HANNAH WELLS: OK, I have Bryan spotlight. Perfect. So we're going to jump right into our first session, like I said. So I have a unique opportunity. Before I joined the IOD, I actually worked on our first project over in the Collaborative on Community Inclusion. So I'll be presenting today with my colleague Bryan and a few of our participants and facilitators from the PODS project. So Bryan's going to start us off here. 

BRYAN MCCORMICK: Thanks, Hannah. As Hannah said, my name is Bryan McCormick. I'm a professor in the Department of Health and Rehabilitation Sciences at Temple University's College of Public Health. I'm also with the Temple University Collaborative. 

I am a white man. I have a beard. I am balding. I have, like Hannah, a Tree and Temple background. So this project, Hannah, if we can move, yeah, to the next slide. Great. 

So we are the Temple University collaborative. On this slide is an image of some of the resources that we have. There are pictures of the title page of a document called "Why mattering matters." Another document called "Developing community participation stories." Another document about making a difference in your community. And then young professional peer support. So the Temple University Collaborative produces a great deal of research and training materials. And the PODS project is one of the things that when Sally and the folks at the IOD came to us to talk to us about this, that we were really interested in using intervention that we're working on at the collaborative. So Hannah, if we can go to the next slide. 

So the Power of Dependable Souls was designed to address isolation and loneliness for people experiencing serious mental illness. At the Collaborative, we work to support the community inclusion, community participation of people who experience significant mental health challenges that oftentimes disconnect them from the people in the worlds around them. Our focus, really, in developing PODS was that-- the goal was to support people, to be able to develop the skills, collectively, to independently and sustainably participate in the areas of the communities that were of interest to them. 

And this idea was that through having people work together around common interests, they could build this sense of collective efficacy or strengthen their abilities to be able to overcome problems and challenges-- and in many ways, encouraging providers to think about how to support people to become more and more independent. And so over the last two and 1/2 years, we have piloted this program in number of psychiatric rehabilitation peer specialist programs around the state of Pennsylvania. So next slide, Hannah. 

So the Power of Dependable Souls graphic is on this slide. And it describes, graphically, what we were proposing for the Power of Dependable Souls. So the large group-- there are a number of smiley faces on the slide-- and that whole group is called a collective. And so that was part of the design that all people who were interested in being involved could be a part of this large collective. 

But within the collective there would be PODS around whether it was gardening, family activity, sports, employment, arts. And that each of these PODS then collect people who are interested in that particular area. And they work to engage in one of those areas in the community. And so the PODS, themselves, are the activity-based, the interest-based groups, subgroups of five to seven, whereas the collective is the entire group of people at one agency. And if we can go to the next slide. 

And the reason we really focused on isolation and loneliness among adults with serious mental illness is we knew that this was an issue. So one of the graphics on this slide is two bar charts. One is the lower bar chart that identifies where people are with serious mental illness, in terms of loneliness. And so the distribution shows, basically, a normal distribution with the high in the middle. But what we looked at was what's the high loneliness among people who don't have a serious mental illness? 

And that is the top set of bars. And when we use the high loneliness which most people use, which is about the 75th percentile, we found that two-thirds of people with serious mental illness were above that level. In other words, only 25% of adults without serious mental illness have this level of loneliness, whereas two-thirds of people with serious mental illnesses are above that. And even when we start to look at severe loneliness, we see that dramatically more people with serious mental illness report these really high levels of loneliness. So we knew this was one of the issues to address around social connection as a result of the pandemic. 

And so there are multiple indicators that folks who experience significant mental health challenges, they're more likely to live alone than people without some. They're more likely to be single or never married. They're more likely to know fewer neighbors. They tend to have smaller social networks. These networks are oftentimes made up of other service recipients or service providers. 

They might have, typically, fewer friends, and there may be more turnover in the networks themselves. That because of residential relocation, hospitalization, incarceration, all the things that people deal with, there's a potential for disruption. And so we know that these rates of loneliness and isolation are much higher. And that the pandemic actually made that worse. So Hannah, last slide on this. So one of the things we wanted to do is make sure that the folks who were actually doing the PODS program had an opportunity to tell about their experiences with it. And so I'd like to turn it over to Tina, Amy, and Isaac, at this point. 

HANNAH WELLS: Thanks, Bryan. Yeah, like Bryan said, we can sit here and talk all day about what we did and what we learned and things like that. But I think hearing from people who were involved with the program, either as participants or facilitators, can be a lot more effective. And you can hear much more interesting stuff than anything that Bryan and I have to say. 

So I'm joined today by Tina and Amy, who are on screen together. And then Isaac, who's joining from another computer. Tina, if you don't mind starting us off, can you just tell us a little bit about your experience with PODS and what you would want folks to know about it? 

TINA: Sure. First of all, thank you for PODS. It's really changed what we do and how we do it. And so I just want to start off with that. 

So for 25 years I've been working in psychiatric rehabilitation and have, unfortunately, failed miserably at helping the participants of my program make connections outside of the program and with the community. I feel like if we could successfully make healthy connections, all of us, our lives would be so much fuller and richer. And I feel like there have been barriers and distractions from that. 

And that PODS said, here, here's a program. Let's focus on this. And let's make this happen. And it has been such an amazing tool for us. And we have some very unique, I think, challenges in our county. Some that maybe are familiar and common, but maybe some that are unique to us. 

First of all, I think it's not uncommon to meet with people, maybe here at the program or someplace you're comfortable with-- but to go out into the community and be in strange places without supports of maybe staff that you've been supported by for a while. It's hard. Self-confidence, and depression, and isolation kind of are the barriers, I think, that are common. And we experienced that for so many years. 

But in addition to that, in our county, we don't have public transportation available. We are a very rural county. And it's not uncommon for people to live 20, 30, 35 minutes outside of town. And there's no public transportation. Or if it is, it costs $40 one way to come to town, and it's not affordable. And so that barrier just compounds. The challenges that we feel. 

So in addition to that, so lack of resources, lack of money to pay for transportation or even to go out to the movies and grab a bite to eat with someone. So even if you can find the means or you're lucky enough to live in town, things are expensive. COVID has definitely increased the prices of our entertainment and enjoyment. And so that's also a challenge that we faced. 

Our county, actually, is considered one of the most aged counties in Pennsylvania. I looked up the statistics, and almost 20% of our county is 65 years or older. And so with that, we have a higher percentage of personal care homes. So a lot of people live in a facility with maybe 20, 30 other people. 

Most do not have access to telephones or cell phones. They have access to a telephone. Actually, there's usually one cordless phone in one of those homes that is shared by all of the residents, which sometimes is dead by afternoon. 

But most folks don't have cell phones. They don't have tablets. They don't have access to computers. And that's isolating. And that is a barrier that we experience that might be a little more prevalent in our area than most. 

Also, if you live in one of these facilities, the maximum amount of money that you might get in a month is $85. And that's the maximum. If you have co-pays for your medications or if you have a loan and you need-- I mean, $85 to pay for anything you might want to do for a whole month, that doesn't go very far. 

Also, if you live in a facility like this, you're there because you need some support. And oftentimes, if you are part of a town or a local community, the staff often don't grant permission for you to go out and navigate independently because they're worried for your safety. They want to make sure that you're OK. So there's a responsibility that they feel if you live there. And so it's not as easy as hey, I'm going out. And you grab your coat, and your hat, and your purse, and you're out the door. 

So just we have experienced so many obstacles at rehab, and we knew that if PODS was going to work, we were going to have to figure some of these things out. So what happened is I and some of my colleagues, we were at a conference, Pennsylvania Psychiatric Rehabilitation Conference. And we learned about PODS. And we said, yes, this is what we need to do. This is what we're going to do. 

And so I started spreading the word. One of my programs seemed particularly interested. So we focused on that. And I started saying, hey, hey, hey, hey, there's this new thing. It's very cool. 

Just started talking it up. And everyone would say, so what is PODS? And I'm like, oh, wait, wait, wait. I kept forgetting. And, I say, what is it again? And I bring out the flyer. So we just started talking about it. And anybody who had a remote interest in PODS, we said sign them up, sign them up, put their name, on the list. 

And what we did, at that point, is we had what PODS calls a collective meeting. We had a meeting where everyone came together. It's not unusual, then or now. Our meetings usually have between 12 and 19 people, I'd say, in attendance. 

And I will be honest. So the first meetings were, what is PODS, again? What is it supposed to do? How are we going to do this? 

And then it went to it's about connecting people with interests. And so it was kind of talking about what do we want to do, what do we like to do? And some people didn't even know what they like to do because they went to program, and they went home, and they ate, and they came to program. And so it was kind of interesting to see that. But we started to cultivate some ideas of collective interests. And so we collected some PODS. And Amy's going to talk about that later. 

And then the meetings got long, and hard, and painful. I'll be honest, we were in these monthly meetings of facilitators. And the other groups, they were out doing things. And we were still in these collective meetings trying to decide how do we include everybody, how do we work through the transportation barriers, how do we work through when people don't have money? And honestly, the magic started to happen. 

And what happened was the idea came up that we were going to start having fundraisers. And so this collective POD formed this amazing thing that people did. It wasn't just a meeting to figure out what the PODS were going to do. 

So we created a system of if you were going to be part of a fundraiser in any way, how you would make money. And people not only became part of something bigger than themselves, but they went out and sold things, and collected money, and they helped prepare, and organize, and coordinate, and they made money. So that was a way to help combat some of that I don't have the resources that I need to, to make this happen. 

And something else that we started recently doing to help with one of the other challenges with the personal care homes is-- and we've been doing this for a year and a 1/2 now, I think-- maybe a little over. And there is a coffee POD in one of the towns, one of the local towns. It's probably like 20 minutes from here. And there's two personal care homes. And it's strategically, the location is the McDonald's in between there. And we just were having trouble getting people to attend for different reasons. 

So we decided to provide a psych rehab staff. So during this POD, I go to the personal care home. And I knock on the door, and I say, come on, we're going! And then we walk to McDonald's. And we have some time together with some other POD members have joined us, in hopes that the staff will be comfortable. Hey, they're doing that PODS thing, and they'll be more comfortable with people going into the community with themselves with this group that seems OK. 

We do not provide transportation because I want to be able to step back and have people eventually be like, hey, we got this. And to be able to succeed, and be able to socialize, and have fun in the community without me. And if they rely on me for transportation, then that's probably not going to happen. So the one last thing with transportation, probably in the last month? 

AMY: Yeah. 

TINA: We got our first transportation system. It came to town. It's cheap. It's $1 unless you're over 65, and then it's free. And it's local sort of within like 15 minutes. But that is going to open up so many opportunities for people who are at least in town. 

Now, our barrier-- and please don't anyone laugh-- is they sent us the bus schedule, and we don't know how to read it. And we don't know how to ride a bus. And so we're figuring that out. We're figuring that out together. 

So I think I hit it, Hannah. Like why we needed it, what were the barriers, what are some of the things that we did. I don't know if I went over time. But-- 

HANNAH WELLS: No, that was great. 

TINA: Amy has all of the juicy stuff. 

HANNAH WELLS: Yeah 

Amy: All of the juicy stuff. [LAUGHS] 

HANNAH WELLS: Absolutely. No, thank you so much for that, Tina. 

TINA: Mm-hmm. 

