Strong Community Research Articles

Effects of Prenatal Stress on Behavior, Cognition, and Psychopathology: A Comprehensive Review.

Prenatal stress is increasingly recognized as a significant factor impacting an individual's life from the beginning. This comprehensive review explores the intricate relationship between prenatal stress and its effects on behaviour, cognition, and psychopathology. Key findings reveal that prenatal stress can lead to a wide range of adverse outcomes in offspring, including neurodevelopmental disorders, emotional dysregulation, cognitive deficits, mood disorders, and an increased risk of psychopathological conditions. These effects' mechanisms involve epigenetic modifications, hypothalamic-pituitary-adrenal (HPA) axis dysregulation, neurodevelopmental alterations, inflammatory processes, and changes in brain structure and function. Moreover, moderating factors such as maternal stress levels, maternal mental health, socioeconomic status, social support, and early-life adversity can significantly influence the impact of prenatal stress. The review also discusses intervention and prevention strategies, emphasizing the importance of prenatal stress reduction programs, maternal mental health support, nutritional interventions, and targeted early interventions for at-risk populations. These findings have substantial implications for public health and clinical practice, highlighting the need for a holistic approach to prenatal care that prioritizes maternal well-being and mitigates the lasting effects of prenatal stress. Addressing this critical issue promises healthier generations and stronger communities in the future.

Funding Opportunities Designed to Promote Antiracist Change Across a Health Sciences University

As health professionals acknowledge the historic and current influences racism has on patient care and health outcomes, leaders must develop antiracist activities to disrupt current narratives. To examine the outcomes of antiracism funding opportunities for development, implementation, and evaluation of initiatives across a multi-health professions academic university. This mixed-methods cohort study involved the evaluation of 17 antiracism projects conducted at a midsize single academic university in the Pacific Northwest with schools of dentistry, medicine, nursing, pharmacy, and public health. Projects were designed by students, faculty, staff, and community members, many of whom were from diverse backgrounds. Data collection and analyses were conducted between January and December 2022. Influence and reach of institutionally funded antiracist projects and best practices for funding them. Key metrics included project types, allocation of funds, level of community engagement, number of individuals engaged, demographic characteristics of project leaders, and project facilitators and barriers. Forty-two proposals were submitted, and 17 were selected for funding, representing 3 of 5 health profession schools. Study teams included women (15 of 19 [79%]), gender queer (1 [5%]), Asian American (5 [26%]), Black or African American (2 [11%]), Hispanic or Latinx (1 [5%]), Middle Eastern, North African, or biracial (4 [21%]) and White (7 [37%]) individuals. Four of 17 teams (24%) returned funds because their proposed projects exceeded their workload. Eight projects (47%) were fully implemented, most in the School of Medicine. Community engagement surveys were completed by 10 projects (59%), and 1741 participants engaged in 1 or more funded events. Two focus groups were attended by 7 of 17 projects (41%), which reflected diversity among grantees. Participants noted that facilitators of antiracist activities included strong community engagement, improved well-being, and sense of support by both the community and the institution. Barriers to advancing antiracist initiatives included restrictive timelines, being unprepared for the time needed for their efforts, distrust from community members due to previous experiences with diversity and inclusion projects, and difficulties navigating complex institutional systems and processes. The findings of this study suggest that efforts needed to implement antiracist change should not be underestimated. Engagement should be inclusive across academic health centers and communities. Future efforts need to support innovator full-time equivalent support, individual mentorship, and institutional sponsorship.

Light and temperature drive the distribution of mesophotic benthic communities in the Central Indian Ocean

