What Multilingual Health Services and Support Look Like in Brockton, MA

Over the past several years, Brockton Public Schools (BPS) has developed a robust network of support for its multilingual families, including within its nursing department.

During the COVID-19 pandemic, bilingual nurses, English-speaking nurses, interpreters, and family liaisons have all collaborated closely to stay connected with families. Learn more about what this outreach has looked like during the pandemic and what it has accomplished from our interviews with the following BPS staff and leaders:

• Astride Jeune, BSN, RN (School nurse)
• Tracy Politano, MSN, RN (School nurse)
• Stacy Wright, LPN (School nurse)
• Linda Cahill, DNP, RN (Nursing Supervisor)
• Marie Jean-Philippe (District Interpreter)
• Michael Thomas (Superintendent)

Acknowledgements

This article is part of our series on multilingual outreach and support in Brockton, MA and was made possible with the generous support of the National Education Association.

Multilingual Health Support in Brockton

In order to understand why BPS was able to mobilize its COVID-19 response so quickly, it's helpful to understand the health infrastructure that the district already had in place before the pandemic.

Language access for Brockton's families

BPS' Health Services Department includes multilingual nurses who speak Cape Verdean, Creole, Haitian Creole, French, Portuguese, and Spanish. The district also has a language line that nurses can use to support multilingual communication. Astride Jeune, a Haitian school nurse, says, "As a bilingual nurse, it's my role and my responsibility...to make parents feel there's no barrier."

Ms. Jeune's work with the community started long before becoming a school nurse. When the hospital where she worked closed, she learned about the opportunities as a school nurse and said to herself, "This is a great fit for me. I'm still going to be seeing the community. I'm still going to be mingling with children and giving them all the support that I can, making sure that the community is doing what they're supposed to be doing." It was a good move for Ms. Jeune. "I love it," she says.

Collaboration around communication

While Ms. Jeune's primary outreach focuses on the Haitian community, she also has experience in using the district's language line to support families from other communities. The same is true for all of the other BPS nurses serving multilingual families. According to Tracy Politano, a school nurse who has extensive experience collaborating with community advocates and interpreters, "There's no hassle in getting an interpreter anywhere in this district." The relationships that district interpreters have with families are essential, she says, noting that she collaborates with the interpreters whenever she can. "They have great connections with our families. They know what they need. They know they can come to us for anything, and they are just so helpful," she says.

Ms. Politano says she particularly values her close collaboration with one of the district's Haitian interpreters, Marie Jean-Philippe. "Oh, yes!" Ms. Jean-Philippe says. "Tracy's my best buddy!" Ms. Jean-Philippe notes that she also brings many questions from families to Ms. Politano, who always shares any information she can to support families.

For example, she says, Ms. Politano knows which doctors are most welcoming to multilingual families. "Sometimes I call her and ask her if she knows any good pediatricians," Ms. Jean-Philippe says. "She knows doctors who are very compassionate and committed to helping others."

For her part, Ms. Politano has always seen herself as an advocate for multilingual families. "I've always worked with interpreters who were coming from the hospital," she says. "I was a very strong advocate for always having interpreters available. I worked in a stress lab, and if you're doing a cardiac stress test on somebody, you want to make sure you have an interpreter there so they understand what's going on fully.

"I encourage all my families in my school to reach out to an interpreter anytime they go to their doctors' appointments. I've had some cases where families were never offered an interpreter and I told them they have a right to an interpreter at every appointment that they go to."

Video: Breaking down barriers with multilingual families

Astride Jeune in Brockton, MA explains why her role as a bilingual school nurse is so important for family outreach and how the nurses support each other.

Video: How school nurses collaborate with interpreters in Brockton, MA

Tracy Politano describes how she partners with interpreters to communicate with multilingual families and how she encourages families to advocate for language access in their medical appointments.

Video: Why I love my work with families as a community facilitator

Marie-Jean Philippe, a community facilitator and liaison for Haitian families in Brockton, talks about her role and her work helping her families navigate health care.

Health Outreach During COVID-19

Throughout the COVID-19 pandemic, the Health Services' department has taken on a wide range of responsibilities. Early on, one of the district's first steps was to provide a group of nurses, guidance counselors, and adjustment counselors with dedicated cell phones that families could call with questions. The district also established a health call center to field family questions.

In addition, the nurses' responsibilities have included:

• Contact tracing (often using the language line to connect with interpreters)
• Sharing safety practices
• Holding flu vaccine clinics
• Answering families' questions

All of these efforts have included multilingual resources, outreach, and communication to make information as widely available as possible. The district has been particularly interested in the use of video as a more personal way to reach families. PBS Public Relations Officer Jess Hodges notes, "We were very intentional in wanting to use video so that families would get to know the nurses and feel comfortable reaching out throughout the pandemic. It’s often daunting to contact someone with health concerns when all they are is a name and number on a piece of paper. We wanted our families to see that, while these nurses may not be at their child’s school, they are here to support all BPS families."

For examples of the nurses' multilingual outreach, you can see these videos promoting the school's flu vaccine clinic in the following languages:

• English | Spanish | Portuguese | French

COVID-19 Health Updates and Vaccines

At the same time, the nurses (and interpreters) have fielded numerous questions from families about COVID-19 and the vaccines. Ms. Jeune notes that the families she serves have asked her questions such as, "Is the vaccine safe to take? Which one of the three vaccines are the safest? After the vaccine, can we still catch COVID?" She says families have a lot of questions related to vaccinating their children and she expects those only to increase once vaccines are approved for younger children.

