Contribution of North Texas Korean Nurse Association COVID-19 Task Force Team to Promote the Health of Local Korean Immigrant Community Amid the Pandemic

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(1)EDITORIAL. eISSN 2093- 758X. J Korean Acad Nurs Vol.51 No.5, 505 https://doi.org/10.4040/jkan.21154. Contribution of North Texas Korean Nurse Association COVID-19 Task Force Team to Promote the Health of Local Korean Immigrant Community Amid the Pandemic Lee, Kyoung Eun, Editorial Board Member of JKAN1 · Lee, Mikyoung A.2 1. College of Nursing and Health Science, Texas A&M University, Corpus Christi, TX College of Nursing, Texas Woman’s University, Denton, TX, USA. 2. According to the most recent report from the Center for. Disease Control and Prevention [1], the COVID-19 pandemic. has caused nearly 35 million cases of the disease and ap-. proximately 610,000 deaths in the United States (U.S.) as of. July 30, 2021. While the pandemic has impacted every community in the U.S., it has disproportionately impacted the. underserved individuals and communities with socioeconomic. et al. [5], many Korean immigrant struggle to overcome the linguistic and cultural barriers that adversely affect their health literacy and their ability to manage chronic health conditions like hypertension and diabetes. It was also claimed that low health literacy among Korean immigrants is likely a major contributor to health disparities in this country [5].. Therefore, to improve Korean immigrants’ health especially. inequities and health care disparities such as the Korean im-. under the current given pandemic situation, it attaches sig-. migrant population [2]. According to the 2019 American. nificance to community-based health promotion programs. Community Survey data from the U.S. Census Bureau [3], 1,908,053 Korean Americans are living in the U.S. and. 108,796 living in Texas. Texas has the third largest Korean. organized by bilingual Korean health care providers or an community-serving organization like North Texas Korean Nurse Association (NTKNA).. American population next to California and New York. Among those Korean Americans living in Texas, 58,808 are. NORTH TEXAS KOREAN NURSE ASSOCIATION. first generation of Korean immigrants born in South Korea. The Korean immigrant population has been more likely to be highly affected by infectious diseases due to a number of. factors including cultural insensitivity, limited access to health care, lack of health insurance, and inadequate com-. According to the historical report in the “Angels in white. gown” [6], the Korean immigration in the state of Texas. started when 43 Korean nurses immigrated to Dallas on April 9th of 1967. The NTKNA is a non-profit organization. munication and/or comprehension of the importance of pre-. established in November 1968 by 21 Korean immigrant. can negatively impact on their health care seeking behaviors. One hundred seventy-eight members have registered to the. ventive primary health care [4]. In addition, linguistic barrier. nurses, working at Parkland hospital in Dallas, Texas [7].. due to the inability of adequately expressing themselves and. NTKNA but there are currently only 54 active members,. the concern to be misunderstood when healthcare providers. mainly due to various personal reasons such as relocation. utilize an interpreter (often by phone) [4]. According to Kim. and no time to volunteer due to family issues.. Address reprint requests to : Lee, Kyoung Eun College of Nursing and Health Science, Texas A&M University, 6300 Ocean Drive, Corpus Christi, TX 78412, USA Tel: +1-361-825-2162. Fax: +1-361-825-2484 E-mail: [email protected]. Received: August 3, 2021 Revised: October 7, 2021 Accepted: October 11, 2021 Published online October 31, 2021 This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.. © 2021 Korean Society of Nursing Science. https://jkan.or.kr.

