The Impact of Community Engagement in the Design and Implementation of the Flint Registry

Background: The Flint water crisis (FWC) was a public health tragedy caused by crumbling infrastructure, subverted democracy, and indifference toward a predominantly poor and Black community that resulted in lead -in -water exposure, Legionnaires' disease, and emotional and health related trauma. Through the cooperation of community partners, the Flint Registry (FR) was conceived to track long-term health and improve public health via service connections. Objectives: This study sought to share the FR's community partnered, multi -tiered engagement strategy and determine the efficacy of this strategy to engage the community and reach Flint residents. Methods: Community engagement and impact were measured by collecting and describing feedback from the community engagement strategies and by comparing the demographics of the enrollees recruited through community engaged recruitment (CER) and non-CER methods. Enrollees indicated how they heard about the FR; CER involved direct interaction with a community member. Results: Community engagement strategies incorporated approximately 1,200 people and 7 funded organizations, impacting 22 key areas of FR design and implementation. More than 50% of enrollees heard about the FR through CER methods. They were, on average, more likely to be younger, female, Black/African American, and living outside of Flint during the FWC. Conclusions: Community engagement elevated voices of those impacted by the FWC. CER methods were as effective as non-CER methods. Although there were no differences in screened measures of social vulnerability, there were in age, gender, and race. CER methods may increase participation and build trust in populations which historically are hesitant to participate in public health efforts.