HANNAH WELLS: I just have a couple quick thoughts, and then we'll jump into Amy's-- 

TINA: Sure. 

HANNAH WELLS: Well, when you were talking early on, you mentioned how you felt like you had failed for so long in community participation. And I wanted to highlight that I think this is-- obviously, this is a bigger systemic issue. And so even though, as individual practitioners, sometimes we feel like we're not able to do the things that we want to do, it doesn't mean that we are personally failing. It's just sometimes there are these systemic challenges that exist. And so the fact that you were willing to try out a new program and be really creative in ways to overcome those barriers, I think is great. So thanks for sharing that. 

I have a lot of other comments, but I want to leave time for Amy and Isaac, so I'm going to skip that and pass it over to Amy. Amy, thank you so much for being here today as well. I know Tina kind of hinted at a couple of things, but do you mind sharing a little bit about your experience with PODS, please? 

AMY: Sure. Welcome. Thank you, everyone. I was so taken back and empowered by Tina's excitement for this thing. I think it really has helped to create it what it is today. And keeping those initial-- almost mystery as to what it could be and that investigation into what PODS could be for our area-- and looking at where our barriers, and really trying to investigate and weed out those things. Although we were very slow to start, it gave us a good foundation to have a program where we could, long-term continue and continue to tackle any barrier that could come up here, in the future. 

Initially, when we got together for our interest meeting, they had it here at CSG-- and it was just us talking about our interests and what PODS-- what we had known, at that point. And we were getting to know each other a little bit more outside of the program. 

And we settled on PODS that overlapped everyone's interests. And we created a POD that liked to go out, and go to the movies, and eat out. We had another pod that was creative, that took into those that arts, those that food art. And third POD we started with was people that to play games, either bingo, or card games, or board games. And then our last pod we tried to start focusing on was traveling. And while it hasn't had the most development, hopefully, in the future, that can go a lot further. 

But each month we had a meeting to try and keep refining what it really meant to be a part of PODS. And through this, we try and keep talking about events that are happening in everybody's community and keep that conversation going-- so that people are looking out in their community and seeing, oh, there's a fair here. There's a meal at this church. 

So we give time for people to open up and let us know what's happening amongst our communities, even though they are widespread. But we've gone to Bloomsburg Fair. A couple of us have met up and walked around the fair. And in fact, enjoyed it to the point, where we looked in the buildings, and people were talking about trying to make stuff to enter into the Bloomsburg Fair this year. 

And towards fall, we had a night where people in this area have a possibility of getting some free bowling games. And so we tied that in. We did a bowling night. And then we had card games there available for people to play after they played their two games of bowling. And that was pretty successful. 

And our meetings, themselves, have become a POD of their own. And just people working to get things together to-- they'll run anywhere from three hours to the whole six hour day. We're scheduling monthly activities that we do. Like Tina was saying, the coffee, which we call coffee, but it's really a space and time for people to get together, have a snack, and just stepping out their door sometimes maybe, even if they're just there and not necessarily speaking so much. 

HANNAH WELLS: Right, I think that's a really important point that whatever participation levels people are comfortable with, just supporting them to start in that space is great. We are starting to run a little low on time. So, Amy, I wanted to ask if you could share a little bit about one of the things that we spoke about in prepping for this-- was really how you felt that PODS impacted individuals' mental health. Do you mind speaking to that a little bit real quick? 

AMY: No problem. When mental health is affected, your world changes dramatically. Sometimes it means you no longer go to a job that you've gone to. Sometimes it no longer means you go to get your groceries at the same. It creates a much smaller world for you. 

And the places you go, the things you do, that's usually where you start some of those social aspects. And with that world shrinking, it compounds. And PODS is a way to really meet us each where we're at and have someone that's understanding. 

I personally know of people and myself, who it changes friendships sometimes. And people who don't understand all of the mental health-- sometimes it's just not something you can explain. And they just can't understand that you're not showing up in the same way. You're not able to do the same things or just how much effort it takes to do some of the very limited things sometimes. 

And so on top of that, then internally, your self-worth just can spiral-- and having a battle of who you are anymore. And just, yeah, trying to redefine yourself. 

TINA: May I interject? 

AMY: Go right ahead. 

TINA: So what I saw is Amy saw a need in PODS of leadership. And Amy has such fantastic leadership skills. Can I tell them about it? A teacher, and she came out. And she just took over. We sat back. We smiled. And she runs the collective meetings, a lot of times. And I think it just redefined and reminded you of all of those wonderful things that are still within. 

AMY: It did remind me of things that I was capable of. It gave me practice of some of those skills and a safe space and time to practice those skills because they're not quite the same all the time. And having that space, space safe and time, it's invaluable-- just trying to create that sense of community that so often is stripped away with mental health. But also, just in society in general, today, we don't have the strong community or tribe that we used to have. And PODS was a way of giving-- creating a little bit more of that community back. 

HANNAH WELLS: Great. Thank you so much, Amy. That was a really great way of describing how doing activities together can help regain some of that sense of self and that self-confidence. So thanks for sharing that, you and Tina. 

Isaac, we are quickly running out of time. But if you don't mind sharing just briefly. Maybe let's focus on how PODS can be used to really promote independence, right? So that's something that you and I speak about at length a lot, but really how, as a facilitator, can you use PODS to promote independence among participants? 

ISAAC SMITH: Sure. Good morning, everyone. With independence and PODS, that is the big thing I latched on to whenever I started working with it. A lot of our folks have independent schools where they want independent housing. They want to be done with their services in such and such year. So independence is a really big piece of a lot of the programs that we have, especially with psychiatric rehabilitation. And PODS' implementation of that independence is what we really latched on to at our program. 

I will tell you that independence is a very scary thing. We, as facilitators, we, as mental health staff, we find it hard to give our folks that independence piece sometimes, not out of malice, not out of us being-- really, trying to control them. However, it does end up happening. Through PODS, we can really encourage our folks to-- hey, I'm going to step back-- you figure out what POD you're doing, what are the barriers, and how you going to overcome those barriers. And through that process, we have seen a number of our individuals really take on a more independent role and more of a leadership role at that. So I know I'm short on time, but the independence piece of PODS is one that is really high up there in importance. 

HANNAH WELLS: Great. Thanks so much, Isaac. So sorry that we ran out of time, but this is the perfect time to plug an upcoming webinar. We ran out of time today, but on June 3 at 12:00 we are going to have a webinar all about PODS. And maybe we can dive more into what Isaac started to share about. So there is a QR code here. And I will also share the link to register in the chat. 

So thank you guys so much. I'm going to stop recording. Thank you Tina, Isaac, and Amy for sharing today. 

SPEAKER 1: Just [AUDIO OUT] health conditions is certainly one of the areas that we're moving towards. And we will talk a little bit about some of that in the webinar that's upcoming. 

SPEAKER 2: Great. Thanks, Brian. So now I'm going to pass things along to my colleague, Elijah Youngs, who works with us at the IOD. He's fantastic. And he's going to be presenting with a couple of his colleagues as well. 

So I have started sharing. I have started the recording. Our next session focuses on challenges related to digital equity and introduces one project which worked to address this. So, Eli, you should have permission to share your screen. So just double-check that real quick. Great. We see it. So I will pass it on to you and look forward to learning from you. 

ELIJAH YOUNGS: OK. Good morning, everyone. Thank you. Sorry. I have a new mouse, and it's doing its own thing. [LAUGHS] Well, thank you for everyone joining us and taking the time out to hear all the great work that we all have done. My project was called Connect with Tech. And Connect with Tech also was birthed out of COVID-19, facing the many challenges that came about due to COVID-19. 

And today, I'm going to be presenting with Tobey, who is the CEO and founder of Generations Online, and Abisha. She is, or was, my grad student worker, but she is now a PhD student in psychology. And we'll go ahead and get started. So Connect with Tech-- Bridging the Digital Divide. 

So introduction to health disparities-- COVID-19 just highlighted a lot of structural health disparities in the United States. Especially in Pennsylvania, the rural areas, there was low resources. Communities faced unique challenges, geographic locations. Also, situations due to low income. It could be disabilities and poverty situations as well. 

What we came to know is that there was a shortage of physicians and healthcare access, especially in these communities. There is a high poverty rate and lack of insurance. Aging populations were hit very hard during COVID with increasing risk. And in Pennsylvania, older adults, especially in rural areas, face compounded barriers-- location, geographic location. 

There weren't many companies in these locations that supply internet services, or they just couldn't get internet at all, or it was a low signal for them to connect to the internet to do certain things on their phone or computer or tablet if they had one. 

This grant, the Pennsylvania Department of Health and CDC COVID-19 Health Disparities Grant, it helped to reduce COVID-19 health gaps in underserved communities by removing these barriers, fighting discrimination, and building partnerships between different state agencies, community groups. 

The goal of this program was to improve access to resources and support for everyone. We reached out to different organizations, notified them about our program, and tried to make these connections to reach those underserved communities. 

So our program overview-- Initially-- let me just start here. We really didn't know initially what we were getting into. [LAUGHS] We thought one thing, but also had to pivot many times. We were planning on doing 5,000 tablets over the two-year program. But that, as you know, got extended. And we end up distributing over 12,000 tablets. 

And just to give you an idea of how large this program is or how many people needed access, we received about 18,000 applications or attempts of applications. Only 12,000 was approved, a little bit more than 12,000. And that's over the whole state of Pennsylvania. 

We reached 66 of the 67 counties. There was one county that we struggled with, which was a rural county. And we came to the conclusion that maybe a lot of people go there for resources, but don't live within that one county. 

So our purpose-- the purpose Connect with Tech was to distribute tablets so that people have the technology to access medical services through telehealth and connect to the internet. While we did not supply internet connection or connectivity, we did provide them with resources. 

That was programs-- we had the Affordable Connectivity Program. We had Comcast. Spectrum was another big cable internet provider out in some of the rural areas, and they had low-income programs to help people to get connected to the internet. 

We did support and training, teaching them how to use their tablets. We also installed home pages on tablet-- use in teaching them how to use the tablet and maneuver through the tablets and different things of that nature. And Tobey will touch up on that later because Generations Online is the company that created that program for us. 

Some of the barriers addressed was also location, disability, race, gender, and gender identity and income. We come to find out a lot of people found that it was too expensive to buy a tablet or some type of device. As we all know, electronic devices are not cheap, so that was one of the big barriers. And this was developed by TechOWL, funded by the CDC and Health Disparities Grant. 

Telehealth and technology-- so telehealth became essential during the pandemic. As anyone know, many of us had to do our doctor's appointments if you were-- did not have to go into the doctor's office. They would prefer you to do your doctor's appointments via telehealth. 

Some people in the rural areas did not have ways to get to the doctor. One, it was either too far away from them, or they didn't have any facilities in their location. So telehealth became very essential during this time. Especially for adults over 65 who are less likely to use tech for health, and lack of broadband internet access, Connect with Tech addressed the gaps by providing these tablets and connectivity resources, while supporting individuals to manage their health efficiency-- effectively. Sorry. 

Why this program matters-- COVID-19 exposed many health inequities-- isolation from health care services, shortage of providers in rural areas, high poverty rates, and aging populations, limited broadband and tech use among older adults, and rural seniors faced the greatest digital health barriers. 