AbstractAimResearch on mesophotic coral ecosystems (MCEs) has increased exponentially in recent decades, and the significance of this ecosystem has been recognised both in terms of biodiversity and distribution. However, this research has mostly focussed on corals and is globally sporadic, with the Indian Ocean remaining largely unexplored and overall MCEs under protected. Hence, baseline data on MCE benthic communities is lacking, but nonetheless essential for developing adequate management strategies. Here, we assess the variation in diversity and community structure of MCEs along the depth gradient and among sites in the Indian Ocean and the environmental parameters that are potentially driving these differences.LocationEgmont Atoll, Chagos Archipelago, central Indian Ocean.Time PeriodPresent.Major Taxa StudiedMarine benthic invertebrates, plants.MethodsUsing a remotely operated vehicle, we collected video transects between 15 and 160 m. We analysed the diversity and composition of benthic communities and used DistLM analysis to determine the environmental drivers of the community structure over the depth gradient and between sites.ResultsWe observed distinct benthic communities along the depth gradient, with a strong community break observed at ~60 m. We also identified a clear zonation of the benthic taxa with depth. This zonation was primarily driven by downward irradiance and temperature, with additional environmental processes playing a minor role in structuring the benthic communities.Main ConclusionsWe show that MCEs in the Chagos Archipelago are distinct communities, and their distribution is driven primarily by irradiance and temperature. Our results highlight the variability in benthic community structure of MCEs, both along the depth gradient and at local geographical scales for the study region. This study showcases the uniqueness of MCEs and will aid in predicting their distribution, potential refugia for shallow reefs, and in developing evidence‐based protection for MCEs, to maintain overall marine biodiversity.

Representasi Santri Milenial dalam Wacana Literasi Digital di Instagram (Analisis Wacana Kritis Norman Fairclough pada Instagram: @elmahrusy)

This study aims to analyze the representation of millennial students in digital literacy on Instagram using Norman Fairclough's critical discourse analysis. This study describes how millennial students represent themselves in the context of digital literacy through popular social media platforms such as Instagram. A critical discourse analysis approach is used to reveal the power relations involved in this representation. This research method involves analyzing visual and text content uploaded by millennial students on their Instagram accounts. This study's results indicate that millennial students' representation of digital literacy on Instagram is strongly influenced by their cultural, religious, and social context factors. They use Instagram to express their religious identity, share religious knowledge, and promote Islamic values relevant to the digital era. However, there are also constructions of representation that face conflict with the dominant narrative. Millennial students face challenges in navigating the complex digital literacy space, often facing negative stereotypes or discrimination. This research identifies the efforts of millennial students to challenge negative narratives and build strong communities on Instagram. Thus, this research provides a deeper understanding of the representation of millennial students in digital literacy on Instagram. The implications of this research can be used to strengthen the role of millennial Santri in influencing public narratives and promoting a better understanding of Islam in the digital era.

Building a Strong Clinician-Investigator Community of Practice.

Building a Strong Clinician-Investigator Community of Practice.

Assessment of Water Supply System Performance Indicators Based on the Customer Bill-Based Approach

Significant efforts have been undertaken over the last two decades by governmental organizations and local and international non-governmental sectors to improve water supply and sanitation structures; however, there are significant challenges to the town's growth and expansion. Chiro town's population is increasing, and the community is affected by water and excreta-borne diseases as a result of a lack of proper sanitation facilities and a water supply system. In this study, billed data from Chiro Town water supply service enterprise customers have been used to assess the performance of the water distribution network over ten years (2011-2020). The findings show that the Town's water coverage is 62.9%, the water demand is 8,121.6m3/day, and the computed annual water production is 4,222.3m3/day. Residents of the town have complained about a lack of access to improved drinking water supplies, low water consumption, and sanitation facilities, particularly in the community of those who live in the town's borders and practice open defecation. For all domestic use, 16.32% and 83.68% of respondents used unprotected and protected water sources, respectively. This study suggested that strong sectoral coordination, community involvement, and sufficient financial resources were required to identify the root causes and provide an efficient water supply system in the study area.

Microbial interactions strengthen deterministic processes during community assembly in a subtropical estuary

Systematic studies on the assembly process and driving mechanisms of microbial communities in estuaries with diverse seasonal and spatial scales are still limited. In this study, high-throughput sequencing, and microbial network analysis were combined to decipher the impact of environmental changes and biological interactions on the maintenance of microbial diversity patterns in the Jiulong River Estuary (JRE). The results showed that overall, stochastic processes dominated the bacterioplankton community assembly in the estuary, accounting for 49.66–74.78 % of the total. Additionally, bacterioplankton community diversity varied significantly across seasons and subzones. Specifically, the concentration of soluble reactive phosphorus (SRP) in the estuary steadily reduced from winter to summer, and the corresponding bacterioplankton community interactions gradually shifted from the weakest interaction in winter to the strongest in summer. The deterministic processes contributed more than half (50.34 %) to microbial assembly in the summer, but only 25.22 % in winter. Deterministic processes prevailed in the seaward with low SRP concentrations and strong bacterioplankton community interactions, while stochastic processes contributed 70.14 % to the assembly of microbial communities riverward. Biotic and abiotic factors, such as nutrients and microbial interactions, jointly drove the seasonal and spatial patterns of bacterioplankton community assembly, but overall, nutrients played a dominant role. Nevertheless, the contributions of nutrients and microbial interactions were equivalent in spatial assembly processes, albeit nutrients were the primary seasonal driver of the bacterioplankton community assembly process. This study emphasizes the significance of microbial interactions in the bacterioplankton community assemblage. These findings provide new and comprehensive insights into the microbial communities' organization in estuaries.