(2) 506. For more than half a century, the NTKNA members have been serving the Korean immigrant community in North Texas to promote their health through various activities as follow: 1) community-based health promotion educations on. various topics including management of chronic disease, healthy diet, perimenopausal symptoms management, self-. Lee, Kyoung Eun · Lee, Mikyoung A.. ventions: Launching the NTKNA nurse hotline service and assisting in online registration for COVID-19 vaccination.. 1. Launching North Texas Korean Nurse Association nurse hotline service After a systematic preparation process to develop the spe-. breast exams, and prevention of depression etc., 2) commu-. cific operational protocol, the NTKNA’s COVID-19 task force. nity medical services such as annual administration of flu. team launched the nurse hotline service in September 2020. vaccines, 3) annual Korean community health fair, 4) health consultations, 5) volunteering at local Korean centers such as. Grace Korean Elderly Center, 6) supporting Korean language. and the service is still ongoing (Figure 1). It involves the use of electronic communications to enhance Korean immigrants’. understanding of healthcare information, support them to. school for second generation of Korean American children,. access appropriate health care, and promote self-care by. and 7) volunteering services during other local Korean com-. addressing their questions or inquiries. Based on their clinical. Worth Korean golf day) [8]. In addition, the association is. signed to one of seven specialty categories including adult. munity events (e.g., running first aid center Dallas-Fort expanding its roles to mentor future Korean nurses in the community and local Korean immigrant nurses who just moved to Texas. It also provides information about graduate. and educational expertise, 15 task force members were as-. healthcare, pediatric healthcare, mental healthcare, women’s healthcare, geriatric healthcare, home care, healthcare access and local financial resources, and healthcare under the. nursing education programs, continued education opportuni-. COVID-19 pandemic. The hotline link guides the inquirer to. dated rules and regulations of Texas Borad of Nursing [9].. the health question (multiple choices), health insurance sta-. ties, available nursing career in north Texas areas, and up-. CONTRIBUTION OF NORTH TEXAS KOREAN NURSE ASSOCIATION COVID-19 TASK FORCE TO PROMOTE THE LOCAL KOREAN COMMUNITY’S HEALTH. the survey asking the age, sex, e-mail address, category of tus, and consent to the use of NTKNA hotline service. It also. has a blank section to fill out the inquirer’s specific questions. The specific protocols related to the COVID-19 nurse hotline service operation are as follows: 1) NTKNA advertises the NTKNA nurse hotline service in the local newspapers [10] and on bulletin posters at local. NTKNA is the oldest Korean American nurse association. Korean grocery stores to inform the Korean community of. in the U.S. and celebrated its 50th anniversary in 2018. The. the nurse hotline service link (https://www.surveymonkey.. association’s efforts to improve the health of the local Korean. com/r/6Z3KDHR) and its user instructions written in both. immigrants have never stopped even under the pandemic. In. Korean and English.. order to timely respond to unmet healthcare needs and pro-. 2) The hotline service is open to the public during the. mote the health of the local Korean immigrant community. weekdays from 6:00 am to 9:00 pm and the availability of. amid the COVID-19 pandemic situation, the NTKNA decided. to organize the COVID-19 task force team in August, 2020.. The team consists of 15 active members including seven. critical care registered nurses, two nursing professors, four advanced registered nurse practitioners, two nurse adminis-. the service is properly advertised via local newspaper and Dallas Korea radio broadcast station. 3) The NTKNA homepage manager screens the inquiry questions and classifies the question topic of the question from Korean immigrants on a daily basis. The questions are. trators. Serving as a task force team member was 100%. then forwarded to the task force members who are desig-. voluntarily basis commitment without any financial compen-. nated to one of seven specialty categories.. sation. The task force implemented two main strategic interhttps://jkan.or.kr. 4) The task force members who receive the inquiry queshttps://doi.org/10.4040/jkan.21154.

(3) 507. NTKNA COVID-19 Task Force Team. NTKNA = North Texas Korean Nurse Association. Figure 1. NTKNA Task Force Team to Local Korean Community in North Texas.. tions are responsible for responding to questioners and the homepage manager within 24~48 hours. 5) Since this service is provided via electronic communi-. cation, the software security protocol of the hotline link was designed to protect the confidentiality of the patient/individual’s identification and the consent to the use of NTKNA nurse hotline service was obtained as a part of the hotline service survey. 6) The inquiry submitted via the hotline link will be re-. 2) Better understanding of medical terms, concerning. health conditions, medications (e.g., proper administration,. precautions, possible side effects etc.), lab/test results, and/ or COVID-19 information and the protective behaviors. 3) Obtaining information on the available healthcare services at minimal or no cost in the community. 4) Obtaining information related to available financial support (fund available provided by county state or federal funds) for the healthcare services.. viewed by only the NTKNA homepage manager who kept. 5) Receiving education related to general measures for. his survey link login credentials as private secure the sub-. health promotion & COVID-19 safety measures including. mitted inquiry data. The information communicated through the hotline is lim-. ited to health education, consultation, and the service and. proper handwashing habits, increased physical activities, healthy eating behaviors etc.. When a person accesses the nurse hotline services, NT-. does not include diagnosis, treatment recommendations, or. KNA task force team members implemented precaution. medical prescriptions by the nurse practitioners due to health. measures to minimize potential risk related to the breach of. liability issues. Despite of this limitation, the task force team identified followings as the benefits of receiving the nurse hotline service: 1) A free consultation on specific health issues by health. care professionals with educational and clinical credentials in the specific specialty area. https://doi.org/10.4040/jkan.21154. personal health history while using electronic communication. software. For example, when the hotline users click the hotline link, they require to read and agree to the possible risks. and benefits of this service stated in a short online consent form, which was adopted from Health Insurance Portability. and Accountability Act rules and regulations, before they https://jkan.or.kr.

