COVID-19 “Pop-up” Teams Examine the Wide-reaching Impacts of the Pandemic
In 2020-2021, 13 Bass Connections project teams tackled research related to the impact of the COVID-19 pandemic. These teams were part of a special call for proposals issued in partnership with the Duke-Margolis Center for Health Policy with support from the Duke Clinical and Translational Science Institute.
Bringing together faculty, students, and staff from across the university, these projects tackled a range of issues prompted by the pandemic including:
- Health inequality and the unequal distribution of testing and access to care
- Building community capacity to respond to public health emergencies
- Mental health and family well-being
- Use of wearables for early detection
- Food insecurity among Latinx communities
While all of these teams addressed issues of national or international import, many teams partnered with local community organizations, adding a local grounding to their work and delivering immediate community impact. The work of many of these teams continues through Bass Connections project teams operating in 2021-2022, manuscripts under review, and submissions for external funding. Summaries of each team can be found below.
By the Numbers
Indicative of the broad range of topics addressed and the interdisciplinary approach of the Bass Connections program, these teams brought together expertise from across Duke. Participation from the School of Medicine was particularly strong.
Team Summaries
Assessing an Innovative Community-based Response to COVID-19 in Rural North Carolina
In rural, coastal North Carolina, residents are particularly vulnerable to COVID-19. This project team examined the challenges faced by residents of Pamlico County and explored how to build agile community-based response networks to strengthen and empower individuals and local organizations to effectively respond to disasters.
Partnering with Pamlico’s grassroots COVID-19 community task force (CCTF), as well as the county health department and a local healthcare clinic, team members conducted surveys, qualitative interviews, literature reviews and data analysis to provide and implement recommendations for community partnerships to improve chronic disease management, build community engagement to prevent the spread of COVID-19 and strengthen the capacity of the county’s health department to address health inequities.
The team also created several posters and newsletters encouraging safe health behaviors and distributed them across Pamlico through the CCTF.
“Participating in my year-long Bass Connections project gave me confidence that I could pursue a career in global health. It inspired me to begin my own independent research study, building off of what I learned from my faculty mentors and graduate-level peers. My experience with Bass Connections developed a foundation that I will continue to build on for the rest of my Duke career and beyond.” –Nikhita Gopisetty ’23
Community-based Testing and Primary Care to Mitigate COVID-19 Transmission
In Durham County, COVID-19 services have largely been implemented within existing health service infrastructure and networks that exclude Black and Latinx communities. Seeking both immediate and long-term solutions to health inequities in Durham, this project team collaborated with Advance Community Health in Wake County to bring testing resources and vaccination information to Latinx community members in partnership with La Semilla, a local service-based non-profit.
With partners in medicine, community health, nursing and public policy, the team also investigated scalable and sustainable care delivery models for strengthening community-based care in under-resourced communities. This team is continuing its work in 2021-2022 with the goal of improving the responsiveness of local health systems and identifying best practices for vaccine distribution in Durham County.
Coping with COVID-19: Using Behavioral Science and Digital Health to Promote Healthy Families
During the COVID-19 pandemic, a secondary mental health crisis has emerged with many families facing disrupted routines, financial stress from job loss, pressures to work from home while caring for children and ill family members.
Professor Eve Puffer (top left) has spent much of her career building therapeutic programs to improve families’ mental health in sub-Saharan Africa. When the pandemic arrived, Puffer led a survey of parents in 17 southern states to learn more about their well-being. She and her colleagues found significant levels of depression and anxiety symptoms; concerns about social, emotional and behavioral difficulties in children; and reports of deteriorating relationships within families.
To address these family stressors, this team worked with community partners to adapt a family intervention program that has proven effective in Kenya for use in North Carolina. In May 2021, around 25 families in Durham and surrounding areas began the Coping Together program, meeting virtually with trained facilitators from the partner organizations. In the eight-week program, families participated in activities designed to address stress, strengthen relationships, reduce conflict and improve problem-solving techniques.
This team continues to evaluate the impact of the program with the hope of expanding to meet community needs. Through a Bass Connections Student Research Award, several team members are also working to establish a parallel virtual intervention strategy in Kenya.
“Usually, it’s an institution hiring people to come in and do this work, and I don’t know about the success of that. With this, because it’s embedded within the community and has full community participation, I think that is really going to be what makes the difference.” –Wanda Boone, Community partner (Together for Resilient Youth)
This project team investigated the challenges that the pandemic posed to democratic electoral processes related to voter turnout and voting rights. Focusing specifically on absentee balloting, team members examined the history of absentee ballot rejection, monitored ballot rejection rates in several counties in North Carolina and evaluated the effectiveness of BallotTrax, a new app that N.C. counties used to track absentee ballots.
The team also worked to promote voter turnout in the 2020 election. Collaborating with Durham Drives, a grassroots organization created to drive voters to and from the polls, team members reached out to thousands of Durham voters who do not have drivers’ licenses to see if they needed rides to the vote. The team also created Spanish-language voter resources and aimed to increase student turnout by assessing and developing student-centered voter messaging.
