Making Service Delivery Relevant for Latino Families during COVID-19 through Responsive Adaptation

Authors:

Latino families have experienced a disproportionate burden from the COVID-19 pandemic. As of September 2020, Latinos have represented 29.5 percent of all COVID-19¹ cases for which race/ethnicity data are available (while representing only 18.5 percent of the total U.S. population). Latinos also have the second-highest mortality rate of all racial/ethnic groups when age is considered. Higher-than-expected rates of COVID-19 cases and deaths may be due to Latinos’ overrepresentation among essential workers and unpaid caregivers. The economic impact of the pandemic has also been substantial, with 49 percent of Latino adults reporting that they or someone in their family have lost a job or experienced a reduction in wages. The impact on mental health has also been severe, with a recent survey showing that Latinos are reporting the highest prevalence of symptoms of anxiety, depression, and suicidal thoughts of any racial/ethnic group.

Agencies that serve Latino communities have also faced numerous challenges during the pandemic. These include challenges in providing virtual programming and addressing families’ basic needs like food and housing, and meeting emergent needs related to staff training and family stress. In July 2020, the National Research Center for Hispanic Children & Families held a panel discussion with leaders of four organizations—AVANCE, Identity, Family Bridges, and El Futuro (see below)—that have redesigned services to meet the needs of Latino communities flexibly and creatively during the COVID-19 pandemic. These organizations represent different types of programs (e.g., parent education, youth development, marriage and family strengthening, mental health) across the country.

How four organizations adapted services to meet the needs of Latino families during COVID-19

AVANCE, a national nonprofit based in Texas that supports parent education programs for hard-to-reach low-income families, pivoted to help families meet basic needs, providing food, diapers, and cash assistance for rent and utilities. To continue programming through virtual methods and help parents manage heightened stress, AVANCE created numerous videos and made them available on Facebook and WhatsApp (a secure messaging app). They also created supports for staff working remotely for the first time, thereby increasing staff confidence with new technology and promoting self-care.

Identity, an organization in Montgomery County, Maryland that provides a wide range of community and school-based youth development programs for Latino youth living in high-poverty areas, also made a dramatic shift to meet families’ needs for food, housing, and other emergency assistance. Identity prioritized youth access to computers and wifi to enable them to stay engaged in school, and found that many families preferred to communicate on their phones via WhatsApp, which many in the community were already using. To help Identity’s staff better support young people and parents/guardians through the crisis, the organization provided substantive training in community mental health strategies like active listening and stress management techniques.

Family Bridges, based in Illinois, found new ways to help families manage stress and support young children, via Facebook live events in Spanish—a very different approach than the marriage and family strengthening workshops and conferences the organization typically provides through its partnerships with over 1,000 community organizations. Family Bridges discovered that this approach connected people across geographic areas and fostered meaningful virtual relationships.

El Futuro, a clinical outpatient program providing comprehensive mental health services for Hispanic families across 20 counties in North Carolina, has successfully provided telehealth services to almost 100 percent of its clientele across all ages. This has required navigating privacy requirements and technological challenges with significant administrative support, but has enabled staff to securely connect with families using video platforms on their phones. El Futuro has modified how and when it conducts sessions with families, even if a session involves just a 10-minute conversation with the client sitting in their car for privacy.

From the experiences described by these exemplar programs, we derived four key principles for adapting services to meet the emergent needs of Latino families:

1. Address families’ immediate needs first.

Being responsive to families during the pandemic and economic shutdown involves recognizing families’ existing knowledge and needs and serving the whole child and family. This includes addressing basic needs such as food and housing and helping families cope with stress. Organizations can also make services relevant to families by building upon what they already do and know, such as using phones for teletherapy rather than computers and using WhatsApp (a secure messaging service) for video communication. Making use of smartphones and platforms already adopted by Hispanic² families also promotes digital equity, bypassing challenges related to lower rates of broadband access. For research-informed communication strategies to reach and engage Hispanic communities, see this guide from Child Trends’ Hispanic Institute.

