Exploring Health Communications, Sensemaking, Collective Action, and Sensegiving in a Rural Public Health Setting During the COVID-19 Pandemic
San Juan Basin Public Health (SJBPH) is a local public health agency in southwest Colorado responsible for monitoring, investigating, and communicating health conditions in Archuleta and La Plata Counties. To fulfill their mission during the pandemic, SJBPH leaders need to understand how their external constituents engage with health information during an emergency, in this case, the COVID-19 pandemic, and how they communicate with each other and what processes they use. I analyzed 167 survey responses from Archuleta and La Plata County residents and conducted 14 interviews with the SJBPH COVID-19 Response Leadership Team in Spring 2021 with the goal of informing agency preparation, communications, and leadership during future emergent events. Results are as follows: SJBPH was the main source of information for COVID-19 information, and this did not vary by age or county of residence. SJBPH communications reached respondents frequently and engagement with SJBPH increased. Respondents indicated high trust for SJBPH, and that conversations with other people and SJBPH communications both helped with pandemic sensemaking including understanding information about the pandemic, reducing uncertainty, helping people feel they could navigate the pandemic, and increasing understanding of the vaccine and its benefits. However, these sensemaking indicators were 5%-16% higher for all categories for SJBPH communications compared to conversations with others. Finally, SJBPH uses a variety of tactics and processes under collective action and engages in strategic sensegiving relying on external entities. Despite many internal, external, and pandemic-centric challenges, evidence suggests SJBPH staff grew, connected, and improved as an agency. The findings of this study may also be applicable to other similar rural public health agencies.