A Team of ‘Community Influencers’ Gave Vital Coronavirus Information to Black and Hispanic Communities

BENTON HARBOR, Mich.—Early in the coronavirus pandemic, it was becoming clear that African
Americans and other minorities were far more vulnerable to the virus in the U.S. than whites.
This was disturbing news to many people, including the people charged with overseeing public health in
Berrien County, Michigan, which includes the small, adjacent cities of Benton Harbor and St. Joseph. The
mostly Black city of Benton Harbor and its environs were getting hit harder by the coronavirus than the
small, mostly white towns across the St. Joseph River and most of Berrien County, which is about 75%
white.

The virus was spreading quickly. Health authorities needed to act fast.

To compound the problem, false information was circulating on social media in the Benton Harbor area
— potential lethally false information. One myth maintained Black people could not get COVID-19.

Facing a Communications Hurdle

But a big communications obstacle faced leaders of three entities in late March as they prepared to
disseminate helpful information to Benton Harbor-area residents about the coronavirus. The three are
the Spectrum Health Lakeland hospital system, the Berrien County Health Department, and a team
working with them to close racialized health disparities in Berrien County as part of an ongoing effort
called Community Grand Rounds: Healing the Trauma of Racism.

The obstacle was distrust of the local hospital system by many African Americans in Benton Harbor,
Benton Township and a part of St. Joseph Township adjoining Benton Harbor known as Fairplain. Benton
Township also has a significant number of Hispanics and Latinos. Many of the residents of these
communities have little engagement with Lakeland’s conventional, mass means of communication. Like
racial minorities elsewhere in the U.S., this population has history-deep reasons not to trust mostly
white-led health institutions.

Jerry Price, Manager of Diversity and Inclusion, Spectrum Health Lakeland

These residents of the 49022 ZIP code are no different from people in other marginalized communities who suffer from their communities’ disinvestment and don’t always trust their local hospital systems, according to Jerry Price, the Lakeland hospital system’s manager of diversity and inclusion. “At times some of those marginalized populations don’t always use the same communication vehicles that larger organizations use,” he said.

Let’s Try ‘Community Influencers’

Candidly confronting this institutional weakness, Price proposed an idea: why not recruit so-called community influencers — people who are “on the ground” in the community and trusted — to work with local health officials? Influencers could get vital, potentially life-saving information about the coronavirus to 49022 residents. They could also disseminate other information such as the importance to the Benton Harbor area’s future of filling out census forms. (NOTE: Although the 49022 ZIP code covers a big area including tiny towns to the east, this article refers primarily to the denser populations of Benton Harbor and Benton Township.)

Brainstorming names and starting the community influencers’ work happened quickly in late March.
Price said a group calling itself the Community Communications Planning Committee organized the
49022 campaign. It consisted largely of representatives of the county health department and Lakeland’s
Population Health Department, plus others, including a member of a Hispanic church.
“We settled on the term ‘community influencers’ because, literally, we wanted people who had
influence in the community,” said Price, an African American who grew up in Benton Harbor and is well
known there. “It was just that simple.

“We literally thought about who has the largest sphere of influence in the community. We all used our
personal networks to think about who were those individuals,” Price said. “Once we built the list, we
were very intentional about [being] multigenerational: What was their reach, and who did they reach?
We didn’t want to have all influencers who only reached the young people.”
None of the 13 people who has stuck with the work as community influencers is a conventional
community leader such as an elected official. None is a leader of a nonprofit organization, or executive
from a large local business.

Fundamental Trait: Trust

Ronnika (R.J.) Williams

Price emphasized the influencers needed to be people whom 49022 residents trusted. “We wanted people who were trustworthy in the sense of they have spent years doing this work already, but in an informal way,” he said. For example, he mentioned Ronnika (R.J.) Williams. She works at the Boys &; Girls Clubs of Benton Harbor and for several years also has been interviewing people in the community about grief for an ongoing documentary series.

“So, she’s built this trust with people, this intimacy with people, and she’s built this large circle of influence that’s multigenerational, from her work at the Boys &; Girls Clubs with the young teenagers, to her work on grief deep into the community,” Price said.  “The Coronavirus — And a Bit of Levity, Too.”

Cortez Mone

Other influencers include Cortez Mone, who has a Facebook page named “The 49022 — Voice of the People,” and Betty Fisher, who has a Facebook Live show called “The Internal Work of Love.”

Betty Fisher

 

 

 

 

In April, Fisher teamed with another community resident, Bertha King, co-founder of Strong Women of Faith, in a Facebook Live conversation with Spectrum Health Lakeland CEO Dr. Loren Hamel about how to keep
Benton Harbor-area residents safe from the coronavirus.