This kind of outreach has been happening throughout the district. "The school nurses have been incredible in answering questions and communicating with families in their preferred language throughout the pandemic," says Miss Hodges. "They would explain the quarantine process and provide support where possible."

Getting vaccines into the community

This personal outreach has proven critical in helping families get vaccinated, combatting myths on social media, and lessening the stigma of the vaccine — and it has occured in partnership with the city. "I think the city has done a great job in trying to get the word out and do a lot of outreach and make it easier for folks to get the vaccine if they want it," says Ms. Cahill. "They have a vaccine ambassador to encourage folks...They've had vaccine clinics weekly at the Cape Verdean Association, at Westgate Mall, and at various churches. Education is a huge piece of it."

The district has also partnered closely with the city around other vaccine clinics for the community, as well as for school staff and families. The first clinic that school nurses held was for Brockton first responders and others followed as the vaccines were approved for use among other groups, including students and families. The nurses are now facilitating vaccine clinics for students 5 and older at schools around the district, and they are publicizing sites where families can access testing, vaccines, and boosters.

These clinics have also involved a lot of multilingual support. Stacy Wright, a one-to-one school nurse, notes that interpreters were at the clinics, which made a big difference in helping the clinics run smoothly. The vaccine clinics have been a highlight of Ms. Wright's career. "I have so enjoyed doing the vaccine clinics. It's probably the best nursing experience I have ever had...Everyone is just so warm and welcoming and excited about it, so it's been a really phenomenal experience."

Multilingual resources in the community

To see some of the other multilingual outreach resources in Brockton around vaccines, take a look at the following:

• COVID-19 vaccine registration website (available in multiple languages)
• Multilingual vaccine update videos (City of Brockton, MA)

Video: The community spirit at our vaccine clinics

Stacy Wright talks about the warm and welcoming spirit in Brockton, MA"s community COVID-19 vaccine clinics.

Video: What vaccine outreach has looked like in Brockton

Linda Cahill, the nursing supervisor for Brockton, MA, describes some of the ways that the city has supported outreach for the COVID-19 vaccine.

Collaboration with the Brockton Education Association

Another example of collaboration that has supported the nurses' role during the pandemic has been the ongoing work between the school district and the Brockton Education Association, the local teacher's union whose members include school nurses. Both parties have worked closely together around these developments as nurses' schedules and responsibilities have shifted. According to Brockton Superintendent Michael Thomas, "Kim Gibson, our local union president, and I met and we came up with an agreement to allow nurses to help with contact tracing. That was easy to get done and it couldn't take a lot of time and it didn't. So a lot of people had to jump in, and our nurses did that right away, led by Linda Cahill."

The union and district also worked together when, not long after the pandemic began, the Brockton's municipal Board of Health asked the school district if Ms. Cahill could fill in as interim board director for the city. Once again, Mr. Thomas and Ms. Gibson went back to the drawing board and figured out how to make it happen. "The role that she played city-wide has actually really helped us in the school system because it continued to give us information to help us deal with COVID-19," says Mr. Thomas. (He also notes that the work done by Ms. Cahill, who has a doctorate in nursing, and the nurses has benefited the city considering that, due to budgetary issues, Brockton only had one full-time nurse working for the Board of Health at the start of the pandemic.)

In addition, Ms. Politano, who is a union representative, shares that the union has been instrumental in advocating for better ventilation in school buildings. "Kim has worked hard to ensure that every school had adequate air supply and air exchange in every single building. She has the guidelines down to a science and that wasn't easy. We have a lot of older schools in the district, and she made sure every school was safe for our staff and students. It was a huge accomplishment on the union's part."

Community Outreach During COVID-19

In addition to all of these efforts, the nursing staff has been involved with other kinds of community outreach and support during the pandemic, including:

• collaborating with community health care providers and local clinics
• staffing Parent Information Centers to help families access medical records
• connecting families with the district's resources for food and housing assistance
• doing home visits
• managing deliveries of food, water, diapers, and other supplies
• organizing winter clothing drives
• partnering with hospitals and local universities
• attending community meetings
• collecting donations of board games for family game nights
• collaborating with the police department to share holiday gifts with students

Families have expressed their appreciation for all of the support. "The nurses relate to me the gratitude that our families speak about when they receive food and clothing," says Ms. Cahill. She also notes that the outreach extends beyond the district's families into the community, which has been valuable throughout the pandemic.

A Close Team

Given how much they have been through and how closely they work together, it is not surprising to learn that the BPS nurses speak highly of their team. "We are always checking in on each other," says Ms. Politano. Pointing to Ms. Wright next to her in the interview, she says, "Who else would bring in matching headbands on a hot day today while we are working? It's definitely a family."

The nurses also credit Linda Cahill's leadership for this key support during such a difficult time. "She's always there to support us," says Ms. Politano. "There's times when I go crazy trying to get things for my kids and she's right there behind me.  She's there to make sure it happens and ensure our kids get what they need."

Ms. Jeune echoes this sentiment. "This is a great team. I could not ask for a better team," she says. "I have very good moral support, which is very important...and I'm thankful for that."

Recommended Resources

Learn more about Brockton's COVID-19 response from Debbie Zacarian's article Proactively Building a Rapid Response Team.