(4) 508. proceed with their inquiry or general questions. As a method to discuss the efficiency of the hotline ser-. vice, the NTKNA task force team meets on a weekly basis. Lee, Kyoung Eun · Lee, Mikyoung A.. community in the North Texas areas. The NTKNA COVID19 task force team members dedicated a significant time and efforts to timely respond to the healthcare needs of Korean. every Saturday night to review the received inquiries and. immigrant community members compounded by the ex-. task force’s responses over the prior week as well as to. tremely challenging pandemic situation. Despite the NTKNA. share any issue/concern and to develop strategies to ensure. task force team launched the COVID-19 nurse hotline ser-. the provision of quality services.. vice after considerate process to develop the service proto-. 2. Assisting in online registration for COVID-19 vaccination Since the emergency approval of COVID-19 vaccine by U.S.. Food and Drug Administration in December 2020, the vaccination process has been expedited in the U.S. [11]. Based on. col, there are couple of important lessons to learn for the task force team. The inquiries to use the hotline service itself were available only to those community members who have access to or are capable of using a computer/internet to initiate an electronic communication with a task force member. There-. careful review of the TNKNA nurse hotline service inquiries. fore, the Korean immigrant older adults, who are considered. related to vaccination and increased availability of COVID-19. as the most vulnerable population due to multiple chronic. that many local Korean community members, especially. strategies to improve the hotline access need to utilize alter-. vaccines to the public, the COVID-19 task force team noted older adults, were having difficulties in scheduling COVID-19 vaccination appointments requiring online registration pro-. cess. In response to their requests for help, the task force team decided to assist local Korean community members. utilizing two different methods, face-to-face and telephone assistance. The team set up dates for face-to-face assis-. health issues, were not able to use the service. Different nate resources and formats, for example cooperating with youth group at local Korean church. And the nurse hotline service could be set up during the local Korean community events or on specific dates at local senior centers like Grace Korean Elderly center which provides daycare to them. On the other hand, for those who are young and familiar with. tance at a local Korean community center for those who. internet and social network services, the interactive tele-. were not able to use computer/internet service or who had. health format for the hotline service could be utilized as an. difficulty in navigating the registration sites. To receive the. effective method to provide timely healthcare consultation. telephone assistance, an individual needs to call to the provided contact phone number to set up a personal telephone. and education. The hotline service is still ongoing so we could have more. meeting with one of the task force team members. These. inquiries in the future. However, the number of hotline ser-. strategic services provided to the local Korean immigrant. vice users has not been meeting our expectations of having. community in an effort to increase vaccination in this high-. 10~20 inquiries per week. More aggressive public advertis-. risk population were highly appreciated by many older adults. ing methods using various resources (e.g., weekly broad-. who received the face-to-face or telephone assistance in. casting advertisement through local Korean radio station,. online registration of the for COVID-19 vaccination.. cooperation with local Korean church leaders etc.) will be required to reach out more local community members to. WHAT WE LEARNED AND WHAT IS NEXT As a professional nursing organization, the NTKNA mem-. make sure they are aware of the NTKNA nurse hotline service available to them at no cost.. Lastly, there is still a lack of public awareness toward the. bers has been striving to improve the quality of healthcare,. professionalism of Korean nurses as reliable health consul-. contribute to the well-being of the local Korean immigrant. Korean society, the professionalism of healthcare provided by. promote networking and fellowship among its members, and. https://jkan.or.kr. tants, especially among Korean older adults. In traditional. https://doi.org/10.4040/jkan.21154.

