Reviving health mediation during the COVID-19 crisis and beyond: an implementation study in deprived neighbourhoods of Marseille, France.

Area of Science:

• Public Health
• Health Disparities
• Epidemiology

Background:

• Initiated in 2020 during France's COVID-19 response, the CORHESAN program utilized health mediation interventions in Marseille's vulnerable neighborhoods.
• The program aimed to address health disparities exacerbated by the pandemic, focusing on testing, contact tracing, and vaccination.
• Funded by regional health authorities, it operated until June 2022, employing a multidisciplinary team and establishing numerous partnerships.

Purpose of the Study:

• To evaluate the CORHESAN program's mixed-methods research approach and its effectiveness in reaching vulnerable populations.
• To assess the program's impact on COVID-19 testing and vaccination rates in socioeconomically disadvantaged areas of Marseille.
• To analyze the correlation between intervention targeting and COVID-19 hotspot levels using statistical models.

Main Methods:

• Mixed-methods research involving analysis of CORHESAN program documents, interviews, and activity data.
• Comparison of intervention data with weekly COVID-19 hotspot data at the neighborhood level.
• Application of generalized linear mixed models (GLMMs) to analyze the effectiveness and targeting of interventions.

Main Results:

• The CORHESAN team accompanied 6,253 individuals, administered 5,180 RT-PCR and 1,875 antigen tests, with a 40% positivity rate.
• 5,929 vaccine doses were administered through various outreach methods, including home visits and temporary vaccination posts.
• GLMMs indicated significant targeting of interventions in socioeconomically disadvantaged neighborhoods (aOR=2.75) and those with high COVID-19 hotspot levels (aOR=1.83).

Conclusions:

• The CORHESAN program demonstrated the significant potential of health mediation in addressing health disparities during a pandemic.
• The intervention successfully targeted testing and vaccination efforts towards vulnerable populations and high-incidence areas.
• Findings support the expansion of health mediation for improving health equity, with a new program focusing on cancer screening and vaccinations in deprived areas.