North Carolina

The Innovations Fund

Phase: 2020

Project Description:


North Carolina Agricultural and Technical University (NC A&T), supported by the North Carolina Action Coalition, implemented Project RARE (Reciprocal, Authentic, Relationships for Equity) using the Campaign’s Health Equity Toolkit. The project sought to develop a community engagement model to address health equity issues through coalition-building with nurses, nursing students, pastors, and church congregations. In addition, they created a Regional Steering Committee which reflected the key partner organizations (NC A&T, Cone Health, and Guilford County Health Department), to engage stakeholders for the purposes of addressing social determinants of health in local African American and rural communities.

Summary of completed project

Project staff leveraged and built upon existing relationships with the Congregational Nursing Program and the local faith-based community, particularly pastors, to assist communities with access to care. Initially, the program focused on COVID-19 vaccination and testing, before broadening its focus to address other health-related issues.

Congregational nurses, community health agencies, and pastors worked collaboratively to increase education of congregation members and provide access to health-related services, including COVID-19 vaccinations, testing, health screens, and connecting those at risk to health care providers.

The Regional Steering Committee was created to continue addressing social determinants of health, and factors that affect the health and well-being of the communities they serve.

Five of the seven participating churches served as COVID-19 testing and vaccination sites within their communities, all of which had indicators for inadequate access to care along with higher rates of COVID-19 deaths. While the vaccination rates in the targeted counties were lower than the national average, in all but one zip code, the vaccination rates of non-whites was higher than the rates for white people. In fact, in two zip codes, the percentage of non-whites vaccinated was twice the percentage of whites vaccinated. Project staff attribute those higher numbers to the work of the nurses and pastors.

Initially, pastors did not believe they had a role in addressing health issues amongst their congregations. However, as the project progressed, pastors began to take a more active role and saw themselves in partnerships with their congregational nurses. The partnership with NC A&T, an historically Black university, was critical in building trust with the congregations and other partners.

Partnership with Cone Health was established, paving the way for educational opportunities for congregations and the establishment of COVID-19 vaccination and testing sites. Additionally, this partnership led to additional services like a flu vaccine drive being offered at one congregation.

Furthermore, a partnership was formed with Guilford County Health Department, who agreed to provide data and resources for testing and vaccination to the congregations as needed. Other relevant partnerships formed with the North Carolina Department of Health and Human Services, local media, and the University of North Carolina at Chapel Hill.

Project RARE will continue to meet as the Regional Steering Committee to further this work and to add members to cultivate strategic partnerships.


Project RARE’s goal of creating partnerships in underserved communities to address health equity issues was successful in bringing awareness and access to COVID-19 vaccinations and testing by mobilizing congregational nurses and pastors. Furthermore, partnerships with local health departments and health agencies are expanding the work beyond COVID-19 and addressing other social determinants of health.