Maintaining Integrity and Expanding Authority: The Role of Ulama Women in Madura

In Indonesia, religious authorities are viewed as one of the most influential figures due to the number of pesantren alumni who play important roles in society. As in Madura, religious authorities are the obvious figures within the puritanical, conservative community with a strong religious attachment community. Meanwhile, Ulama women are viewed to have a limited role due to the adoption of patriarchal culture in Madura. In fact, in this modern era, there has been an important transformation done by Ulama women in strategizing daʿwa to significantly influence the ummah, which will be discussed in this research. This paper will first elaborate on the social background, the authority of religious figures, and the roles of women in Madura to broadly observe the role of Ulama women in maintaining their integrity and expanding their authority. The methodology applied in this research is qualitative, with a study case approach in Sampang, Madura. Data are collected from interviews as primary sources and articles related to the topic from books, journals, and documents as secondary sources. The framework used in the research is the concept of new Muslim womanhood in assessing the transformation to increase the reliability and validity of the research.

Maintaining Integrity and Expanding Authority: The Role of Ulama Women in Madura

In Indonesia, religious authorities are viewed as one of the most influential figures due to the number of pesantren alumni who play important roles in society. As in Madura, religious authorities are the obvious figures within the puritanical, conservative community with a strong religious attachment community. Meanwhile, Ulama women are viewed to have a limited role due to the adoption of patriarchal culture in Madura. In fact, in this modern era, there has been an important transformation done by Ulama women in strategizing daʿwa to significantly influence the ummah, which will be discussed in this research. This paper will first elaborate on the social background, the authority of religious figures, and the roles of women in Madura to broadly observe the role of Ulama women in maintaining their integrity and expanding their authority. The methodology applied in this research is qualitative, with a study case approach in Sampang, Madura. Data are collected from interviews as primary sources and articles related to the topic from books, journals, and documents as secondary sources. The framework used in the research is the concept of new Muslim womanhood in assessing the transformation to increase the reliability and validity of the research.

Rural Communities and Water Governance: Understanding Participatory Processes for Catchment Management in the Upper Umzimvubu Catchment

Water is a crucial issue for sustainable livelihoods, and a lack of it impacts human life. Catchment areas play an essential role in water provisioning, and their management is fundamental for sustained water availability. The UN-endorsed Integrated Water Resources Management (IWRM) approach best expresses catchment management ideals that resonate with South Africa's constitutional ideals of efficient and equitable distribution of resources. South Africa has a history of inequality that led to severe neglect of rural areas in many facets, including the water sector. Despite the country's reformed laws and policies, sustainable water provision and access remain challenging, particularly in rural-based municipalities where land degradation and a weak revenue base interact to reduce access to water for most communities. This paper reports on a study that sought to understand participatory processes for catchment management in the upper Umzimvubu catchment within Matatiele Local Municipality in the Alfred Nzo District Municipality in the Eastern Cape Province. This study used a qualitative approach to data collection and document analysis. The findings show that participatory water governance strategies exist and tend to coalesce around non-governmental structures. The findings also show that there is room for improving water governance in rural communities, including the need to finalize the establishment of Catchments Management Areas (CMAs) in all nine existing Water Management Areas (WMAs) while incorporating strong community involvement and strengthening the capacity of rural municipalities.