This team is continuing its work in 2021-2022 by evaluating balloting and demographic data from the 2020 election to make county, state and national-level recommendations around election procedures.
“The most inspiring part of Bass Connections was actually hearing about what everyone else on the team was doing. It was amazing to be surrounded by a group of similarly passionate and dedicated students, and I learned so much from how they identified and approached their particular issues … Action requires an understanding of the landscape it exists within, and I [was] very excited to lay the groundwork for some longer term, and hopefully highly impactful, democracy work.” –Abigail Phillips ’23
Equity and Efficiency of Using Wearables Data for COVID-19 Monitoring
To quickly identify and isolate new COVID-19 infections and clusters, public health officials have been seeking new tools to target diagnostic testing for individuals who exhibit symptoms.
In April 2020, Duke launched CovIdentify to test the viability of using wearables to quickly identify individuals who may have contracted the coronavirus. The CovIdentify platform integrates information from widely used wearables (e.g., smartwatch) with simple, daily electronic self-reports on symptoms and social distancing. Since April, the study has collected data from over 7,500 individuals using a “bring-your-own-device” (BYOD) model.
This project team enhanced and expanded the CovIdentify study by creating a data pipeline to better manage and analyze collected data and modifying their iOS application to more easily collect participant information and reduce barriers to symptom reporting. Team members also increased participant engagement through targeted outreach and examined biases that may occur in the BYOD study model. Their research on biases in study design and the potential effects on downstream technology development resulted in a publication, including a set of guidelines for improving demographic imbalances. This team is continuing its work in 2021-2022 with the goals of redesigning the platform’s database and diversifying its population of student participants.
Impact of Face Covering on Patient Communication and Health Outcomes
While face masks have played a crucial role in reducing the spread of COVID-19, they eliminate access to facial information that’s necessary for effective communication for many individuals with hearing loss. Recognizing this added barrier to communication in the midst of a public health crisis, this project team set out to evaluate the impact of mandatory face mask use by providers, clinical staff and patients on communication and health outcomes in an outpatient setting.
Focusing on adults over the age of 60, team members developed a survey to assess how patients perceived their listening effort, understanding and overall ease of communication while masked. The team also developed a tip sheet for healthcare providers including suggestions for enhancing visual cues and gestures while masked and using alternative forms of communication such as speech-to-text applications or written notes. The team plans to share its findings in a forthcoming publication.
Implementing Electronic Symptom Screening for Telehealth Visits
Symptom monitoring is integral to quality oncology care. Research shows that the collection and monitoring of patients’ symptoms using electronic Patient Reported Outcomes (ePROs) assessments can enhance care and lead to improved quality of life; however, before the pandemic, physicians had only collected and utilized ePRO symptom screening data during in-person visits.
This project team developed a system that implements ePROs for telehealth visits. Team members designed a flowchart outlining the steps that needed to be taken to integrate screening data and designed a workflow to minimize patient survey fatigue and optimize the platform for physicians. Team members identified seven physicians to participate in the test run and worked with Duke Health IT to implement the symptom assessment survey into the e-check in process. The trial-run workflow became active in Spring 2021 and is currently being evaluated and refined.
Improving Food Security to Increase Resiliency to COVID-19 for Latinx Populations
This project team took on the problem of food insecurity among Durham’s Latinx residents, one in five of whom said they sometimes skipped or limited their meals. In the context of the pandemic, access to sufficient nutritious food took on even greater importance.
Working with Root Causes, an organization run by Duke medical students, the team researched strategies for adapting to COVID-19, such as modes of contactless food delivery. Using surveys and deidentified medical records, team members assessed the impact of Root Causes’ Fresh Produce Program on patient health and food security amid pandemic conditions. Through interviews and a comparative study of food redistribution organizations, the team identified (and continues to identify) local and global best practices in addressing food insecurity as part of the response to the pandemic.
Members of the team continued their work during the summer of 2021, facilitating a Community Consultation Studio with Triangle area food security organizations in conjunction with Duke’s CTSI Community Engaged Research Initiative (CERI).
Partnering with the Duke Campus Farm, the team also expanded the Fresh Produce Program to around 150 households in Durham, including many high-need Latinx families. Deliveries included fresh food as well as masks, household essentials and educational materials.
“Even though our work has been done virtually for the most part, the work and research that goes into our investigation of Latinx food insecurity feels impactful and salient, especially in the context of COVID-19 and how it has impacted much of the world around us … My experience [has] fueled an interest in the political integration of migrant and immigrant rights, particular as it relates to health and healthcare. I anticipate pursuing this further as I continue my academic endeavors here at Duke.” –Elaijah Lapay ’24
The pandemic has exacerbated many challenges for North Carolinians living with disabilities, including disrupting healthcare services, furthering isolation, and increasing financial stress and mental health burdens. This project team investigated the lived experiences of people with disabilities in Orange, Durham and Wake counties to develop evidence-based, disability-inclusive policy recommendations in response to the pandemic.