So our implementation and process-- our marketing of this program was essential to get Connect with Tech off the ground. We use a combination of social media because I'm with TechOWL, TechOWL has a pretty large following on social media, Instagram, and TikTok. If you don't know, check this out at TechOWLpa-- trying to put that plug in there. But also, we had to market and do targeted marketing outreach. 

My students, before we actually launched Connect with Tech, we spent about two months doing research and searching different organizations and programs in rural and in the city in urban areas to reach those underserved populations. And with that, we got these connections, emails, phone numbers. And we sent out a email blast letting them know about our program and instructions on how to apply to the program. 

We also had informational flyers to share with clients. Some of our resources included our assistive technology resource centers, who went out to do presentations. Some of our staff, they go out to exhibits and do presentations and tabling. And they would give out our flyers and promote this program to get it out. 

And also, word of mouth, which people tend to forget about. That's very important. Once people found out this program was legit and not some type of gimmick, the word started to spread. 

And from conversations that I had with many applicants, oh, I heard through my brother or my sister or a friend or my neighbor, especially in senior living facilities. If one person got one, it was like-- it would just spread like wildfire. So that really helped us a lot with getting the word out about Connect with Tech. 

So our device distribution-- we distribute-- we gave everyone a headset, which is important. If you're having a telehealth session with your doctor, and you're in a public library or in a public setting or a cafe, you want to not have everyone hear your conversation. 

So we provided a headset, the tablet, and a stylus, and a protective case. Because one, these devices are expensive, and we want you to protect them. And if they drop so they're not damaged or broken because we do not replace them. It's one tablet, and that is all we can provide because we want to try to give everyone access to this. 

Initially, we started out with a Lenovo tablet. That tablet, as we discovered, was very slow. It wasn't very user-friendly. So over time, we transitioned to Samsung Galaxy tablets to improve the user experience. 

So our operation overview-- I managed a team of 32 students when this program began over the three-year span. That team included the tech coach team, who provided technical support and digital literacy coaching to our participants. They may have helped them with even things outside of just learning how to use their tablet, setting up their email, connecting their tablet to their phone. 

Some people got locked out of their tablet. They had to assist them with resetting the factory settings on their tablet. So many things of that nature, especially when it comes to our seniors and those who are not experienced with technical devices. 

The shipping team handled inventory management and packaging of all the tablets, shipping them out, handling all those different things that come with that, the logistics of handling just this whole project and shipping things out, our distribution, making sure the tablets are working, that they're turning on. And supplies, demand-- supplies that we have and keeping me up to date on what we have and what we need. 

The key responsibilities of our student workers was to process new applications and enroll participants into the program, provide one-on-one tech support and troubleshooting, created and managed UPS shipping labels for our outgoing and return shipments. 

And as we know here at Temple University, we did have some complications with that. We had UPS leave the campus. So then we had to pivot and change the way that we process shipping and get things out to people. 

We oversaw the assembly and distribution of kits to participants across the state of Pennsylvania. We verified that tablets were working and were in working order before we shipped them out, and add educational resource home pages to each tablet. 

So our education resource for our recipients was created by Generations Online. And Tobey will be taking over. I will continue. She created the Easy Tablet Help home page for us, and I'll let Tobey talk on that. Tobey. 

TOBEY DICHTER: Next slide, please. Thank you. I'm Tobey Dichter, founder and CEO of Generations Online. And for 25 years, we have tried to help older adults get over the barriers of access, skill, and intimidation. And we were so proud, especially I, as a double Temple grad, when we were approached by TechOWL. 

The results and the process, as intense as it was, is such a worthwhile, it was so reliable, and it worked so well. Here's the way-- I'm just going to whip you through five slides, six slides, that show you how we did it. 

The whole idea is for those of-- what you would see on the screen is an owl sitting on a branch. And under the branch are four tablets. And those four tablets represent what we are teaching. 

So there are the basics-- how to use the web, and how to stay in touch with everything from texting to emails. And then additional apps of how to take pictures and how to download apps. The importance is that there are instructions on every screen. 

And so short-term memory for older people. Sometimes other kinds of disabilities required other kinds of accommodation. We built that in at the very front end. And as Eli was talking about the coaches, these 32 young people were helped by us with an online resource center. 

So everything from their six boxes down at the bottom of the screen that you'll see, help getting learners started, all the way to printable materials so that they can have surveys or any kind of background they need. Next slide, please. 

This is the way it would look, is let your fingers do the walking, is what it says. And if you put your thumb on the green thumb print and then swipe your finger up while keeping it on the screen, then you see more of the screen. 

This kind of simple language for people who are intimidated or overwhelmed, in large type, simple words, and absolutely no jargon helps a person feel that accomplishment of learning how to do something. It's senseless to give them tablets if they're not going to learn how to use it. Next slide, please. 

And so as Eli talked about, both finding a vaccine. Do you remember how hard it was to register? And people were asking relatives to go online for them. So we created-- it was simple, but it was important, how to find a vaccine, how to register for it. Next slide. 

We consulted back and forth. Feedback loop is the best way to improve things. And there was a tight bond between our group. Generations Online, by the way, is a national non-profit. So this was-- we were all in our sweet wheelhouse. This is what we do. This is why we do it. 

So as we would consult back with TechOWL, what do people really need? Well, they don't want to go through the whole basics. They just want to learn how to do an email. And so we would refine it, and then we would troubleshoot it. The email guides them step by step how to get a Gmail account because that's the most flexible. Next slide. 

As we were talking about telehealth-- the telehealth, it's so interesting when you work on the front lines with some of these people, particularly older adults, but also those who are maybe shut in for other reasons. It is not easy for them to get over the simple thing of using their camera. 

We worked with Penn Geriatric Center and learned what the patients need and where they stumbled, where they would get confused. And so we built just a simple tutorial that takes them through the basics. And you can see if you're looking at the screen, tap the image on the right to begin. So once it taps, then there's only two or three instructions-- big type, simple language on each screen. Next slide, please. 

And finally, as our final-- by the way, this is still operable. You can go on to Easy Tablet Health-- EasyTabletHelp.org and see the entire work that we created for TechOWL. But the number of scams and phishing that is done for new users is unconscionable. They prey upon older adults, but anybody can get caught, as you know. 

So we put forth a very thorough, comprehensive internet safety training. And in each of the trainings, there are the basics. So tap the image to the right to begin. If nothing happens, try again. These kinds of simple reinforcements were part of it. 

I have to say, we were just completely awed by the way Eli and his team handled this, and the fact that we could help 12,000 people to any extent that they needed was very gratifying. Thank you. I'll turn it over. 

ELIJAH YOUNGS: Thank you, Tobey. Now we're going to have Abisha, or Abi, as I call her, take over. 

ABISHA EBENEZER: Hi, everyone. My name is Abisha. I'm the former graduate assistant to Temple TechOWL, and I'll be talking a little bit about our challenges, what it took to run this operation. 

So firstly, with some of the logistical physical considerations, we had to make sure we were carefully coordinating and collaborating between multiple departments and external partners. We were collaborating with other community organizations to receive applicant referrals, provide tech support, market the program. And within Temple itself, we were collaborating with other departments. So we wanted to make sure we maintained those relationships and carefully coordinated with them. 

With a team of 32 student workers, as a graduate assistant with Eli, we had to make sure that the daily operationals or the day-to-day functioning was efficient and carefully supervised. We made sure that we delegated tasks appropriately and created manuals or protocols whenever problems did emerge, so that as we trained new students we had-- we were increasing efficiency, and we had more of these manualized structures in place. 

Third consideration was making sure that we continuously adjusted our inventory process and our tech support protocols. So sometimes there were gaps or phases where we were waiting for new inventory or waiting for new tablets or accessories, making sure that we notified applicants of any delays and notified them about what tech support might look like, so creating a protocol for that kind of logistical consideration. 

We also wanted to make sure we had clear communication all throughout the program to make sure that we could deliver the kits in a timely fashion and also provide participant support in a timely fashion. So making sure that we, once again, let participants or applicants know about any delays we had or what that timeline would look like from submitting your application to getting your kit delivered, giving them a transparent view of that process. 

And then we used REDCap as our database or software to track our applications real time. We used GPS to track our shipments in real time. Making sure we had these real-time tracking systems is also important so that we could stay on top of any problems that might occur, and also provide that transparency again and create efficiency. Next slide, Eli. 

Overall, our impact-- we'll go a little bit more into our specific successes. But our broader impact, we did see that we did bridge the digital divide. Like we said, we were able to serve 12,000 Pennsylvanians. We were able to distribute tablets and provide internet access resources, provide training and ongoing tech support. And we were able to start increasing that access to telehealth and health services at a time where it was very much needed right after the pandemic. 

And we hope that throughout this process and overall, that we were able to empower Pennsylvanians to manage their health, and also empower them to start using these other sorts of resources to make better health decisions. [INAUDIBLE]. 

This is just a quick picture of the counties we served in Pennsylvania. So as you can see, Erie, Allegheny, and Philadelphia and Delaware County had the most applications approved by far, which kind of makes sense. These are also the counties with probably the most amount of people. 

If you look closer in Central PA, we didn't have as many applications-- so Mifflin, Snyder, et cetera. And I think there was only one county that we didn't receive any applications. 

ELIJAH YOUNGS: Correct. [LAUGHS] 

ABISHA EBENEZER: Hopefully, if this program is replicated in the future in Pennsylvania again or in another state, that would be a consideration to think about. How do we continue to reach more rural counties and more rural populations? And how do you create more engaging collaborations with some of their community stakeholders and partners? But you can see here that we were able to reach a broad variety of applicants and participants from all across Pennsylvania. 

And then a little bit more about specific statistics. So overall, throughout the program, we received 14,000 applications. I remember when this program started, and it was kind of a slow roll of getting applications. And then all of a sudden, it burst. We were receiving 50 to 100 applications per day once. And through those 14,000, we deemed 12,000 as eligible through our criteria. 

And we tried to make our inclusion criteria pretty broad. We didn't want to make it super specific where we were excluding too many people. So 12,000 people were deemed eligible. Only 2,000 were ineligible. And we were able to assemble and distribute 11,500 kits. 

And through those applications, we were able to provide 6,200 instances of tech support. So not just providing the tablets themselves, but also having that one-on-one support with participants who might have needed that extra help with their device or, in general, with technology. 

Some of the more specific successes of our program-- so we were able to really connect with some of these underserved rural communities through partnerships. We made it a point, when we were at the beginning of the program, thinking about marketing the program and reaching out to community organizations, of going county by county and looking at their county's website, trying to find different county organizations, contacting them, emailing them, speaking with them to make sure that we could create partnerships not through just email, but meaningful collaborations and learning more about the people in their county and the population they serve and what their needs were. 

We've heard so many stories and so many first-person accounts of how this resource has helped people, from telehealth visits to seeing the social media engagement and providing that digital literacy support. Even through some of the phone calls we would get, people would talk about their stories and how this has really helped them, or through their applications, how this device or this resource is really needed. 

And one of the successes that I'm personally proud about is we did-- I think we had a really efficient distribution model. Eli knows me. I'm all about, how do we streamline this process? Because we had so many student workers and we had a lot of hands in the pot, so making sure that we were able to have a system where it can go step by step, and we were able to fix any missteps that came about. And I believe the reason why we were able to distribute so many tablets as we were able to is because we had a system that was running pretty smoothly and pretty efficiently. 