Corey Smith, an evaluation consultant leading a team to track the effectiveness of Community Grand

Corey Smith, Evaluation Consultant, Community Grand Rounds

Rounds work, including that of the influencers, said organizers planned on assembling a team of influencers who each had their own, distinct audiences, with little overlap. Smith and his evaluation colleagues’ research bore out this was the case. Further, the influencers were reaching audiences essentially distinct from those of the local hospital system and the county health department.

 

 

 

In the Zoom Where It Happens

Like so many meetings around the nation during the pandemic, the influencers’ get-togethers are virtual affairs. They check in every Friday on Zoom to share what’s working and what’s not. To begin their work, the influencers were asked what kinds of coronavirus messages would work best with their Black and Hispanic audiences. Smith said the question to the influencers was essentially: “What kind of content do you think people need to hear?”

Three Community Grand Rounds communications professionals created 25 simple, one-panel memes
reinforcing safety precautions about the virus. The influencers were asked whether these memes looked
and sounded the right way. Messages were revised according to their feedback and sent back to the
influencers before they posted them on Facebook.

Each public health meme contained just a few words, accompanied by simple imagery. One meme, in
big white letters on an orange background, said: STAY HOME. STAY SAFE. SAVE LIVES.

Only People of Color in Memes

Among the 25 memes were ones that: urged people with suspicious symptoms to phone or go online for
free COVID-19 screenings; showed two people with six feet between them to illustrate social distancing;
advised people of safe outdoor activities to get exercise: “solo outdoor activities like walking, running or
biking;” showed graphically how one sick person could quickly multiply into 30 sick people; and warned
people against playing team sports or taking part in any gatherings.

Any memes with drawings of people were only people of color, and the background or frame of many
memes was the orange-and-black stripes of the beloved Benton Harbor High School Tigers mascot,
chosen to resonate with the community. Notably, there was no branding by Spectrum Health Lakeland,
the Berrien County Health Department or Community Grand Rounds.

Most messages had the hashtag “#StayHomeMichigan” at the bottom. Others had “#SeparateTogether,”
and “#IStayHomeFor.”

Colloquial and informal language was in; jargon was out.

Following Their Own Styles

After sending the influencers the 25 memes to post on their Facebook pages, Price and the other
organizers kept their distance. They didn’t want to pressure the influencers and cause them to change
their individual ways of communicating on Facebook.

As Price put it: “We told the influencers we didn’t want them to change their cadence,” but to operate

in their natural ways. Mary Gayen, a junior evaluator, said, “All of us … just watched and let people who already had existing relationships with the influencers work with them.”

Some influencers sent all 25 public health messages at once, “because that’s how they did other things,” Price said. “And you had some who, each week was kind of a different thing, and then they began to attach personal stories along with the memes,” he said. “So, each influencer used their platform the way
they were accustomed to using it.”

Although social media is the primary communication method, the influencers’ work also has employed flyers, word of mouth, bulk messages through WhatsApp and online chats.

Reluctance to Divulge Data

Early in their work, the influencers pressed to have the Berrien County Health Department release
geographic and racial data showing what people in the county were suffering the most infections.
Evaluation Consultant Smith recalled some resistance among county leaders. But they ultimately
complied. Once they did, “it was a key piece of information for a lot of the influencers,” he said.
Price agreed that releasing the information was pivotal but could understood the health department’s
reluctance. He said it was probably trying to make sure the information was “packaged in such a way”
that didn’t create more bias by feeding into a common perception of, “Well, it’s their behaviors, that’s
why they’re catching this virus.”

Influencers Become Leaders

The influencers were doing their thing on Facebook with their individual audiences and meeting on
Zoom every Friday with the communications committee.

Price described a sudden change in who was leading whom. “We would check in with the influencers,
get feedback from them, but, more importantly, they were able to ask us questions and direct us as to
what they needed,” he said. “What started off as ‘We can give them information’ really turned into this
true community engagement where they raised their hands and said, ‘Hey, that was good, but we
actually need this.’

“So, they were directing the machine,” Price continued. “We were really their soldiers. They gave us
direction as to what they needed, what information they needed.” He called this “community
engagement at its best.”

The Right Lingo, Please

The influencers said the language of some memes didn’t resonate with their audiences, and they
needed some changed after they started posting on Facebook, Price recalled. The term “social distancing” gave way to “no kickbacks” for the younger audiences. A kickback is a visit to someone’s house. “When we said social distancing, although we know what it is, some of those younger folks are like, ‘But I can still go by my friends’ houses.’” Price said the answer was: “’Well, no, so no kickbacks either.’”

