Community engagement for COVID-19 prevention and control: A Rapid Evidence Synthesis

Abstract

Introduction Community engagement has been considered a fundamental component of past outbreaks, such as Ebola. The COVID-19 pandemic and its control efforts require social actions and behaviours, all of which place a large reliance on individual and community compliance, highlighting the need for appropriate community engagement to support such work. However, there is concern over the lack of involvement of communities within COVID-19 thus far. Identifying how community engagement approaches have been used in past epidemics may support more robust implementation of community engagement within COVID-19 response. Methodology A rapid evidence review was conducted to identity how community engagement is used for infectious disease prevention and control during epidemics. Three databases (PubMed, CINHAL and Scopus) were searched in addition to extensive snowballing for grey literature. Previous epidemics were limited to Ebola, Zika, SARS, MERS and H1N1 since 2000. No restrictions were applied to study design or language, though articles must have detailed a minimum of one community engagement for infection prevention and control initiative. All authors participated in searching, screening, and data extraction, with a minimum of two authors at each stage. Results From 1,112 references identified in our search, 32 articles met our inclusion criteria. All but 3 articles were published on or after 2015 which details 37 community engagement initiatives for Ebola (n=28), Zika (n=5) and H1N1 (n=4). Twenty-seven of these initiatives were implemented in low-income countries and 10 from high-income countries. Six broad community engagement actors were identified: local leaders, community and faith-based organisations, community groups, health facility or community health committees, individuals and key stakeholders. These actors worked across six different functions: designing and planning, community entry and trust-building, social and behaviour change communication, risk communication, surveillance and tracing, and logistics and administration. Leaders were the most prevalent actor being engaged, and behaviour change communication, risk communication, and surveillance and tracing were the most common function of community engagement. Implementation considerations community engagement in prevention and control of COVID-19 are reported within. Conclusion COVID-19 global presence and social transmission pathways require social and community responses. This may be particularly important to reach marginalised populations and support equity-informed responses. Previous experience from outbreaks shows that community engagement can take many forms and include different actors and approaches who support various prevention and control activities. Countries worldwide are encouraged to assess existing community engagement structures, and utilise community engagement approaches to support contextually specific, acceptable and appropriate COVID-19 prevention and control measures.

Behaviour adoption approaches during public health emergencies: implications for the COVID-19 pandemic and beyond

“…In other health emergency contexts, community engagement efforts with trusted and influential community members have been used to promote protective behaviours. 19 For instance, during the 2014–2016 West African Ebola outbreak, large-scale community engagement interventions were implemented by thousands of faith leaders, traditional leaders, influential women leaders and other trusted community members; they worked together to locally interpret top-down measures and ensure that they were appropriate for their communities; then they promoted and modelled the protective behaviours in their communities. 19 30 In Sierra Leone, structured community engagement interventions supported locally owned community action plans that addressed unmet needs for sustained behaviour adoption.…”

“… 19 For instance, during the 2014–2016 West African Ebola outbreak, large-scale community engagement interventions were implemented by thousands of faith leaders, traditional leaders, influential women leaders and other trusted community members; they worked together to locally interpret top-down measures and ensure that they were appropriate for their communities; then they promoted and modelled the protective behaviours in their communities. 19 30 In Sierra Leone, structured community engagement interventions supported locally owned community action plans that addressed unmet needs for sustained behaviour adoption. 30 46 The emerging evidence from the COVID-19 pandemic, past health emergencies and established theories explaining human behaviour, all point to the need for more innovative, bottom-up approaches that engage trusted community members to communicate the benefits of the protective behaviours and support communities to develop action plans based on their local circumstances, means and strengths.…”

Understanding How Communities Respond to COVID-19: Experiences from the Orthodox Jewish Communities of Antwerp City

“…Future research should therefore continue to focus on documenting best practices of effective community engagement that go beyond passive consultation and actively include community representation in all steps of the outbreak response cycle. A recently conducted evidence synthesis concluded that such knowledge gaps remain especially evident in high-income countries [35]. Yet, the potential bene ts of a community-based approach are well-known and reiterated by this current research study.…”

A Comunicação do Risco e Envolvimento da Comunidade na Pandemia de COVID-19 em Portugal

“…Sem um sistema que informe sobre as necessidades de comunicação de risco e que avalie regularmente o impacto das medidas, que a este nível vão sendo tomadas, será impossível realizar uma comunicação do risco e envolvimento da comunidade de forma adequada. 5,6 Na ausência de um tratamento eficaz, ou de uma vacina, o enfoque em dimensões comportamentais e psicossociais associadas ao envolvimento das populações afetadas através da comunicação de risco tem sido apontado como um dos aspectos mais relevantes na gestão eficaz de pandemias como a do VIH/SIDA e de surtos epidémicos como o Zika ou o Ébola. 5,6 No contexto da pandemia de COVID-19, a Nova Zelândia demonstrou ser um exemplo de sucesso na gestão da comunicação de risco.…”

“…5,6 Na ausência de um tratamento eficaz, ou de uma vacina, o enfoque em dimensões comportamentais e psicossociais associadas ao envolvimento das populações afetadas através da comunicação de risco tem sido apontado como um dos aspectos mais relevantes na gestão eficaz de pandemias como a do VIH/SIDA e de surtos epidémicos como o Zika ou o Ébola. 5,6 No contexto da pandemia de COVID-19, a Nova Zelândia demonstrou ser um exemplo de sucesso na gestão da comunicação de risco. Desde o início a comunicação foi focada num responsável governamental e no Diretor-Geral da Saúde, com mensagens claras, instruções simples e dirigidas à adoção de comportamentos preventivos.…”