And then some of our challenges, and this is the last slide I'll be speaking on. So reaching rural areas. Like you see, there were a couple of central counties and some of the rural counties where we didn't receive as many applications. 

So we did partner with local organizations. I think that is a consideration for the future, like I mentioned, about how do we create more partnerships? How do we get the word out there? And also, how do we gain trust with the community that's typically underserved or typically not represented? 

Preventing duplicate applications-- So REDCap was a learning curve, but we were able to understand how to implement a verification process, learning how to support offline applicants, so participants who couldn't submit applications traditionally online, and then just making sure we adjusted our distribution model when it came to shipping. 

ELIJAH YOUNGS: Thank you, Abi. So I'll take back over. And just talking about our major lessons learned. I know we're running out of time. So just to run through that. It was all about scalability. Expanding from 5,000 to 10,000-- that was something we literally had to make adjustments to do. 

One, finding space to store all the tablets here at Temple University and make sure they're secure and locked down; collaborating with other community partners to expand our reach using our assistive technology resource centers; using that distribution list, and just talking to people in the community and reaching out to our neighbors, our friends, our other organizations, our networks, and using their reach as well. 

Technology-- it simplifies the process. As Abi stated, making automation improve-- making things automated in REDCap, which also was a task, but it also improved our handling of everything-- automatic emails, letting them know the application was submitted, letting them know the application was reviewed. And also automation emails letting them know OK, your application was approved or you were denied. And getting feedback from all our stakeholders also help improve or help us in this process. 

I'm going to move forward to the next slide, which is just some feedback from some of our participants or recipients of tablets from the program. I'm not going to read all of them, but just leave them up here for a few seconds just to let you go through. 

One of my favorites, I'll just read that. "My name is Judy, and I recently received my tablet-- my first tablet. My late husband was my connection to all things tech. Thank you for all that you have done, Judy G." And these are just some of the testimonies or feedback that we received. A lot was over the phone. 

One applicant, her name was Love. I remember her last name because it's Love. But I felt like she became my grandmother because I talked to her about twice a week for two months and just taught her how to use her tablet, and we built this connection. 

And just one more here. "Thank you so much. You have no idea how much this means to me. This is going to be extremely helpful with classes and for the upcoming semester and overall access to life for life." 

That's big. Saying how life is going to change because we issued and gave her a free tablet. So that lets you know how effective this program is, how broad it is and touched many people's lives throughout the state of Pennsylvania. 

And finally, how they got access to Connect with Tech. People applied to the program through our website. A lot of it came through over the phone. We would process applications over the phone and submit them for them. Paper applications came to us through our networks and our other resources and partners. 

And we have our outreach team that went out into the community. Some of our coworkers would go to senior living facilities and take a whole bunch of paper applications. And they would either bring them back to me, or they would mail them back. And we would get stacks of envelopes with applications and had to put those into REDCap electronically as well. So it created more work, but we got it done. 

And that is the conclusion of Connect with Tech. I'm sorry I ran over a couple of minutes. Any questions? 

SPEAKER 2: That's OK, Eli. Thank you so much. That was a fantastic presentation. Thank you, Eli, Abisha, and Tobey. 

SPEAKER: I know that was a really quick break, but hopefully everyone had a chance to grab some water. And we're going to go ahead and jump in and get started with Amber, Luke, and Alex's presentation. 

AMBER DAVIDSON: Hi, everyone. Thank you for having us. We're excited to be a part of this presentation. So our research study, or what we're presenting today, is about building what we called the SAFE program. And it was to promote accessibility for infectious airborne diseases in the workplace. We wanted to create an accessible guidance around workplace safety with infectious airborne diseases for individuals with intellectual and developmental disabilities. 

My name is Amber Davidson. I'm joined today with my colleagues Luke and Alex. I also put Beth Pfeiffer on here. Dr. Beth Pfeiffer is the director of our REACH Collective Lab. The REACH Collective prioritizes looking at community participation and health for individuals with intellectual and developmental disabilities, and we are trying to determine different barriers or facilitators that allow individuals to participate in their communities more. 

So for this presentation, we're just going to give a little background on what the research or what the study was intended to do. Look at the different objectives. Then I'll talk to you more about the SAFE lessons and what was included in the different lessons, the curriculum that we created. Talk to you about the results based on the experiences of those who we piloted the lessons to and what their feedback was. And then Luke will give a little bit of real-life experience on what it was like to actually deliver the SAFE program. 

Then now we have a current phase going where we're really looking at, is there anything missing in the SAFE program? And so Alex will talk to us a little bit about we went out and reached out to people to determine if there were some different lessons that could be included. And then talk to you about some future implications on the SAFE program. 

So just a little bit of background, people with intellectual and developmental disabilities are much more likely to be at risk for illnesses like COVID-19 and other infectious airborne diseases. This could be because of other chronic conditions they already have, or because of behaviors that might make some of the preventative behaviors a little less-- or a little more challenging for them. 

So the CDC guidelines don't always meet the unique needs of this group. Or even if they do meet them, they aren't always delivered in an accessible way. So the SAFE program was developed to create and help individuals stay safe in the workplace. 

The SAFE program was created with other community organizations. We had community organizations that we work with. CIS, Community Integrated Services, as well as JEVS, come to us and tell us that there was really a need to create an accessible curriculum or accessible lessons to teach about infectious airborne diseases. 

So when COVID-19 was happening, it was really important that individuals who had ID, who were out in the workplace, often in essential roles, had a place where they could come to and better understand what the preventative behaviors needed to be in the workplace, understand better what COVID-19 or infectious airborne diseases were. 

And so with their communication and with our different groups that we reached out to, we really looked at how can we create these lessons best so that people who need to be out there could understand them-- understand what was happening. 

So the objectives of this project were to create these health messages. So to develop this easy, understandable lessons or curriculum to stay safe from things like COVID-19 and other airborne diseases. We once we created something, we wanted to update this, and constantly with the feedback of individuals with IDD parents and community organizations and staff that worked with this group. 

We then needed to test it. So we wanted to see what we developed, was it actually feasible, was it acceptable? And how did people enjoy it, or what was the feedback on that? So we did that. And then it's also important that we share what we learned. So oftentimes we create these great tools, and then if we don't disseminate or provide the results to our families, advocates, and community partners, we feel like we're missing that. So today, we're also, in part 4, sharing that information with you, and then we've also tried to get out there and share it with others. 

So the SAFE lessons, in the early stages, we did an initial survey, and we asked individuals with IDD to tell us what their already experiences with knowledge around infectious airborne diseases, how they understood staying safe from them, and just an overall-- get a baseline of where people's knowledge was at. 

And so with that, we were able to determine what kind of facts were out there, what people understood, what maybe they weren't understanding correctly, and what needed to be included in this curriculum. So with that, we decided, we determined that, first of all, we needed some general knowledge about what infectious airborne diseases are. 

So that was our first lesson, just an overall general knowledge. Then we needed to understand better how to protect yourselves. So that was things like handwashing, wearing masks at the time, social distancing. Then we were talking more about what to do if you're sick. So what symptoms look like, some ways that you might want to include that information to others. And then what to do if other people around you are sick. 

So those were our main core lessons when we received the survey and we analyzed that data and we knew what to include. Then as we kept going and started talking to our different groups more, we learned that we should also include things about fear and anxiety and things about advocacy, because those are really important topics, maybe not specific to-- as you would think about infectious airborne diseases, but they really related to the infectious airborne diseases, especially when COVID-19 was happening and there was so much with fear and anxiety. 

So there is a link for both of these curriculums. I'll just-- oh, I don't know if I can actually do that. So our REACH Collective website, which I will make sure we include in the chat, has this information for everyone that you can see and you can access. 

The lessons themselves, I think the other important component here is when we did our surveys, we also tried to understand best how people learn. So we wanted to make sure that we had videos, that we had engaging interactive types of discussions, that we had hands-on activities. 

We also had some materials that were more reading and digesting information that way. So we wanted to speak to all different learning styles in these curriculums. 

Once we created the SAFE program, like I said, we wanted to pilot it and see how people felt about it, what their understanding was, if it was usable or not. So first, we had to train the staff that was going to implement this. We trained some teachers at some different school districts in the Philadelphia area. We also trained Luke, who will talk about his experiences doing this. And in that, then they were able to actually deliver the SAFE program. 

We worked with 28 individuals that we piloted this program to. So our study is a lot smaller than some of the other things that people that went before me talked about because it's still ongoing and we're really trying to make sure this curriculum is effective. So participants were interviewed like before and after the curriculum was delivered, and we were looking to see if knowledge increased. We were also looking to see how acceptable and feasible the program was. So these are the types of outcomes we were looking for. And then we looked at the data, and I'll show you some of the results that we have. 

So what this slide shows here, there is a chart up that-- it's sort of a very blurry graphic. And it has some words about if a person increased their knowledge and their overall approval of the content. 

Basically, 81% agreed or strongly agreed that they had a better understanding after they received the SAFE lesson about infectious airborne diseases. 74% agreed that they-- or strongly agreed that they had a better understanding of how they spread. 78% believe that they were more likely to use SAFE and protect themselves against infectious airborne diseases using SAFE behaviors that were taught to them. 

More likely to take action to help themselves stay safe is an 89%. More confident to ask for help and protect themselves against infectious airborne diseases. So that's our advocacy piece. That was 74% either agreement or strong agreement. And then using strategies to decrease anxiety towards infectious airborne diseases. That, again, was a 78% of agree or strong agreement. 

So you can see by-- well, sharing these results have hopefully suggested that there was a lot of agreement or strong agreement that the SAFE program did help them have a better understanding about infectious airborne diseases, anxieties towards them, behaviors towards them, and advocacy. 

On this slide next are two graphics about the feasibility and acceptability of the SAFE program. The SAFE program overall, there was an agreement in that the SAFE program seems doable. So just overall, that, "Yeah, I think I could implement this," or "I think I could go through these lessons and it would be OK to do this." It seems easy, it seems possible, and it seems implementable. So that was what the feasibility was really measuring. And overall, the results on here had an agreement or a strong agreement as opposed to people who disagreed with this. 

And then acceptability-- so now we're talking about that the SAFE program meets my approval, it's appealing, I like it. And it can be even welcoming. So again, we had a lot of strong agreement here. 67% said it meets their approval and 60% said it was welcoming. 

Like many of you that presented before, I think it's really important to hear what students say. This is a graphic of a word cloud, which I had hoped would be a little bit more interesting, but you can see, the students really thought the helpful information in the SAFE program were things like talking about germs. They liked the videos. People said they learned a lot. They liked honesty and knowledge. So some of the bigger words that show up in this word cloud are those ones that I'm talking about right now. Bacteria, ways to prevent, careful hand-washing. So that's some of the feedback from our students. 

From our teachers, we also really wanted feedback from our teachers who were implementing this. Luke's going to talk a minute after this slide or two. But from just the Philadelphia teachers that were implementing this, some of the-- many people had positives to say. They thought what was in the curriculum was well, so the content was good. That many of their students were engaged. 

There was some challenges with the different levels of support needed in a classroom and what content existed. So we really took that feedback to heart as well. And as we continue to work on edits and revisions of the SAFE program, we've tried to apply now two versions. So one for a specific maybe-- a higher support level, and one for individuals that require lower support. And so there are different prompts, different activities, different engagement that can be accessed depending upon support level. 