Awakening Uniqueness: Branding Strategy of Undisan Rural Tourism in Bangli Regency Through Eco-Experience

This research article explores the branding strategy of Undisan Rural Tourism in Bangli Regency, with a focus on its success in winning the 3rd Places of Tourism Village Award through an eco-experience. The study utilizes a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis to identify and evaluate key factors that contribute to the village's branding strategy. Undisan Rural Tourism embodies a unique blend of natural beauty, cultural heritage, and sustainable practices, making it an exemplary case study for rural tourism development. The research methodology involves qualitative approaches. Primary data is collected through interviews, surveys, and participant observations, while secondary data is gathered from relevant literature, reports, and online sources. The SWOT analysis framework is applied to assess the internal and external factors that influence the branding strategy of Undisan Rural Tourism. The findings of the study reveal several strengths that have contributed to the success of Undisan Rural Tourism. These include its pristine environment, rich cultural heritage, authentic local experiences, and strong community engagement. Additionally, the village has capitalized on opportunities such as increasing demand for sustainable and eco-friendly tourism experiences. However, the research also identifies certain weaknesses and threats that need to be addressed, including limited infrastructure, inadequate marketing efforts, and competition from neighboring tourism destinations. Based on the SWOT analysis, this article proposes strategic recommendations to further enhance the branding strategy of Undisan Rural Tourism. These include improving infrastructure and facilities, expanding marketing efforts through digital platforms, fostering partnerships with local stakeholders, and implementing sustainable practices to preserve the environment. The study concludes that Undisan Rural Tourism's success in winning the 3rd Places of Tourism Village Award can be attributed to its unique branding strategy, which highlights the village's distinctive characteristics and eco-experiences. By addressing the identified weaknesses and capitalizing on existing strengths and opportunities, Undisan Rural Tourism can continue to thrive as a leading destination for sustainable rural tourism, setting an example for other tourism villages in the region

Sustainable home gardens in Western Kenya: A qualitative study for co-designing nutrition-sensitive interventions

Populations living in rural sub-Saharan Africa (SSA) increasingly face negative climate change impacts on their nutrition and health status. For smallholder farming families, home gardens can serve as an adaptation strategy, by offsetting climate change-related harvest losses and diversifying households' diets. The present study aimed to identify perceptions and experiences among rural caregivers of children under five years and local stakeholders working in the fields of agriculture or nutrition with regard to home gardening in Siaya County, Kenya. Thirty in-depth interviews with caregivers of young children and 26 interviews with local stakeholders were conducted, using a semi-structured interview guide. The data were analysed employing inductive content analysis. Caregivers and local stakeholders perceived home gardens as beneficial for the households’ nutrition, finances, and women empowerment. However, they also pointed to five major challenges in the process of establishing and maintaining home gardens: 1) water scarcity, 2) limited financial capital, 3) demanding physical labour, 4) limited land availability/control, and 5) lack of knowledge and technical support. For the design of sustainable home gardens, we identified four components as essential at the implementation stage: 1) locally available material and resources, 2) strong community collaboration and co-design, 3) comprehensive capacity building, 4) and lasting local partnerships. In conclusion, the establishment and sustained management of home gardens in Siaya County require a holistic, participatory and multi-actor approach. This will facilitate the provision of essential inputs and activities to ensure a sense of ownership and responsibility.

Seasonal variability of lotic macroinvertebrate communities at the habitat scale demonstrates the value of discriminating fine sediment fractions in ecological assessments.

Despite lotic systems demonstrating high levels of seasonal and spatial variability, most research and biomonitoring practices do not consider seasonality when interpreting results and are typically focused at the meso-scale (combined pool/riffle samples) rather than considering habitat patch dynamics. We therefore sought to determine if the sampling season (spring, summer and autumn) influenced observed macroinvertebrate biodiversity, structure and function at the habitat unit scale (determined by substrate composition), and if this in turn influenced the assessment of fine sediment (sand and silt) pressures. We found that biodiversity supported at the habitat level was not seasonally consistent with the contribution of nestedness and turnover in structuring communities varying seasonally. Habitat differences in community composition were evident for taxonomic communities regardless of the season but were not seasonally consistent for functional communities, and, notably, season explained a greater amount of variance in functional community composition than the habitat unit. Macroinvertebrate biodiversity supported by silt habitats demonstrated strong seasonal differences and communities were functionally comparable to sand habitats in spring and to gravel habitats in autumn. Sand communities were impoverished compared to other habitats regardless of the season. Silt habitats demonstrated a strong increase in Ephemeroptera, Plecoptera and Trichoptera (EPT) taxa and functional richness from spring into autumn, while vegetation habitats displayed a peak in EPT abundance in summer. Only silt and sand habitats demonstrated temporal variability in functional evenness suggesting that these habitats are different in terms of their resource partitioning and productivity over time compared to other habitats. Gravel and vegetation habitats appeared to be more stable over time with functional richness and evenness remaining consistent. To accurately evaluate the influence of fine sediment on lotic ecosystems, it is imperative that routine biomonitoring and scientific research discriminate between sand and silt fractions, given they support different biodiversity, particularly during summer and autumn months.

