Door knocking works to get information to immigrant communities. Why aren’t more places using it for Covid-19?

WASHINGTON — Kica Matos wants to knock on every single door in her neighborhood. But this isn’t a run-of-the-mill political effort: She’s using the canvassing playbook to sign people up for Covid-19 vaccine appointments.

So far, Matos and a team of other volunteers and community organizers have secured vaccine appointments for over 5,000 people in Fair Haven, a predominantly Black and Latino neighborhood in New Haven, Conn.

“We know our community. We know these streets. We had a sense of what would work,” said Matos, who is vice president of initiatives at Vera Institute of Justice.

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Experts agree that door-knocking campaigns like the one Matos is leading in Fair Haven are a crucial tool for contacting hard-to-reach populations — especially vulnerable immigrant communities that have been otherwise shut out from accessible vaccine information. But in most of the country, there has been far more emphasis on video tools and virtual scheduling platforms than on door-to-door community organizing, leaving those without internet literacy and Wi-Fi behind.

It’s not as simple as just propping up a door-knocking operation. Local health department staff and budgets are already stretched thin. And even more importantly, door-knocking, unlike an online announcement, works best if it is helmed by people who have already established relationships within their community, experts acknowledged.

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The state of Connecticut, for example, spent over $2 million to hire an outside firm to try knocking on doors to share Covid-19 information, without input from community organizers, Matos said.

“Relationships aren’t built in 20 minutes,” Adriane Casalotti, chief of government and public affairs at National Association of County and City Health Officials, said.

Door knocking has several key advantages over print fliers and social media posts. Most directly: It’s far better at building trust where there might not be much.

“If you’re just given the material, you’re not getting a dialogue, so you’re not able to address any additional fears or concerns that an individual or an entire community might have,” said Jill Weatherhead, assistant professor of tropical medicine and infectious diseases at Baylor College of Medicine.

Door-to-door knocking can also transcend language barriers for non-English-speaking residents, as well as internet literacy barriers for those unfamiliar with navigating virtual registration platforms.

“This is a tactic that has been used in community organizing for a long time. And it’s a really good one,” said Joe Fuld, president of The Campaign Workshop, a consulting firm for advocacy campaigning.

But these strategies require sufficient resources and data to identify where the gaps in vaccine distribution are, which Casalotti said can be difficult to obtain for local health departments, many of which have faced budget cuts and funding shortages.

Door knocking is already far more expensive and time-consuming than other public awareness campaigns; this cost can increase depending on the scale of the campaign and supply costs. Newly essential public health gear, like masks and hand sanitizer for volunteers, could drive those costs up even more.

New, Covid-related funding from the Centers for Disease Control and Prevention also goes directly to state health departments, with the exception of a few large cities, so most local health centers are reliant on how fast the state is able to distribute it.

“It takes time to move money out the door,” Casalotti said.

Door knocking drives also just don’t work unless community leaders have already built relationships with local health departments, according to Casalotti. Local health systems have little control over whether online registration systems provide accurate translations or educational resources for non-English speakers, she said. They also don’t have full access to vaccine distribution data, so there’s less of an understanding where the gaps and inequities are occurring.

“If you don’t have the systems already in place, it’s really difficult to build those systems up in a pandemic,” Casalotti said.

Other experts said the risk of spreading Covid-19 may play into the lack of widespread door-to-door knocking campaigns. As the rest of the world has shifted toward relying on virtual gatherings, so have these types of outreach efforts. Politicians across the country, for example, went back and forth on whether to conduct door-knocking campaigns during the 2020 election. President Biden, who gave them up for most of the race, started using them again during the final month before Election Day.

“The nature of Covid has made it very difficult to get messaging out to more hard-to-reach communities that may not have access to internet or other social media platforms,” Weatherhead said.

But some local organizers disagreed. Many of the immigrants they’re engaging with are frontline workers and are therefore already disproportionately at risk for contracting the virus.

“Knocking on doors is not making any more of a difference for us than going to the supermarket or trying to survive during this crisis,” said John Jairo Lugo, community organizing director at Unidad Latina en Acción in Fair Haven.

Source: STAT