Breaking Down Silos and Building Partnerships at the Grassroots Level: Lessons from the COVID-19 Response Infrastructure in South Central Texas

As a global public health emergency, the impact that COVID-19 pandemic has had on the world is significant. Lessons from past epidemics have shown the importance of community engagement and multi-sectoral collaborations in developing effective response strategies. Yet little critical and qualitative research exists that examines how diverse local stakeholders, amid a pandemic marked by widespread desperation, improvised collaborations to meet urgent community needs. Drawing on culture-centered approach to health communication, this study examined how community-based organizations, healthcare professionals, and city officials and council members in San Antonio, Texas, navigated shifting pandemic contexts, tight timelines, budget constraints, and state policies to meet the needs of the most severely impacted communities. A grounded theory approach and inductive thematic analysis of 15 stakeholder interviews revealed the systemic structural barriers that hindered their ability to address community needs, the ways in which they drew on preexisting relationships and formed strategic partnerships to navigate these challenges, and the centrality of trust, mutual respect, and equitable collaboration in fostering enduring partnerships needed for effective crisis response. This study calls for public health planning and crisis preparedness to formally include community members as experts and decision-makers, thereby embedding equity into the design of partnership structures, and to invest in collaborative partnerships well before crises emerge. Centering local knowledge and community leadership and engagement can enhance equity, efficacy, and contextual responsiveness of future public health and communication strategies, both during crises and in periods of stability.