Most people did comment that there was some difficulty in certain lessons. Like I said, again, depending upon the support level, there were many people had suggestions for improvement. And so we took that feedback and really tried to incorporate it in our revisions. So now I'm going to pass it on to Luke. Luke, hopefully you can share your experiences with implementing the SAFE program. 

LUKE CHRISTOPHER TOMCZUK: Thanks, Amber. So, you can correct me in the chat if I'm wrong, Amber, but I believe we delivered the SAFE curriculum to four or five schools in the Philadelphia area. Most of them in person, one of them-- two of them were through Zoom, but we noticed these common themes-- these five common themes-- or six common themes, excuse me, about what it was like to deliver SAFE in these different settings. 

So as Amber mentioned a moment ago, we adjusted the lessons based on the different learning styles and support needs. One thing I will comment on that is in pretty much all the classrooms that we went to, there were some. There are some students that require higher support needs and some that did not require as much support. So it was a mix of those two. There was at least one that had-- all of the students needed a lot of support. So, for lack of better terminology. 

But across all the groups, we observed strong engagement with certain topics. One topic-- so we noticed this pretty clearly among the last two lessons, which were all about fear and anxiety related to infectious airborne disease, and all about standing up for yourself. 

So among the students that had lower support needs, I would say that their engagement increased significantly. For the higher support, I would say it was about the same, but if they needed higher support, their teacher or support staff was able to help them figure out some answers to some of these questions. So, that's about the second point. 

The next point was identified which activities were most effective. So as Amber mentioned, the hands-on activity-- we had a few hands-on activities, including videos. And they seem to-- the students seem to like those. One classroom in particular I thought did really well with the discussion. 

And then for recognizing emotional responses during lessons-- so the two lessons that I mentioned a moment ago that had stronger engagement, I would say that they created, again, emotional responses during lessons. And these weren't necessarily sad or difficult emotions, they just-- I think it was more powerful. Or what we were saying in those lessons resonated more with the students. It wasn't-- again, it wasn't a negative reaction. I would think of that in a positive way. 

And then because of that, the participants were able to see real-world connections being made by participants. So in some of-- in at least two of the classrooms, they connected examples shown in the lessons with internships they obtained out in the community. So they were able to figure out how they were able to use what we were teaching in SAFE in their day-to-day life, which is what we were hoping for. 

And then I was able to help Amber by delivering the curriculum. I helped her and the other and the other members of the REACH Collective note areas where materials could be improved or expanded. And the one thing that comes to mind was some of the later classrooms we delivered this to, it had been further away from the COVID pandemic. So maybe not as much emphasis on masking and things like that, or social distancing. 

So those were some of the things that I commented on with regard to that. So I'd be happy to answer any questions after that, but I think we'll pass it along to the next slide. 

AMBER DAVIDSON: Thanks, Luke. So I wanted to share next, before we go into the next phase that we're looking at, determining if there are anything-- if there's anything missing in our curriculum related to workplace safety. So the fourth objective of our study was to make sure that we disseminate and share this information. 

And I just wanted to point out that one of the things that we're doing, in order to make sure that we accomplish that goal, is attending many different conferences, sharing this with the different community organizations that we work with, putting out presentations like this, as well as using our website and social media as a tool to get that information out there. 

So it's very important to us that we let people know that we heard what the community was asking for, we needed more accessible information, we're trying to create that, and we have this available to people if they need it or want to use it. 

So like I've been suggesting, there's an additional phase now of this project where we're trying to identify, through the same different groups that we used-- we worked with before to get their feedback, parents, professionals, as well as individuals with lived experience, we're trying to identify is there something, in addition to what we already have in the SAFE program, that could be useful or helpful to include in this workplace safety topic. 

So if we remember, some of the information that we've already received or that we already have in there is about knowledge, is really about spread of diseases, how to stay safe, how to communicate your symptoms, what to do in that place if you or someone else is sick or not feeling well, and then anxiety and advocacy. 

So I'm going to pass it along to-- not quite yet. First, I'm going to share with you that we did focus groups. We conducted focus groups to really determine what is missing in these different lessons, or what could be included, or what could be revised. 

And so we worked with 20 individuals in each group. So we sat with them for about an hour, an hour and a half. We reviewed all the lessons again. So these are people who may not have already been a part of the implementation of the lessons, but we're just reviewing the lessons to see the topic and identify new areas for us. 

And then we took all this information. We used transcripts and different forms of different ways to analyze the data, and I'm going to let Alex talk to us about our findings and that piece that happened next. 

ALEX ROTARU: Thank you so much, Amber. So after we've conducted these focus groups, we found a couple of key themes. First things first, we've found that people in focus groups remembered at least one or two lessons from the curriculum, which is incredibly encouraging that the information stuck with them. It was usually either-- the lessons were usually either from the infectious disease side or from the skills side, and this is actually reflected in more of what people want to learn more and what a potential new lesson could be. It would be more on the specifics of infectious airborne disease or more general skill-building. 

That being said, we also found out that most people with intellectual and developmental disabilities within the cohorts we looked at were, on the one hand, working frontline jobs for the most part, and then also had strong supports at home, at work, and in the community, and these are things we could leverage in building a potential next lesson. Next slide, please. 

And so the four key themes that we found-- one slide. There we go. The four key themes that we found were workplace preparedness and safety, health and wellness, communication and social interactions, and infection prevention and hygiene. When we talk about workplace preparedness and safety, we mean everything from situational awareness to making sure that people are complying with the job-specific requirements. Health and wellness is everything from avoiding cross-contamination to maintaining hygiene in the workplace. 

And then communication and social interactions was the big one that we heard about, everything from making sure people-- making sure their-- sorry. Their tone was more appropriate for professional settings to ensuring that they are able to communicate their needs. And so next slide. 

And so the one key lesson that would cover all four themes would be workplace communications. And this is not just language, it's also things like tone and asking for help and learning where to find people that might be helpful in certain situations. And what this lesson would be is the groundwork for anything-- for things like orientations, interacting with coworkers who may not be familiar with the conditions, building the necessary supports, and just making sure that the person more easily integrates into the workplace. And next slide. 

And so this lesson is broken down into three parts. We're also-- as Amber will mention it a little bit later, we're also pilot-testing this lesson as we speak. So this is subject to change, and in fact, some of the feedback we've received lately has been to reorder some of these slides and how we deliver this. But as of right now, there are three key components to this lesson, but they may be in a different order. 

Right now, the first part is focusing on how to communicate respectfully, as well as what behaviors to avoid. So this is starting with a bit of a brainstorm thing about, oh, in my experience, this is effective, this is not effective. These are things I like, these are things I don't like. 

And then the section culminates with an exercise that is supposed to be more of an empathy builder where each person shares how they like to be talked to and how. And the whole goal is to see that, on the one hand, people have different needs and different communication styles, and on the other hand, there are consequences to certain behavior types. And so this should be a primer on how to more effectively communicate with others in general. Next slide, please. 

And then the second part is more so on finding supports, navigating tense situations because at the end of the day, all workplaces are interconnected. And so the emphasis the emphasis here is on staying safe, and because a lot of the participants are frontline workers, we've also integrated a little bit of a How to Handle Tense Situations Guide. So this is a screenshot of the slide. 

So first know they have to remain calm, observe the situation, try to deescalate. And then know, if things go wrong, get a manager, and then try to get themselves-- remove themselves from the situation. 

That being said, there's an exercise on social stories where people are just given a couple of prompts and they tackle. And then finally, this is the third and last part. This is the shortest part, which helps segue into the lesson on advocacy. And so what they're doing-- what we're doing here is basically introducing the concept of a directory, and the section culminates with an exercise where they look at a fictional company, and then seeing all the roles, and then putting into these empty boxes who they would contact in each situation. 

This is, for instance, the high-support version of the exercise. There is also a much more complex lower-support version as well. This is one of those two tier exercises that Amber has been mentioning. And, yeah, now I give it then. Thank you so much. Now Amber, take us away to the end. 

AMBER DAVIDSON: Yeah, thank you, Alex. I see we have two minutes left. We're going to actually finish right on time, which is great. I see some questions that have been in the chat really emphasizing that the COVID-19 pandemic is still very, very much alive and people are still, unfortunately, dying at high rates in our country. 

So I don't want to discredit that when we talk about infectious airborne diseases and that things are shifting. We are very much changing our language to infectious airborne diseases just so that we can include more things when we talk about it, but we are still talking about behaviors and preventions that affect all infectious airborne diseases, and definitely COVID-19 as well. 

So what's next for us is, like Alex was saying, and I've said before, we are definitely going to continue revising and listening to feedback from others on the information that the SAFE program provides. We are working and excited about this new lesson that we've created. 

We know that communication in the workplace is important. And so we're really looking forward to implementing this feedback and refining that final lesson. So that's where we're at now. I think someone did put the REACH Lab-- or the REACH Collective into the chat. So hopefully anyone that's interested can jump on and see our SAFE program curriculum there. Thank you again for letting us share our research. 

SPEAKER: Great. Thank you so much, Amber, Luke, and Alex. Give me just a second to transfer our speakers over. 

SPEAKER: Great. I will pass it over to Taye and Makhari who are going to share information about us, about what they learned regarding community perspectives on public health communications during the COVID-19 pandemic. 

MAKHARI DYSART: Hello, everyone. Thank you for having us. Just give me one moment while I share my screen. All right. 

Hello, everyone. My name is Makhari Dysart, and I'm here with my colleague Taye Hallock. And we did a research project, so we'll be talking a little bit about research. And our goal was to better understand community perspectives on public health communications during the COVID-19 pandemic. 

Now, we learned a lot through this. So I'm only going to give a very broad overview for the first 20 minutes, so we will have time for questions at the end. Please, if you have anything that comes up, add it to the chat or the Q&A section and we'll get to it for the last 10 minutes. 

So what did we do? We really talked with people across Pennsylvania about what did they know about COVID-19, and how did they get health information during the first two years of the pandemic? So this data was collected in 2022. 

And we used the information that we got from these conversations to describe the best ways to create health information and share them with people. And our goal with this was really to improve how we create and share health information, which will make sure that people get the information when they need it and can stay healthy as a result. 

And we really focused on populations that we knew were disproportionately affected by COVID-19 for those first two years. That included people with disabilities, seniors, so those who are 65 years old or older, and those who identify as having a mental health condition or serious mental illness. 

So as we said before, we use focus groups, which really is just getting a group of people together to talk about these key subject areas. These focus groups were in three locations across the state, as well as one online. And we really recruited and sited those focus groups within community-based organizations. So that includes the Centers for Independent Living, senior centers within Philadelphia. And the goal of that was really to connect to existing networks to try to reach people and learn more about their experiences. 

And in these conversations, again, we talked about, what did people know about COVID-19? What were their preference for receiving health information or COVID-19 information? What were their experiences around receiving that information? 

And lastly, we provided some examples of existing COVID-19 messages and got their feedback on their opinions. Did they find these messages to be successful? What were some of the barriers they found in the messages that they were looking at? 

And so we recorded these conversations when they happened. And then we coded them to try to find key themes that were coming up across the different conversations and different locations. And with that, that's where we were able to create themes that guided some recommendations. 