2. Support program staff members’ well-being and provide training for new needs.

Program staff will likely need training and support in a variety of areas, including self-care, to support their mental health and improve their technology skills. Across the four organizations, program staff demonstrated commitment to their clients and resilience in adapting to new ways of interacting with and serving families. To support staff in learning new technologies, AVANCE incorporated tutorials and resources into the payroll system (such as tip sheets, including one focused on staff members’ well-being) and obtained weekly staff feedback to inform trainings on an ongoing basis. To support staff in responding to families’ mental health needs, Identity provided 16 hours of training over a two-week period; this training was so successful it was extended to other county employees.

3. Leverage partnerships to address new and ongoing needs.

To address Hispanic families’ emergent needs during the pandemic, organizations may need to develop new partnerships with other community groups and organizations (e.g., faith institutions, organizations that serve children, community health workers). Some partnerships may bring in resources to address families’ immediate needs; others might address longstanding challenges such as technology resources and access for families in rural or remote areas. Partnering with respected community leaders who families trust can support services and provide accurate information that reduces risks and promotes health during the pandemic.

4. Relationships based on trust and respect are critical.

Organizations must build trusting relationships based on cultural sensitivity to reach and effectively serve Hispanic families during this time of unprecedented challenges and stress. When families trust an organization, they may be more willing to work with that organization. Families may also be more likely to engage with services in a new way if they feel that their needs and preferences are heard and understood.

Conclusions

These four exemplar programs demonstrate that Latino families have been responsive to new service approaches based in trusting relationships that address their emergent needs. It is likely that many other programs serving Latino communities have also successfully adapted their service models in similar ways. Addressing challenges created for families by the COVID-19 pandemic may also provide opportunities to enhance future services. For example, using new technologies may increase future service access and/or decrease costs through more strategic use of virtual services (i.e., blended delivery models). Organizations may create new partnerships during this time, which could prove valuable for the future.

Program flexibility, innovation, and responsiveness to families’ needs in the context of supportive policy will help ensure the success of organizations’ service delivery during these times. More broadly, given that experiences of stress across the country have been ubiquitous, there should be ample opportunities to further address mental health needs within the Hispanic community. In addition, state and federal policies can support programs in addressing the needs of Hispanic families, many of whom are not eligible for economic aid from the Coronavirus Aid, Relief, and Economic Security (CARES) Act. For example, federal guidance to states on expanding Medicaid coverage of telehealth services, including mental health, has been helpful to programs like El Futuro in reaching and supporting families. Other policy efforts to decrease barriers and promote access to services would help reduce longstanding disparities across service sectors.

Acknowledgements

We would like to acknowledge the following panel members for sharing their experiences and expertise:

Maria Santos Arellano-Buchanan, MA, MDiv, Vice President of Expansion, Family Bridges
M. Teresa Granillo, PhD, MSW, Chief Executive Officer, AVANCE
Juan Prandoni, PhD, LPA, HSP-PA, Training Director, El Futuro
Diego Uriburu, MS, Executive Director and Co-Founder, Identity

Footnotes

¹ Estimates come from the Centers for Disease Control and Prevention and are updated regularly and often. This percentage was retrieved on September 22, 2020. There may be variation since the time this publication was developed.
² We use the term Latino interchangeably with Hispanic.

About the authors

Desiree W. Murray, PhD, is a senior research scientist in the Youth Development area at Child Trends. Her work focuses on promoting the well-being of youth, particularly those living in adversity, by creating more supportive home, school, and community environments. Her expertise includes adolescent stress and self-regulation.

Lina Guzman, PhD, is the principal investigator and director of the National Research Center on Hispanic Children & Families, where she oversees a broad research agenda; robust communication and capacity building activities, including efforts to build the pipeline of diverse scholars; and strategic partnerships with the research, policy, and practice community. She is vice president of strategy and strategic initiatives at Child Trends and serves as the director of the Child Trends Hispanic Institute. Her research focuses on describing the characteristics and experiences of diverse communities of Latinos living in the United States to help inform policies and programs.

Melissa J. Perez is a project assistant in the Reproductive Health and Family Formation area at Child Trends. She works with the National Research Center on Hispanic Children & Families to better serve low-income Hispanic children and families.