July 15, 2020

1. Innovations in Contact Tracing from California:
Health Coaching and Communicating Effectively
About COVID-19
July 15, 2020

2. CME Credit
• Bridgeport Hospital Yale New Haven Health is accredited by the Connecticut State
Medical Society to sponsor continuing medical education for physicians. The
Bridgeport Hospital Yale New Haven Health designates this live activity for a
maximum of one (1) AMA PRA Category 1 CreditsTM. Physicians should claim only
credits commensurate with the extent of their participation in the various
activities.
• This activity has been planned and implemented in accordance with the Essential
Areas and policies of the Accreditation Council for Continuing Medical Education
through the joint sponsorship of Bridgeport Hospital Yale New Haven Health and
the Weitzman Institute. Bridgeport Hospital Yale New Haven Health is accredited
by the Connecticut State Medical Society to provide continuing medical education
for physicians.
• The content of this activity is not related to products or services of an ACCME-
defined commercial interest; therefore, no one in control of content has a relevant
financial relationship to disclose and there is no potential for conflicts of interest.
2

3. Innovations in Contact Tracing from California:
Health Coaching and Communicating Effectively
About COVID-19
www.newarknj.gov

4. COVID-19 by population, U.S.A.
3,431,574 cases 7/15/20 up from 2,983,961 cases on 7/7/20
136,466 deaths https://coronavirus.jhu.edu/map.html

5. Daily New Cases per 100k people
Data shown from 1/22/20 to 7/13/20
https://coronavirus.jhu.edu/data/new-cases-50-states

6. News updates
• US Biotech firm Moderna to start Phase 3 human
trials for its vaccine on 27 July
– Sinovac - Inactivated + alum
– University of Oxford/AstraZeneca - ChAdOx1-S
• School districts in Los Angeles and San Diego -
online education in August
• New Zealand has gone 70 days without a single
case of community transmission
– swift, localized lockdowns and rapid contact tracing to
ensure anyone close to a confirmed infected person
was isolated

7. Resources
• Nuvance health:
• https://spark.adobe.com/page/qrH7iY0Gi0hU9/
• CDC:
https://www.cdc.gov/coronavirus/2019-ncov/index.html
https://emergency.cdc.gov/coca/calls/2020/
• WHO:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019
• Johns Hopkins:
https://coronavirus.jhu.edu/map.html
• Others
https://www.thelancet.com/coronavirus
https://covidactnow.org/

8. Innovations in Contact Tracing from
California: Health Coaching and
Communicating Effectively About COVID-19
Rachel Willard-Grace, MPH
Director, UCSF Center for Excellence in Primary Care
Solange Madriz, MA, MS
Academic Coordinator, UCSF Institute for Global Health Sciences

9. UCSF Pandemic Initiative for Equity & Action
California Prevention Training Center
Center for Excellence in Primary Care
Curry International Tuberculosis Center
UCLA Extension
UCLA Fielding School of Public
Health
Community Health Sciences
Credit to…

10. • Share practical skills that may be relevant when
thinking about the work of health center staff in
the time of COVID-19
• Highlight the value of health coaching to the
success of efforts to curb the virus spread
What are our goals today?

11. Basic Case Investigation &
Contact Tracing Workflow
Clinic or
provider
Surveillance Lab Case
Investigation
Contact
Tracing
Community
Outreach Hubs

12. Contact Tracing Team Composition
Team Lead
Team Clinician
Tracer 1 Tracer 2 Tracer 4Tracer 3 Tracer 5

13. 13
Purpose of the Contact Tracing Team
As quickly as possible . . .
• Inform contacts of their encounters with
a confirmed positive case.
• Disseminate information and guidance
on quarantine and isolation.
• Prioritize resources on high-risk contacts
who are:
– pregnant
– 60 years or older
– have pre-existing conditions, are
immunocompromised, and/or
– experiencing homelessness
Decrease Transmission
Protect Vulnerable Populations
Protect Healthcare Workers

15. GRAPHIC for Solange’s in their shoes exercise?

16. What is Health Coaching?
Health coaching is a set of tools to support people in
gaining the knowledge, skills and confidence to care
for their health.

17. How is Health Coaching relevant to COVID-19
contact tracing and case investigation?
Actions such as quarantine:
• Require significant behavior
changes
• Are disruptive to people’s lives
• Rely on understanding and
buy-in

18. DIALOGUE
“Tell-tell-tell” and an open loop

19. What is Ask-Tell-Ask?
A client-centered way to assess and build on what
people already know

20. What is
Ask-Tell-Ask?
ASK To learn more about the
contact’s knowledge and
perspective
TELL Provide information
based on the contact’s
response
ASK Close the Loop

21. Asking contacts to restate the information that you have provided
in their own words
What is Closing the Loop?

22. Closing the Loop makes Information
“Stick”

23. How do we close the loop?
Phrases to use… Phrases to avoid…
Just to make sure I explained that well,
would you mind telling me in you own
words…
We covered a lot of information today!
Starting today, what will you be doing?
•Do you
understand what
I said?
•Repeat back
what I just said.
•What did I just tell you?

24. What is
Ask-Tell-Ask?
ASK “What do you know
about how to stop the spread
of COVID-19?”
TELL “You’re right! A few
additional ways include…”
ASK “Just to be sure I
explained that well, would you
mind telling me in your own
words…”

25. DIALOGUE
“Ask-tell-ask” and a closed loop

26. Where are we going with Contact Tracing?
• Adapt training to community-based contact
tracers
• Add more training around cultural humility and
implicit bias
• Sharing best practices and resources across
regions and communities

27. https://www.kevinmd.com/blog/
2020/06/how-to-make-covid-19-
contact-tracing-work.html
Resources
Visit our website for free resources on
health coaching:
http://cepc.ucsf.edu/
Email: Rachel.Willard@ucsf.edu

28. 28 * This initiative is supported by 28

29. Thank You!
www.weitzmaninstitute.org/coronavirus
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