(5) 509. NTKNA COVID-19 Task Force Team. AUTHOR CONTRIBUTIONS. nurses has been undervalued and there was a learned bias that nursing care is inferior to a doctor’s care. This view-. Conceptualization or/and Methodology: Lee KE & Lee MA.. point is still prevalent especially among older Korean adults. However, Korean immigrant nurses in the U.S. are taking. Data curation or/and Analysis: Lee KE.. active roles as team leaders within the U.S. health care sys-. Funding acquisition: None.. tem thanks to their expertise in healthcare knowledge and. Investigation: Lee KE & Lee MA.. skills as their professionalism. More aggressive and continu-. Project administration or/and Supervision: Lee KE & Lee. ous efforts should be made through proper cooperation with. MA.. other Korean nurse associations in the U.S. to dispel the. Resources or/and Software: None.. prejudicial perception toward professionalism of Korean. Validation: Lee KE.. nurses and their ability to promote the health of the local. Visualization: Lee KE & Lee MA.. Korean community members.. Writing original draft or/and Review & Editing: Lee KE.. Korean nurses who are working in many other foreign. REFERENCES. countries in the world have had a significant impact on promoting the health of the local Korean communities by actively taking responsibilities as community leaders and by. 1. Centers for Disease Control and Prevention (CDC). Case report in the U.S. [Internet]. Atlanta: CDC; 2021 [cited 2021. being an inspiring role model to the young Korean American. generation. However, their dedications to the communities. Jul 10]. Available from: https://www.cdc.gov/coronavi-. were rarely reported to the public. This brief case report on. 2. Infectious Diseases Society of America (IDSA). COVID-19. the contribution of the NTKNA task force team amid the. policy brief: Disparities Among rural communities in the. COVID-19 pandemic is a good example of nursing care ex-. United States version: December 22, 2020 [Internet]. Ar-. rus/2019-ncov/cases-updates/cases-in-us.html.. lington: IDSA; 2021 [cited 2021 Jul 2]. Available from:. cellence by addressing the unmet healthcare needs of under-. https://www.idsociety.org/globalassets/idsa/public-health/. served vulnerable Korean immigrant community members. covid-19/covid19-health-disparities-in-rural-communities_. living in Northern Texas in the U.S.. leadership-review_final_ab_clean.pdf 3. United States Census Bureau (USCB). American Community Survey data [Internet]. Suitland: USCB; 2021 [cited 2021 Jul. CONFLICTS OF INTEREST. 15]. Available from: https://www.census.gov/programs-surveys/acs/data.html.. Lee KE has been the Editorial Board member of JKAN. since 2020. Except for that, we declare no potential conflict. 4. Rhodes SD, Song E, Nam S, Choi SJ, Choi S. Identifying and intervening on barriers to healthcare access among members of a small Korean community in the southern USA. Patient. of interest relevant to this article.. Education and Counseling. 2015;98(4):484-491.. ACKNOWLEDGEMENTS. https://doi.org/10.1016/j.pec.2015.01.001. 5. Kim MT, Kim KB, Ko J, Murry N, Xie B, Radhakrishnan K, et al. Health literacy and outcomes of a community-based self-help intervention: A case of Korean Americans with. None.. type 2 diabetes. Nursing Research. 2020;69(3):210-218.. DATA SHARING STATEMENT. https://doi.org/10.1097/NNR.0000000000000409. 6. North Texas Korean Nurses Association (NTKNA). Angels in white gown. Houston (TX): GLPI; 2011. p. 1-243.. Please contact the corresponding author for data availability.. 7. North Texas Korean Nurses Association (NTKNA). History of NTKNA [Internet]. Dallas: NTKNA; 2021 [cited 2021 Jul 12]. Available from: http://www.ntkna.org/xe/history. 8. Cho HS, Cho MK, Lee KE. The emergence of the North Texas Korean American Nurses Society and its contributions. https://doi.org/10.4040/jkan.21154. https://jkan.or.kr.

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