He said some Spanish-language memes were rewritten to reflect the dialect spoken by the Benton
Harbor-area Hispanic population.

The Storytellers Emerge

The influencers naturally began assuming responsibility to seek out more information themselves. Price
said they passed on information to their audiences from trusted sources such as the Centers for Disease
Control and other national health organizations.

One influencer with a big network of social media friends took an intimate — and highly effective —
approach. He reached out to friends suffering from COVID-19 who had posted about their battles with
the virus and asked if they would share their personal stories on his page as well.

“When he shared it, other influencers were able to see it and share it on their pages,” Price said. “So,you had this barrage of personal stories from people from Benton Harbor who were being affected by COVID-19. And this influencer was spreading this information because the influencer felt, for certain groups, it wasn’t real until it hit somebody they knew.”

These first-person accounts were powerful. “People were starting to see that COVID-19 was not just in
New York, it wasn’t just in Chicago, but it was right here in Berrien County and it was affecting people
that they knew,” Price said.

“Those are the things that our community influencers did, that no health care organization could have
done!”

Influencers adapt their messages to current needs and concerns. For instance, Price said, “We’re in this
era of George Floyd,” and influencers have posted about this landmark moment and its meaning

Anecdotes Suggest Behavioral Change

Smith said the community influencers began their work hoping their social media posts would ultimately
help lead people to protect themselves from the coronavirus by staying home, stop congregating in
groups and seeking help if they were sick. This was how they defined success.But evaluators had no way to measure any actual behavioral changes, Smith said.

Price, of the Spectrum Health Lakeland hospital system, agreed any possible changes in behaviors were
not measurable. But “anecdotal observations” from 49022 pointed to changes, he said.

“Our influencers were reporting they saw more people wearing masks, that people were thanking them for sharing the information, or saying, ‘Wow! I didn’t know that. Thanks for sharing that,’” Price said. “Many of the things our influencers shared, their circles of influence were sharing from their pages as
well.”

49022 Still in Eye of Storm

The need for coronavirus messaging remains strong in 49022. A mid-August look at the Berrien County
Health Department’s COVID-19 Data Dashboard showed 49022 is one of the ZIP codes in the county
with the greatest number of confirmed and probable coronavirus cases.

Black county residents, who constitute nearly 15 percent of the county’s population, had accounted for
about 32 percent of the 1,438 confirmed and probable cases and suffered about 30% of the 65 deaths.
Hispanic or Latino residents make up nearly 6% of the county’s population, and by mid-August had
accounted for 9.86% of the cases and 1.56% of the deaths.

Smith said the communications departments of the local hospital system and county health department
need structural change to be better equipped in the future to deal, not just with emergencies, but with
disseminating health information more broadly. The goal will be a continuing communication “with
people in those communities,” he said.

A Track Record of Trust

Price said there is now a track record with the influencers, and trust has built between the influencers
and the coordinators. He spoke of the continuing importance of the influencers relaying information
about the census.

Persuading residents of the 49022 ZIP code of the importance of filling out the census form was a key
ingredient of the effort from the beginning, Price said. He noted that just as they are more at risk from
coronavirus, 49022 residents stand to lose more if there is an undercount of the population in their
community.

“We felt the census was important post-COVID,” Price said. “If we don’t get the count right, then the community loses those dollars for school lunch, for all these other programs.”

A grant early on helped support the work of the influencers, and coordinators are seeking another grant.
“In this model of the community influencers, we felt part of building trust was we couldn’t ask them to
use their personal connections and not” compensate them for their time and efforts, because they are
essentially acting as consultants, Price said.

The creators of the community influencers approach wanted to acknowledge the influencers’ value,
“although,” Price said, “this wasn’t their real value,” but “we wanted to show our gratitude.”

A Model for Other Health Officials?

The collaborative energy that created the 49022 influencers team got high marks from Price. He said the
collaborators were the Berrien County Health Department, Community Grand Rounds and the
Population Health Department and Diversity and Inclusion program of Spectrum Health Lakeland,
assisted by the Berrien Community Foundation as the first funder.

Price was asked if he considers the 49022 outreach a success so far.

“Yes, I do, because I think it’s changing how we engage with the community, from this point on,” he
said. “I don’t think we will ever go back to doing it entirely the same way we used to, based on this
project.”

Speaking of the strong collaboration in Berrien County, he said, “I think it informs other places of how
you can do this work together in that segment. It’s been a great teamwork effort. It truly has.”

Read More: “The Coronavirus — And a Bit of Levity, Too.”