Team members conducted six key informant interviews to gather personal testimonies and held focus groups with representatives from five community-based organizations to discuss how they’re adapting to meet community needs. The team also conducted a second round of interviews using innovative, arts-based methods that incorporate photography, storytelling and body mapping.
A Summer 2022 Story+ team expanded the team’s research to include voices from the Black and indigenous community with the goal of designing a Massive Open Online Course (MOOC) that examines the intersections of disability, race, ethnicity, socioeconomic status and human rights among people with disabilities. Ultimately, this body of research is designed to create community, ensure visibility and bring about policy change for people living with disabilities in North Carolina and beyond.
Mapping WASH and COVID-19 in the Middle East and North Africa
This project team examined how different communities in the Middle East and North Africa (MENA) are responding to the pandemic, with a particular focus on the implications of access to water, sanitation and hygiene (WASH). While many nations across the MENA were swift in their initial response to the pandemic, with the emergence of new waves of infections, it became clear that preexisting vulnerabilities and inequities would heighten the impact of the health crisis and create new challenges.
To examine the diverse impacts of COVID-19 across the MENA, team members created individual country profiles that present systematic information on domestic government responses to COVID-19 through the end of 2020 in Egypt, Iran, Jordan, Palestine and Yemen. These profiles spotlight research on underreported topics, such as the implications of tech-enabled solutions, medical brain drain in Egypt and supply-chain problems across the MENA.
Team members also conducted deep dives as small groups into selected topics such as the impact of COVID-19 on humanitarian organizations in Yemen, the domestic implications of international sanctions in Iran, comparisons of the vaccine rollouts cross-nationally and changes in international monetary aid.
Several of these projects, which make use of narratives, interviews and surveys extended into Summer 2021, including a Bass Connections Student Research Award project led by student team members Sama Elmahdy and Hadeel Hamoud to map WASH infrastructure in Egypt and Sudan.
“[W]eakened systems in the MENA have exacerbated the consequences of COVID-19, especially among refugee populations. Our project seeks to understand how COVID-19 has affected existing efforts by humanitarian actors to expand the capacities of the water, sanitation and hygiene sector; illuminate how the pandemic has fostered new interventions; and identify opportunities for building resilience among humanitarian actors.” –Sama Elmahdy ’22 and Hadeel Hamoud ’22
Privacy Implications of COVID-19 Contact Tracing
This project team analyzed current approaches to contact tracing to examine the impacts of contact tracing technologies on privacy and best practices for data collection, use and storage.
Working in five subgroups, team members developed a survey to assess individuals’ attitudes toward sharing health information; collaborated with the Organization for Economic Cooperation and Development (OECD) to conduct a comparative analysis of contact tracing practices in six countries across the globe; examined contact tracing policies and practices at Duke and in all 100 counties in North Carolina; and evaluated how technology companies and state governments are using different data collection and storage methods to utilize and protect contact tracing data.
The team developed a 30-page white paper as well as a series of best practice recommendations that were shared with project partners.
“The OECD reached out to us when they heard about the project. They were sponsoring a workshop for member countries to discuss best practices on contact tracing and the implications on privacy, so they wanted to have use cases developed ... We had one student take the point on the relationship with the OECD and she did an internship with the OECD [in Spring 2021] and worked with the other students to develop the use cases.”
–David Hoffman, Team leader (Sanford School of Public Policy)
Sex and Contraception Among College and Graduate Students During COVID-19
This project team sought to understand how the COVID-19 pandemic had provoked changes in sexual health, sexual activity and access to contraceptives among college and graduate students. Team members designed and conducted a survey of North Carolina college and graduate students to assess sexual health and examined the availability of student health centers and telehealth at higher education institutions across the U.S. Team members also partnered with Duke Wellness and representatives from North Carolina State University campus health and the University of North Carolina campus health to share results, including an infographic aimed to help students identify resources and consider the risks associated with sexual activity during the pandemic.
The Good That Comes from Bad Dreams
This project team examined the links between COVID-19 dreams and prosocial behaviors by designing a study to test the hypothesis that inducing negative dream content related to COVID-19 motivates prosocial behavior to a greater extent than positive or neutral dream content. Through the three-week study, participants were randomly assigned to a group to receive different curated nightly news stories and then complete surveys detailing their dream content and reporting on their mood, anxiety level, stress and prosocial behaviors. Team members had the opportunity to work with the Mind at Large lab and gained research skills in psychology, neuroscience and research study design.
Learn more
- Check out Bass Connections’ new Health Policy and Innovation theme.
- Submit a proposal for a 2023-2024 Bass Connections project by November 7.
- Read faculty and student perspectives on their experiences with Bass Connections.