Opinion disparity in hypergraphs with community structure.

The division of a social group into subgroups with opposing opinions, which we refer to as opinion disparity, is a prevalent phenomenon in society. This phenomenon has been modeled by including mechanisms such as opinion homophily, bounded confidence interactions, and social reinforcement mechanisms. In this paper, we study a complementary mechanism for the formation of opinion disparity based on higher-order interactions, i.e., simultaneous interactions between multiple agents. We present an extension of the planted partition model for uniform hypergraphs as a simple model of community structure, and we consider the hypergraph Susceptible-Infected-Susceptible (SIS) model on a hypergraph with two communities where the binary ideology can spread via links (pairwise interactions) and triangles (three-way interactions). We approximate this contagion process with a mean-field model and find that for strong enough community structure, the two communities can hold very different average opinions. We determine the regimes of structural and infectious parameters for which this opinion disparity can exist, and we find that the existence of these disparities is much more sensitive to the triangle community structure than to the link community structure. We show that the existence and type of opinion disparities are extremely sensitive to differences in the sizes of the two communities.

Family, community, and the rural social mobility advantage

Children born into poverty in rural America achieve higher average income levels as adults than their urban peers. As economic opportunity tends to be more abundant in cities, this "rural advantage" in income mobility seems paradoxical. This article resolves this puzzle by applying multilevel analysis to new spatial measures of rurality and place-level data on intergenerational income mobility. We show that the high level of rural income mobility is principally driven by boys of rural-origin, who are more likely than their urban peers to grow up in communities with a predominance of two-parent households. The rural advantage is most pronounced among Whites and Hispanics, as well as those who were raised in the middle of the country. However, these dynamics are more nuanced for girls. In fact, girls from lower-income rural households exhibit a disadvantage in their personal income attainment, partly due to the persistence of traditional gender norms. These findings underscore the importance of communities with strong household and community supports in facilitating later-life income mobility, particularly for boys. They also challenge the emerging consensus that attributes the rural income mobility advantage to migration from poorer rural areas to wealthier towns and cities.

Community-Based Diabetes Awareness Strategy With Detection and Intervention: The Mobile Diabetes Education Center.

To prevent diabetes and increase equitable access to health care screenings, Touro University California has created and implemented a community outreach program called the Mobile Diabetes Education Center (MOBEC). This program is a joint effort that also involves Sutter Health, the California Department of Public Health, Kaiser Permanente, the Solano County Department of Public Health, and community-based organizations, focusing on advancing health equity in Solano County's at-risk populations. This article reports on the services and initial successes of MOBEC. With its strong community collaboration, MOBEC has helped to raise awareness of diabetes and ensure access to much-needed health screenings and education. This model can potentially be used as a blueprint for similar efforts nationwide to address the health care needs of medically underserved communities.

Improvements in dietary intake, behaviors, and psychosocial measures in a community-randomized cardiovascular disease risk reduction intervention: Strong Hearts, Healthy Communities 2.0

BackgroundCardiovascular disease (CVD) prevalence has disproportionately risen among midlife and older female adults of rural communities, partly due to poor diet and diet-related behaviors and psychosocial factors that impede healthy eating. ObjectivesThis study aimed to evaluate the impact of Strong Hearts Healthy Communities 2.0 (SHHC-2.0) on secondary diet-related outcomes between intervention and control participants that align with the dietary goal and behavioral aims of the SHHC-2.0, a CVD risk reduction program. MethodsA community-randomized controlled trial was conducted in rural, medically underserved communities. Participants were female adults ≥40 y who were classified as obese or both overweight and sedentary. Communities were randomized to SHHC-2.0 intervention (n = 5 communities; n = 87 participants) or control (with delayed intervention) (n = 6 communities; n = 95 participants). SHHC-2.0 consisted of 24 wk of twice-weekly experiential nutrition education and group-based physical activity classes led by local health educators. Changes between baseline and end point (24 wk) in dietary intake (24-h recalls), dietary behaviors (e.g., Rapid Eating Assessment for Participants-Short Version [REAP-S] scores) and diet-related psychosocial measures (e.g., Three Factor Eating questionnaire) between groups were analyzed using linear mixed-effects multilevel models. ResultsAt 24 wk, participants from the 5 intervention communities, compared with controls, consumed fewer calories (mean difference [MD]= −211 kcal, 95% CI: −412, −110, P = 0.039), improved overall dietary patterns measured by REAP-S scores (MD: 3.9; 95% CI: 2.26, 5.6; P < 0.001), and improved psychosocial measures (healthy eating attitudes, uncontrolled eating, cognitive restraint, and emotional eating). ConclusionsSHHC-2.0 has strong potential to improve diet patterns and diet-related psychosocial wellbeing consistent with improved cardiovascular health.This trial was registered at www.clinicaltrials.gov as NCT03059472.

