Resilience in the System: COVID-19 and Immigrant- and Refugee-Serving Health and Human Service Providers

Introduction: Immigrant and refugee families in the U.S. have been particularly hard hit by the COVID-19 pandemic. Health and human service providers who serve these communities have been essential in supporting them during this crisis, yet have also had to adapt the way they provide services. The current study aims to describe the challenges these service providers have faced and the adaptations they have made. Method: Our research team conducted semistructured interviews with 19 service providers at 10 organizations identified as serving one or more immigrant and/or refugee communities in the state of Minnesota. We analyzed the interviews for themes and used normalization process theory (May & Finch, 2009) to understand how service providers have shown resilience and where gaps in capacity emerged. Results: Mechanisms of adaptation to the COVID-19 crisis included staff taking on larger workloads, utilizing existing service frameworks in new ways, shifting their services remotely and/or substantively, and utilizing the trust they had built with communities and individuals over time. Challenges that had not been fully overcome included insufficient funding for community need and restrictions on methods of interaction. Discussion: Key implications include allocating funding for immigrant and refugee families, developing and evaluating new service formats in collaboration with clients, providing direct support for staff in times of crisis, and using practice-based evidence to speed implementation science research. Public Significance StatementFew studies have examined how health and human service professionals responded during the first months of the COVID-19 pandemic. This study examined the mechanisms by which these professionals managed to continue serving their clients and patients, while identifying the limitations placed on them by the larger environment.