of COVID-19 illness and death than white populations. The Ambassadors worked to reduce that disparity, focusing on making appointments for essential workers at the grocery stores, gas stations and restaurants they had gotten to know over the summer.

As vaccinations became more widely available, the group’s focus shifted from making appointments to promoting equitable access and ensuring Spanish-language access at vaccine events. The Ambassadors joined the Durham Vaccine Equity Advisory Coalition, a group of nine local community organizations trying to address disparities in vaccine access. By the end of the project, those large gaps in vaccine rates were significantly narrowed or closed altogether.

“Helping these businesses weather the economic storm was one big win, and reaching parity in vaccinations — to get to where almost all the groups had the same vaccination rate — was the other big win,” Ribisl says. “It took a lot of effort — we flooded the community with community health workers who would meet at local businesses, camp out at small grocery stores, attend vaccine information sessions and clinics. Every barrier that was there, the team broke through. The dedication of these community health workers was really, really amazing.”