So on this slide, we have a bar graph that just talks a little bit about the identities of our participants. So as we said before, we really were targeting three key groups-- people with disabilities, people who are 65 years or older, and people who identify as having a mental illness. 

And as you can see by the first bar, over half of our sample of participants identified as having a disability at 59%. Over half identified as 65 years or older-- 65 years old or older at 53% About a third identified as having a mental health concern, 33%, and then 7%, respectively, identified as having a substance use disorder or having experienced homelessness. 

And so we had very specific target groups for each of the focus groups. But what we found was that these aren't isolated groups of individuals. Participants often had multiple identities at once. And so often, when we think about targeting public health messages, we might think about a specific community. But it's important to consider the ways in which communities are overlapping because people are complicated and have many identities at once. 

This next slide here has two pie charts. One is showing the race of our participants, and the other is showing gender. So within our participants, about 52% identified as African-American or Black, about a quarter identified as white at 26%. 18% identified as Asian and Pacific Islander, and 4% identified as American Indian or Alaskan Native. 

And for gender, almost 2/3 of our sample, so 63%, identified as female, a third at 33% identified as male, and 4% identified as transgender, non-binary, or another gender identity. 

So after we came together and coded this information, we found that there was really two big categories people were talking about. People talked a lot about who they got their health information from and where they got that information. So what were the people and organizations that they were seeking information from? And what were those channels that they were getting the information from-- online, in person, on TV, via the newspaper? Those were a lot of our conversations. 

And related to those, when people talked about the information they were actually receiving, they were talking about the accessibility, the credibility and trustworthiness, and how actionable those messages were. And that often was really related to who and where they were getting that information, which we'll talk about a little bit later. 

And so with the themes I'm going to talk a little bit more about, we were able to create some recommendations to improve emergency public health communication. The first key theme was trust. I cannot overemphasize how important this theme was in our data. This was an ongoing conversation that often involved very rich discussion. It's the best way I can put it. 

The first thing, people express a lot of mistrust of government in health care. This was often based in past experience. So some people thought their physicians were a great source of information about prevention measures as well as interventions. But some people had had really negative past experience with health care providers that made them mistrust them as a source of information. 

People also didn't always trust that the services would be accessible, like going to a vaccination site. And there was two camps with this where some people just did not think that accessibility was being considered. And so initially, they didn't have a lot of trust. 

Or they might have had an initial encounter where they tried to access services and it was not accessible. And so then in future times in which they were encouraged to access those same services, the trust was already broken. And so people did not have any trust that these services would consider their access needs. 

People often relied on trusted friends, family members, and community leaders for public health information during the pandemic. So this is related to health care providers really past experience influenced where people would go in the future for information. 

So if you had somebody in your community who has been a support to you for years, or a family member who you live with and you rely on, they're also going to be someone you're going to look for as a trusted source of information. And that's very similar to government and health care providers, where if you have established mistrust in the past, you're much less likely to go to that person and trust the information they give you in the future. 

So based on this, we had two main recommendations. First is we need to think about why some people do not trust doctors and the government. And this needs to happen before an emergency. And so often, there is real reasons that are influencing people's mistrust. And in order for emergency communication to be effective, we need to do the work prior to an emergency to really rectify the harms and reestablish relationships of trust and credibility. 

The second is to share health information to the community where people know and trust each other. It is going to take a long and hard effort to rebuild trust and credibility for those who have had bad past experiences with our larger systems. So it's important that while we're doing that, we're also building communication networks within trusted local networks. And that guarantees that emergency health information gets to people the quickest in the ways that they trust the most. 

And so that could be key leaders within communities. It could also just be making sure that whatever channels family members of different communities are talking to, those have the credible information that we want to make sure they get during an emergency. 

Key thing number 2 is inclusion. This was also a large conversation because a lot of participants expressed they didn't feel represented in public health messages. This was a big conversation around images, particularly. When people saw images and they did not look like them, they're not sure if the message applied to them. 

One big example of this was for high-risk populations. If somebody who is high risk within the images is often shown to be an older adult who is a white woman without disabilities, someone might look and say, well, I must not be high risk then because I've never seen myself represented within the imagery. And that can be very dangerous when that is somebody who is high risk and that information is applying to them. And it can help influence who is actually able to act upon the messages that are being given. 

The second thing is many people found it difficult to interpret health information, which led them to rely on others, and then they didn't feel included in the process of accessing information. So in the early parts of the pandemic, a lot was changing, a lot of information was coming out. And often, that information was at a very high reading level and might have had complex information that was not explained properly. And that often led people to go to trusted sources of information. 

But then they weren't allowed to be included within the process because the information wasn't accessible to them. And that made them feel not included, which is really important. That inclusion effort makes people feel as if this is something that is for them and makes them more likely to want to engage within the prevention efforts. 

So again, we had two key recommendations from this. First, your information should show how different communities are. This means including people with different cultures, races, ethnicities, and disabilities. If you're targeting a message to a very specific local community, make sure those imagery in that message and the message overall represents that community. This can also include language access. Make sure that information is shared in the languages of the community you're trying to reach. 

Second, add helpful reading tips to your writing to help people understand it better. This can include plain language. This can include describing what facts mean. For example, sometimes percentages can be confusing. There's been a 100% increase can mean different things if you're not 100% sure what a 100% increase means. That could mean 1 to 2. But to someone it might mean, well, we went from everyone to double everyone. And so it's really important to make sure that we're adding explanations in plain language to any information we're sharing. 

Key theme three is accessibility. This was also one of the largest themes that we talked about. Regardless of if the focus group was focused on the disability community, accessibility was a huge conversation within our focus groups. And I think this quote really summarizes a lot of the sentiments that were being felt. 

It reads, "They don't think about people with disabilities when they're doing these sites," as in websites, "and sending out this information. And then at the end, especially because if you live alone and you have no one that can give you the information you need, then you wind up being one of the ones who's not going to make it." 

This was a really powerful quote when we first heard it, but it was not an isolated experience or feeling. A lot of people expressed that they felt frustration about the accessibility of COVID prevention and treatment methods, and this kind of had two sides to it. Sometimes the information in the message itself was inaccessible. Sometimes the intervention, such as going to a vaccination site social distancing was inaccessible. And sometimes there was environmental barriers that made the actionability of a message inaccessible. 

So, for example, if you are sharing on the news about COVID-19 rates and referring to a graph without explaining what's on that graph, there was a lot of frustration around not being able to access information that you really need just because it's being shared in an inaccessible manner. 

Social distancing was often using visual markers. COVID tests use visual markers. And there was very little conversations about alternatives for people who are blind and low vision. And that was a huge point of frustration because it led to inequities in who's able to access those prevention measures. 

And lastly, there was little consideration for environmental barriers, such as transportation barriers. That was a huge one. If you want me to get vaccinated, but you're not addressing the ways in which it might be difficult for me to get to a vaccination site at a specific time, then I won't be able to participate in the way that somebody else may. And so these are things that are really important we consider in health messages that people were not experiencing. 

And lastly, some people expressed confusion on how messages would conflict with their existing health needs. This was especially important for people with complex health needs. If you already have other medications you're on or other health prevention measures you're partaking in, and those aren't being addressed within a new intervention that's being recommended to you, there's a lot of mistrust and inaccessibility that comes there because you don't know how that might affect your health, regardless of its prevention of COVID-19. And that led to a lot of frustration. 

So we had three key recommendations based on this information. The first, think about accessibility at every step when you share health information. It can't be an afterthought. It has to start the second you start drafting a message and follow through to the point at which it's already being shared and it's being updated. 

There was often a delay experienced where there would be an accessibility update to a message. But that delay has real harm, which we saw within the disparities in outcomes for different communities. So it's important that it's not a month later that a message is accessible. It's when it's promoted and published that it's accessible. 

The second, make sure people can follow the health advice you give them. This seems very simple, but based on the information we received, it was not something that was experienced or thought about. Think about those barriers that people might experience, particularly those in specific communities, and incorporate in the message the ways in which someone might be able to adapt to those barriers. 

And lastly, some people have a lot of health needs at the same time. They will need more information on how to stay safe. I think often, especially in emergency situations, the goal is to get as broad a message as possible-- social distance, vaccinate. 

But in order to be equitable in our information sharing, there also needs to be targeted messages to those who might have much more specific considerations. And that's how we make sure that we have equitable health information is having the general message, but also the specific message to those who have specific concerns and considerations. 

And our final key theme was clear communication. Many people expressed confusion about the messages they received, and there was a lot of reason for that confusion. One was sometimes these messages were conflicting. You might have a sign that says "mask within this space," and so you think this is something required. But then you see everybody who's working here is not masking. 

And so often, there was that conflict between the message and the actions that made people confused as to whether this was really an important step that they should be taking. And those conflicts came up in a lot of different ways. One of them was different people sending different messages, which we'll get to. 

The second is often, the messages would change, and there would be no explanation for why. This was particularly the case within the first year, year and a half, where we really didn't know a lot about COVID. And so often, messages in terms of what are the best prevention methods would change because the science would update. 

But it became confusing when you were getting old messages with the new messages, and there was no explanation for when it changed, why it changed, what is the new thing you should be doing. There was a lot of confusion fusion there. 

Third, which I said we would get back to, is different people would tell you different things. You might have a politician who's saying you're eligible for the vaccine. But then you go to get the vaccine, they're telling you you're not eligible yet. 

You might have different agencies having different messages on prevention. You might have different people in your own community who have different ideas of what is a prevention measure you should be partaking in. And that made it really confusing to know what you should be doing and who you should be listening to and led to a lot of miscommunication. 

And lastly, messages were not shared in places people were seeking information. Some people rely solely on radio for information. And so they might have a family member who says something that they saw on social media or on the news on television that was not communicated on radio. 

And that would lead to a lot of confusion, because it's unclear what communication is the most accurate and up to date. And so altogether, this made an environment that was very difficult to navigate in terms of health communication at a time where it was critical that people got correct, accurate information as quickly as possible. 

So what should we do? We have three main recommendations. First, update your health information often, and that also means explaining why. So it is OK to have an update to information. Date that update. Explain the reasoning for that update. 

Second, share the same health information in a lot of different ways. Oftentimes, there would be a focus-- oh, one second. 

TAYE HALLOCK: I'll pick up here while Makhari steps away. But a lot of times, there were different information coming from different sources. And so when people tried to check that information to make sure it was true or accurate, it could get confusing if they couldn't find that information in a second source. 

And then lastly, we need to point out information that is wrong. And we need to point out when people act in ways that we also know are wrong. And this helps address some of that conflicting behavior that goes against the recommendations that we know we're hearing to keep people safe. And by addressing that conflict, that can help dismiss misinformation, make sure that everybody's on the same page. 

MAKHARI DYSART: Awesome. Thank you, Taye. And really, in conclusion, the main point we have with this is that centering accessibility and emergency public health communication strategies helps build trust and ensure all populations can act in times of crisis. 

So as you saw, a lot of these recommendations are very simple steps that can be taken. But the purpose of them is that we're centering a community that's often not considered within the process, especially during times of emergencies. And so it's really important to us that as we thought about these recommendations, we made sure that they were informed by our community and also considered the ways in which we can promote community inclusion in the practice of public health communication. 

So I'll stop there and open us up for questions. And if you have anything that was not addressed today, our emails are in the slides which were shared. And I'm also happy to drop our emails in the chat as well. 