Analisis Ekowisata dan Budaya Alam Santosa Sebagai Learning Center di Kecamatan Cimenyan Kabupaten Bandung

The establishment of a Learning Center on Ecotourism and Natural Culture of Santosa encourages the development of local policy insights, contributing to the development of national cultural values. Included in the Santosa Nature Ecotourism and Culture private area which provides coffee shop facilities, lodging places with themes that have a strong Sudanese cultural nuance. The purpose of this study was to determine the factors of establishing a Learning Center in a culture-based tourism village. This journal analyzes descriptively qualitatively, filling out questionnaires in the surrounding community, and the parameters seen include attractions, amenities, and accessibility presented in the SWOT analysis. The results of the factors that influenced the establishment of Ecotourism and Culture Alam Santosa to become a Learning Center were influenced by internal and external factors with the strongest factors being the attractions of diverse cultural infrastructure and the trust that was woven with a strong community.

Key Lessons From a Systematic Behavior Change Communication Process Used in a Pneumonia Prevention Program in Five African Countries.

A systematic behavior change communication (BCC) process was designed to enable local partners to effectively conduct formative research and develop a comprehensive BCC strategy, as part of a pneumonia prevention and control program implemented from 2017 to 2021 by the Red Cross Red Crescent in Ethiopia, Ivory Coast, Mali, Sudan, and Zambia. Qualitative content analysis was used to identify, categorize, and summarize key results, lessons, and recommendations related to the BCC process from country evaluation data. Key elements to success of a locally implemented BCC process include: (1) through simple formative research, understanding household decision-making dynamics for timely health seeking and coexistence of modern and traditional medicine; (2) explicitly analyze motivators for uptake of protective behaviors, with strong and deliberate community participation to validate and tailor BCC messages and channels; (3) ensuring that the challenges to access basic services, such as water and sanitation facilities, are adequately addressed as critical enabling factors for behavior change. Other implications include a need for innovative solutions to physical and economic barriers in areas where large distances, lack of transportation, or cost hinder caregivers seeking care for sick children. Community health programs that apply a BCC process through local partners can be effective in achieving behavioral outcomes. Participatory planning and involvement of the community in iterative rounds of validation improved the relevance, appropriateness, and impact. Further research is needed to determine the effectiveness of different communication methods and sustained impact on health outcomes.

Trusted sources for COVID-19 testing and vaccination: lessons for future health communication

ABSTRACT Background Promoting COVID-19 vaccination (both the primary series and boosters) remains a priority among healthcare professionals and requires understanding the various sources people trust for acquiring COVID-19 information. Method From October 2021 to May 2022, we interviewed 150 people who called 2–1–1 helplines in Connecticut and North Carolina about their COVID-19 testing and vaccination experiences in order to (1) better understand where people obtain trusted COVID-19 health information and (2) identify how public health professionals can share emergency health information in the future. We used a mixed methods approach in which semi-structured qualitative interviews and survey data were collected in parallel and analyzed separately. Results Participants were mostly female (74.0%), Black (43.3%) or White (38.0%), and had a high school degree or higher (88.0%). Most had prior COVID-19 testing experience (88.0%) and were vaccinated (82.7%). A variety of information sources were rated as being very trustworthy including medical professionals and social service organizations. We found that repetition of information from multiple sources increased trust; however, perceived inconsistencies in recommendations over time eroded trust in health communication, especially from government-affiliated information sources. Observations such as seeing long lines for COVID-19 testing or vaccination became internalized trusted information. Conclusions Public health professionals can leverage the reach and strong community ties of existing, reputable non-government organizations, such as physician groups, schools, and pharmacies, to distribute COVID-19 information about vaccination and testing.