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What are the symptoms of Corona? How do I get infected? What can I do if I have symptoms? What will happen to me while in quarantine? There is little information that addresses the everyday reality of homeless people in the Corona pandemic. Therefore, the Charité COVID-19 project for and with homeless people used a participatory approach to develop digital information services on COVID-19. The aim was to improve access to information and knowledge about COVID-19 by using new digital communication channels.

For this purpose, an interdisciplinary team (medicine, public health, social work, communication design, people with lived experience) came together in close cooperation with the Robert Koch Institute (RKI) and homeless shelters to develop information and educational materials that are appropriate for the targeted audience. The team decided to produce both videos and posters in different languages.

The videos

Videos are an important extension to written materials such as flyers and posters. They enable a direct outreach – even to people who are not alphabetised. Much of the COVID-19 information for the general population was provided through digital communication channels. However, the circumstances of homeless people were not taken into account and people living on the street were not directly addressed. The project developed two educational videos: one on general information on COVID-19 and one providing information on COVID-19 testing. The protagonists were recruited through existing contacts with institutions and people with lived experience. The scripts were jointly developed so that the language was appropriate for the target group and not stigmatising, and the included information was easy to understand and relevant. Many people with lived experience were actively involved in the project as community partners in front of and/or behind the camera or they did translation work. The videos are available in German, English, Polish, Romanian and Russian.

The videos serve as a first impulse to directly address homeless people with information on COVID-19 in the context of the pandemic. They are intended to provide information on the virus, hygiene rules, rapid tests and potential quarantine. At the same time, they are intended to encourage homeless people to start a dialogue with the professionals in the facilities they visit and to proactively ask questions and communicate their concerns or fears.

The posters

In addition to the videos, a poster series on vaccination was co-created together with people with lived experience and various social institutions. The posters aim to encourage homeless people to receive information from staff in familiar facilities and to get vaccinated against COVID-19. The phrasing "You can get vaccinated" is meant to address the basic right that people can get vaccinated even if they have no fixed address, no documents and no health insurance (Fig. 1). In addition, there are posters that address the aspect of drug or alcohol use ("You can get vaccinated even if you use drugs", Fig. 2). The poster series covers the languages German, Polish, English, Farsi, Russian, Romanian, Bulgarian, Arabic and French. The materials can be distributed and used in both analogue and digital formats.

Lessons learned from the participatory process

It was soon very clear that the interdisciplinary team and the participatory realisation of the project were the greatest advantages. Creative solutions were found, people met and communicated on an equal footing, knowledge was shared and passed on. In addition to the specific project results, the people involved in the process also gained further insights:

  • Both institutions and homeless people appreciated the participatory design, the sensitivity towards possible discrimination as well as the diversity of the materials.
  • The materials were used in over 150 facilities in 46 cities nationwide. They can be individually adapted (e.g. with a date/location for vaccinations).
  • Social institutions and homeless people are not sufficiently digitised. We must overcome the digital gap to provide better access to information and to counteract structural marginalisation.
  • There is a general need for information on health-related topics and progressive (inclusive) health communication.
  • Materials cannot replace personal consultation.

The results of the study and the collaborative development of the educational materials were published on various channels and they were also included in RKI recommendations for health authorities and homeless aid providers (in German). In addition to several congress contributions and a scientific publication (1), the project was presented in the magazine of the Bundesarbeitsgemeinschaft Wohnungslosenhilfe e.V. (Federal Association for Assistance to the Homeless).

Another part of the project was to implement COVID-19 testing in homeless shelters. Results of a pilot study that was conducted with a participatory approach with staff of the shelters have already been published (2).

The project is part of the nationwide “Netzwerk Universitätsmedizin” ("Network University Medicine") and was funded by the Federal Ministry of Education and Research from 01.09.2020 to 31.12.2021.

You can find more information on the study and the multilingual educational videos and posters on the project’s website. On the German page („Häufig gestellte Fragen zu unseren Videos“), you can also find additional information and reflection on the participatory process.

The publication "Participatory development and implementation of Inclusive digital health communication on COVID-19 with homeless people" (1)  was awarded with the QUEST Award for Patient & Stakeholder Engagement.

Prize money

The prize money has arrived and was used according to a list of needs from the City Mission (from stethoscopes to wart removers).

Dr. Andreas Lindner, January 24th, 2024

References

  1. Specht, A., Sarma, N., Linzbach, T., Hellmund, T., Hörig, M., Wintel, M., Equihua Martinez, G., Seybold, J. & Lindner, A.K. (2022). Participatory development and implementation of inclusive digital health communication on COVID-19 with homeless people. Frontiers in Public Health, 10, 1042677. doi: 10.3389/fpubh.2022.1042677
  2. Lindner, A.K., Sarma, N., Rust, L.M., Hellmund, T., Krasovski-Nikiforovs, S., Wintel, M., Klaes, S.M., Hoerig, M., Monert, S., Schwarzer, R., Edelmann, A., Equihua Martinez, G., Mockenhaupt, F.P., Kurth, T. & Seybold, J. (2021). Monitoring for COVID-19 by universal testing in a homeless shelter in Germany: a prospective feasibility cohort study. BMC Infectious Diseases, 21(1):1241. doi: 10.1186/s12879-021-06945-4

Contact

  • Anabell Specht

    Department for Tropical Medicine and International Health (CVK)

    Charité – Universitätsmedizin Berlin

    Contact information
    E-mail:anabell.specht@charite.de
  • Dr. Andreas Lindner

    Department for Tropical Medicine and International Health (CVK)

    Charité – Universitätsmedizin Berlin

    Contact information
    E-mail:andreas.lindner@charite.de