TAYE HALLOCK: I'm also dropping a link to all of our recommendations in one place. So if you'd like to see all of them as a whole instead of broken up with our themes, you're welcome to access them on our website, which I just put in the chat. 

SPEAKER: Thanks, Makhari and Taye. There are a couple questions coming through the Q&A. Would you like me to read those to you, or would you like to address those yourselves? 

MAKHARI DYSART: I can go ahead and read them. OK, I'm going to read the question out loud before we respond to everyone. So the first one is coming from Alex who says, for the inclusion theme, I'm actually curious about how we can create targeted messaging that doesn't stigmatize. 

For an instance, I've read about how targeting HIV prevention messaging to LGBTQ+ populations results in cishet people who inject drugs stigmatizing the very same HIV prevention, despite both groups having HIV risk. Therefore, how would you suggest ensuring we don't stigmatize a population or information in creating inclusive, targeted health messaging? Great question. Great question. 

I would say a couple things. First, I think one part of that issue is that HIV messaging is the entire prevention messaging around that HIV is targeted to a specific community is slightly different than having generalized messaging for a specific pandemic or emergency public health crisis that includes targeted messaging. 

And so I think what we're advocating for is not to have COVID-19 messaging solely target people with disabilities, specifically those with people with complex health needs. But more to say that along with generalized messages, make sure that you're promoting and including within that a targeted message that address targeted considerations. And so I think that's slightly different, but a really important difference because of that stigmatizing point. Taye, would you like to respond as well? 

TAYE HALLOCK: Yeah. I would also add that the number one way that you can ensure that this won't happen is that you have an inclusive team. And so you have members of the population that you want to reach involved in every step of conceptualizing, so like designing those messages so that they are responsive to the community that you're hoping to reach. 

So we saw this for folks with disabilities to be involved in the design of messages, make sure that they can identify what methods are going to be most accessible, and make sure that they're reflecting the actual needs of community members. 

MAKHARI DYSART: Awesome. Thank you. And the second question is, Do you have a person with disabilities on your team to help ensure design was more accessible? That's a great question. I would first say that we do not design public health messages, but we did design these recommendations. And so we went through a pretty thorough process to try to make sure that these were plain language and were important, relevant, and applicable. 

So we did some surveying of the community to see what they thought about the recommendations. We also partnered with two self-advocacy organizations to go through a plain language review process. So Self Advocates United as 1 here in Pennsylvania, that process involved both looking at the language, but also the relevancy of each of the recommendations themselves. 

And with the second organization, the Autistic Self Advocacy Network, they went through specifically just for the language to ensure that it was plain language and accessible. Taye, do you have anything you'd like to add? 

TAYE HALLOCK: We also worked very closely with our advisory board for this project. And so they were made up of community members with lived experience and professional service providers from across the state of Pennsylvania. And they were involved in each step of implementing the project. 

They helped us think through recruitment. They helped us think through the questions. They helped us interpret the results. And so they were very involved in making sure that we had that community check-in throughout. 

MAKHARI DYSART: Great. Those were the two questions I saw in the Q&A. I don't think there's any in the chat unless anyone has any other questions they'd like to ask. 

TAYE HALLOCK: I'll just elevate that we also made several explicit accessibility recommendations that were less about the general health communications and emergency messaging and were more about making sure that you're thinking about accessibility. So I dropped a link for that in the chat as well. So if you're interested, a lot of these recommendations came directly out of feedback that we heard from community members in our focus groups. 

SPEAKER: Any other questions that anyone has for Taye and Makhari before we wrap up? OK, great. Well, thank you both so much for your presentation today. We are scheduled to start our next session at 11:15, and we are going to wait till 11:15 just because people join for specific sessions, so just to keep things on track. 

So please feel free to take a couple minutes to grab some water, grab a snack, stretch your legs, whatever it is that you may need to do right now. So we will pick things back up at 11:15. Thank you. 

RACHEL: Recording to my computer, and I'll pass it on to you, Phil. 

PHILIP MCCALLION: OK, thank you. I'm Philip McCallion. I'm the Director of the School of Social Work at Temple University. And I was thinking to myself, why was I asked to do the presentation? And I guess I was asked to do the presentation because I'm the older adult on the research team. 

And so I want to acknowledge my colleagues Lisa Ferretti, Astrid Uhl, Kelly Banks, Kenneth Fernandez, and Vicky Velazquez, who have played very integral roles in this. I also want to thank the Institute on Disability for including us, the Pennsylvania Department of Health for funding this work. 

And also want to express my appreciation of the other teams that have presented to you already, because this is very much-- it is a collaborative, and we're looking at a lot of different aspects of this. And we in particular have looked at the issues that arose for older adults, although ties in with other work that we have done with people with intellectual disabilities as well. 

But much of this happened because of our community partners. And I'm not going to go through all of these, but I wanted to put their names up, and I wanted to express my thanks for all of the work that they've done. 

But as I said, what we were most interested in was what was happening for older adults. And I was thinking that when the previous presentation-- talking about people not seeing themselves in public health messages-- that this was also an issue for people who were older adults-- that the lives being presented, the ages being presented, frequently were not the ages of the individuals themselves. 

But when you think back to when COVID-19 first started and there was a lot of concern for older adults, much of it was about protecting older adults. In some European countries, they talked about cocooning-- that they put this protective cocoon around older adults so that they would be protected from COVID-19. 

And while that was well-intentioned and helpful in some ways, this was also something that then led to consequences both during COVID and post-COVID because of the lack of contact, the lack of access to the community, the lack of being in the community, and its impact on older adults. 

One of the ways in which many of us sought to try to address this was to look at a program called Friendly Visitors, where individuals visited older adults-- not because they needed a lot of help, but because they appreciated having someone stop in, check on them, talk with them. And we looked at ways in which we could take what was very much an in-person program or a phone-based program and make it more technology-based. 

And so we worked with the Philadelphia Corporation for the Aging-- their Senior Companion Program-- to look at how that might change in this environment with this new addition to the challenges that were being faced. And the [inaudible] program very much highlighted the challenges for people who perhaps were not technologically engaged now having to become more technologically involved. And this was particularly true for some of the older visitors from this program, who themselves did not have a lot of experience with technology. 

And what I always think about with technology, and I think about some of the things that we were doing, particularly during the early days of COVID, there were these great programs that were loaded on. There were this great software that you could utilize that would make it all easier. But what people were struggling with was, can I turn the machine on? Can I get to that first web page? And the lack of an ability, or a belief that I didn't have the ability to do that, robbed people of the confidence to try technology. 

And so much of what we did was that we wanted to help people build up that confidence, and so we're very grateful to the group of visitors who worked with us to understand how we might build up people's confidence. Because it wasn't just that you were asking the friendly visitor to participate-- they needed to be able to help the other person to participate. 

I often think about an 85-year-old woman who it took, yeah, probably like 5, 10 minutes before I could get her to get her camera on, and my own difficulties just now with getting the camera on reminded me of that and the triumph that she felt when the camera came on and people assured her that they could see her. And it struck me that if we had not spent those 5 to 10 minutes working with her to get that camera on, it didn't matter how much technology was donated, given, gifted, it would have sat in the box or sat in a corner. It wouldn't have been used. 

And so one of the things that we wanted to do for the visitors was to give them the confidence that they could help people get to that point. And so you'll see here some data on one of the things that we really wanted to get people confident in was in the use of the technology. And we also wanted to get people to be using the technology because it's like, if I'm doing this a couple of times a week, what I learnt, I forget. That's true for all of us. It's always about the repetition, the building of confidence around this. 

And so we look to build people's confidence in checking emails and joining the meeting, even just in turning on the cameras and the microphone-- that when you experience a difficulty, as I just did, that you persevere. And so you'll see that people's confidence did go up. 

And more importantly, one of the things that we thought was really important was that if people felt confident enough, that they would recommend this to someone else-- that you don't tell your friend to try something that you hate doing yourself. You think this is something that's really helpful, and you want to convey that to someone else. And some of the things that they talked about were that they find that both the training and the materials that we developed as helpful, self explanatory, and again, definitely would recommend the training to friends or family. 

And while this was work that we did primarily with the Philadelphia Corporation for the Aging, we are making those materials and that training to other providers across the state. 

We also wanted to understand what COVID-19 really represented for older adults. Again, I think back to the beginning of the pandemic, and we all thought that we knew what it meant for older adults. We designed programs to help them cope with it. But we wanted to hear from people themselves because the other thing that we were interested in is, what if there is a new pandemic? 

Someone raised that COVID-19 continues. But what if there was a new pandemic? Or, as Amber talked about, a new airborne disease that, again, perhaps would require people to separate from their activities, to wear masks, all the things that happened during COVID. And we wanted to understand what people's experiences were and the lessons that were learned. 

And from that, we wanted to understand, really, where intervention should be focused and to get recommendations for messaging and support. And what really came out of that was that loneliness was a really significant issue for older adults during COVID-19. 

So to do this work, we partnered with Area Agencies on Aging and with senior centers across Pennsylvania. Area Agencies on Aging are sometime called County Offices for the Aging. We wanted to understand what those changes were in people's lives, what happens to their health, what happens to their mental health, how they prepared for and how they responded to COVID-19, and really to understand the changes in contacts with others during the pandemic. And also, what were the stressful life events that happened? 

Again, I think about someone talking to me about death of a family member in another part of the state or another part of the country and not being able to go to the funeral. So you have the stress of the loss, but also feeling like you weren't there when you would have been somebody who would have been there. So really trying to understand those kinds of things that were happening. 

We wanted to draw from different counties across the state. And here's just some examples of the counties that we drew from. And we also wanted different kinds of demographics. One of the challenges for older adults is that everybody seems to know who we are and how we live our lives, and we're all the same. 

And so one of the things that I think about with the data that's here is that we had quite a range in terms of education, and we had quite a range in terms of income. And so we had digital natives within the groups that we were talking to. And we had people with a lot of resources, and we had people with a lot of family members, and we had people who did not have those things. And it was not you either were or weren't. There was this range across a lot of demographics, and that's what we really wanted to gather. 

And what we also were interested in is that we really did want to reach not just the recently old, but the oldest old, and hear from their perspectives as well. And we wanted to understand what were issues that were for everyone and what were issues that were unique to a particular cohorts. 

So one of the things that really came out of this was that three life changes during the pandemic across all the variety of things that we were looking at, the accumulation of three life changes during the pandemic predicted increased loneliness, regardless of people's demographics. And so it helped us to think about, OK, then what are the things that we should be looking at in the design of interventions? And we also utilize some qualitative interviewing. 

And we wanted to understand what happened for people and what were the important things. And people talked about, certainly, there were impacts on their physical health, impacts on their mental health, impacts on their social activity. But I think the one that was particularly interesting was the impact on people's routines. 

And yet, at the same time, we had some people with no changes and people with multiple changes, people with a whole range of distressing situations and events. And a particular issue that stood out was the impact of the loss of loved ones during this period of time. 

So because we were interviewing people after COVID as well, we find that a significant consequence of COVID-19 was increased and continuing loneliness and that we needed interventions to address that. And largely, with input from older adults themselves, we developed this program-- Making the Connection-- designed to reduce experiences of loneliness and isolation. 

As one person talked about, "The sessions taught me to become more understanding of people because we were in a group of total strangers, and yet we made it like a safe space, and people were OK, like, saying things. Whereas you wouldn't tell a stranger, but it felt safe enough. And that was really a really good thing." And so that idea that it was not so much about loneliness as it was about, as we called it, making the connection. 

So as it developed, it was a 10-session psychoeducational programming. We decided, largely with help from the people themselves, that they didn't want serious, sad discussions. They wanted games. They wanted discussions. They were interested in things that they could do at home. They were focused upon enhancing opportunities to connect with others and to support not just their own, but the wellness of people around them. 

So we delivered 22 programs to 331 participants in 14 senior centers across three counties. The research piece of it was we looked at comparisons pre-to-post. We had some control groups. People had the opportunity then to sign up for subsequent groups. We looked at satisfaction surveys. We looked at focus groups. And we did a systematic approach at about 230 of the participants in the program, and we had about 72 control subjects that we were able to assess across similar periods. 

We saw this as a process of further developing the intervention as well, with the input that we were receiving. So people met once a week for about 90 minutes. We had things like gratitude moments, meditations, goal-setting and sharing, group discussion, team gameplay, problem-solving activities, informational handouts. 

As I said on the earlier slide, we organized it kind of Family Feud-style, so there was a little bit of competitiveness, but not too much. And our topics really were designed to strengthen participant knowledge in skills and problem-solving, managing changes, reducing negative thinking, practicing self-care, communicating and setting boundaries, and really reducing experiences of loneliness and isolation. 

So the 10 sessions-- I'm just giving you the titles here-- but you see the range of things that were happening. I think, as someone who's developed interventions over a very long period of time, one of the other things that was a little different here was we were, again, based on our experiences with the other projects, looking to build online skills, online opportunities as well, and helping people to navigate online opportunities to make connections, but really helping people to develop strategies that they could utilize beyond the sessions. 

Do have to say that a number of the groups continued meeting after the 10 weeks were over because they just enjoyed being together so much. I think the decision that we made to utilize senior centers really gave that opportunity not just to recruit, but also that people then started to connect with the services and the opportunities that were provided through the senior centers, and there was a place to meet and a place to continue to meet. So all of these were really helpful to what we were doing. 

And here, again, we had people who represented a lot of different demographics within the groups, a lot of different income levels, a lot of different educational levels. 

And I will say that for group interventions, there is a challenge that I've seen in lots of different psychoeducational groups that I have run-- is that we do a much better job of reaching women than we do of men with these groups. And some of this is probably about the places that we choose to do it, but some of it's about choices that people make. And we need to continue to be thinking about, how do we reach men? And perhaps it's not a group intervention that reaches them, so we're continuing to look at those issues as well. 

So we looked at a lot of different things. And actually, over time, we changed the things that we were looking at because of the feedback that we got from the participants. To me, this is how the participants help to shape interventions-- to help researchers arrive at an intervention that's actually going to be valued and is going to work. 

So we looked at quality of life, social support, loneliness, certainly, coping, and self-efficacy skills. And we did what we call a pre-post analysis. We had intervention subjects. We had control subjects. We gathered data before the intervention began. We gathered it at the end. But then we looked three months later to see whether or not those changes were sustained that we find. 

So for a smaller group, we looked at a number of different things. We were interested in looking at depressive symptoms. We were interested in social connections. We also looked at measures of loneliness. We actually found that there's a one-item loneliness question in the CES-D, which is the depression measure, which actually looked at how often in the last week a participant felt lonely. 

We actually found significantly less loneliness at the second time point. Some of the more traditional measures of loneliness-- we didn't find that they changed. And I think we have to be realistic about-- what is it that an intervention is likely going to be able to change? 

But one of the things that we were interested in was how many sessions did it take for someone to report improvements at the time to assessment. And we found that those who attended eight or more sessions were seven times more likely to report improvements. So a 10-session intervention-- you need to attend eight. So that intervention needs to be really attractive to the people who are participating if you're going to get them to come 8 out of 10 times. 

And so that was really one of the big things that we were looking at-- was, what do we do in the intervention that helps people to want to come? And the reports that we got back from the participants was that the game-like approach-- we had prizes. They were small prizes, but we did have prizes. 

But one of the things that people talked to us about was that they talked to us about coming for the prizes the first couple of times and then just being there to enjoy what was happening in the intervention. So the idea of something that actually helps you, but you enjoy it. 

When you think about all the recommendations that we give people for how they will lead healthier lives and more fulfilled lives and things like that, often it feels like it's just about things that you have to give up, or things that you have to do that you don't really want to do. And what we were trying to do was change that and say, well, let's try to develop an intervention and get feedback from the people involved. And that's not what Philip McCallion thinks. It's what are the participants think-- that I enjoy this. I want to come. 

And so I think that 78% attended eight or more sessions, and there was a good result for those who came. So in our satisfaction surveys-- and this was just in the cohort in 2025-- 99% would recommend to a friend. 91%, very likely. 97% find the activities relevant and informative. 

And then at the three months, as we talk to people, people talked about making new connections, reconnecting with people from the past, starting or resuming hobbies. A smaller amount, but nevertheless a majority talked about joining or resuming clubs, groups, or programs that they had participated in the past. 

These are just some of the quotes people talked about-- "I met a whole lot of people." "I took down names and addresses." "It's helped me to be more positive about doing things." "Decided to join the class because I lost my spouse and the class helped me to connect with others." "Helped me to look into myself, realize that I'm actually pretty lucky with the friends I have." "Gave me a chance to observe how I feel about the topics we discussed. The chance to hear the answers of others broadened my understanding and made me view making new and nourishing relationships differently." 

And so what we find across the work that we've done is that making the connection-- it's feasible. It's useful. And it's capable of influencing rates of loneliness in terms of how many days of the week I feel lonely. There's increased connectedness confirmed-- new connections, hobbies, membership in groups and programs, likely to recommend it to a friend-- and that some of the impacts were lasting. 

So as we look towards the future with this-- in-person delivery of this program brought people together in the senior centers. But as we think about, again, if there were to be another pandemic, we are beginning the process of testing alternative options, including technologically mediated options for [inaudible] delivery. 

And regardless of pandemic, we're thinking about, how do we reach homebound individuals by creating new opportunities for connection and fostering skills? And what we're doing, really, is personalized by the experience of our program participants. We learned so much from the people who have been involved in this. We're continuing to think about, so what do we do next to make this more effective? 

Oh, I thought there were messages, but the messages were all from Hannah giving me my warnings. So I'm happy to answer any questions. 

HANNAH: Thanks, Phil. If anyone has questions, please feel free to either send them in the chat or submit them through the Q&A. So we'll give a minute for those questions to come through. 

PHILIP MCCALLION: But while people are doing that, I want to thank Carrie and Rachel for their interpretation. I always appreciate interpreters whose expressions really communicate-- not just what they're doing with their hands. Thank you. 

HANNAH: Thanks for that, Phil. Well, if there aren't any questions, we can go ahead and wrap up. 

The Power of Dependable Souls (PODS) is an intervention designed to enhance social connection among adults experiencing serious mental illnesses (SMI). In PODS, participants engage in community activities together, supporting each other to work through barriers and increasing their independence. PODS was co-created with an advisory board of mental health service providers and administrators from across Pennsylvania. PODS was piloted in 17 agencies, including peer support and psychiatric rehabilitation programs.

This session will briefly introduce the PODS intervention and share stories and lessons learned from pilot agencies. The session will also share information and resources for implementing the PODS intervention.

The Connect with Tech program was created to provide free tablets to individuals in need, helping them access essential digital tools like telehealth services, online communication, and educational resources. While the original goal was to distribute 5,000 tablets, the program successfully provided over 10,000 devices across 66 of Pennsylvania’s 67 counties.

Key to this success was strong community outreach, strategic partnerships, and an efficient distribution model supported by TechOWL’s outreach team and student workers. The program overcame challenges such as reaching rural residents, preventing duplicate applications, and managing high application volume by implementing tools like REDCap, offering physical applications, and streamlining logistics.

Each tablet included user-friendly resources through Generation Online, ensuring recipients could confidently use their devices. With collaboration, adaptability, and technology, Connect with Tech has made a lasting impact and continues working to bridge the digital divide across the state.

This session will highlight the revision and expansion of a curriculum designed to help individuals with intellectual and developmental disabilities (IDD) stay safe in the workplace. While one of the main challenges was that recruitment efforts took longer than anticipated, the project ultimately resulted in a strong, accessible product tailored to diverse learning needs. The curriculum incorporates multiple modalities to support different learning styles and abilities, promoting engagement and practical understanding of workplace safety. A major success of the project is the creation of a valuable educational tool that is now publicly available on the REACH Lab website, where educators, professionals, and families can freely access and implement it. One key lesson learned is that despite our efforts to design a highly accessible curriculum, some learners still require more individualized adaptations. Another important takeaway is the recognition that different stakeholder groups often bring varying priorities to the project, which required flexibility and ongoing communication.

Stakeholder input was central to the development process, and their voices will be shared in the session through quotes and testimonials, reflecting the meaningful impact and collaborative spirit of the work. This session will be especially valuable for those interested in inclusive education, health, and workplace safety.

The COVID-19 pandemic highlighted existing health inequities among people who have been historically marginalized and chronically underserved by systems. People with disabilities, mental health concerns, and older adults were at increased risk of getting sick and dying of COVID-19. We sought to better understand the experiences of community members to identify areas for improving targeted emergency health communication.

This session takes a close look at the ways inaccessible public health responses eroded trust in public health officials. We conducted four focus groups with Pennsylvania residents about their experiences receiving and using health information during the pandemic. Participants highlighted that many times the message content, delivery, or recommended action was inaccessible. This created difficulties in identifying credible information as guidance rapidly changed. Distrust in government and healthcare institutions, particularly among people of color and those with complex medical needs, compounded barriers. 

Participants identified accessible design and community-based dissemination through trusted messengers as critical to improving access. Accessibility is a fundamental component of effective public health communication. Centering accessibility in emergency public health communication strategies helps build trust and ensure all populations can act in times of crisis.

Social isolation can impact health and quality of life and is measured by an individual’s physical, social, psychological, and spiritual health; ability and motivation to access adequate support for themselves; and the quality of the environment and community in which they live. Often coupled with social isolation is loneliness, when an individual’s perception of their interactions with others does not meet their expectations, causing negative emotional and health consequences. Health, life events, vulnerability, location, and mobility and sensory impairment may play roles in the experience of isolation and loneliness.  

The project began from a recognition that more needs to be known about these experiences among older adults to identify meaning specifically for older adults, key variables that may explain differences in experiences and to identify areas for intervention. We moved on to deliver and further evaluate the effect of the Making the Connection (MTC) program, a psychoeducational intervention that utilizes skill building to help participants connect better with others and reduce their experience of loneliness and social isolation. We will report on key issues in the intervention's design, delivery and evaluation. We will also briefly report on other related activities undertaken to support older adults throughout out the project.

Representatives from all five projects will come together to discuss how each project built and utilized community partnerships. Discussion will include strategies for building partnerships and exploring partnerships in the current world.

Join David Saunders, the Director of the Pennsylvania Department of Health Office of Health Equity, as he discusses additional work completed under the Department of Health’s Preventative Health and Health Services Block Grant. Additionally, he will be available to answer participant questions regarding health equity.