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Social service organizations (SSO) play essential roles in serving ethnic minority communities and particularly for older immigrants who depend on community-based SSOs to satisfy their complex social, health, and behavioral health needs. The impact of the COVID-19 pandemic has been multifaceted. Literature in the past two years has documented services developed to support COVID-19 patients and care providers; however, research attention paid to older immigrants and how community-based SSOs have transformed their services to accommodate older immigrants’ needs is very few. Using contingency theory and resource dependency theory, this study explores the organizational responses during the pandemic and the extent that SSOs would have progressed beyond the pandemic-related responses.
Method
This study followed the case study tradition; community-based SSOs included here were providing services to older Chinese immigrants in New York City. Purposive sampling was used to identify organizations in Manhattan, Flushing, and Brooklyn Chinatown areas; four SSOs were recruited, including two senior centers, one adult day care center, and one community mental health clinic. In addition to reviewing organizations’ documents, site visiting, and observation, one or two staff members in each organization were interviewed in 2020 during the initial phase of the pandemic, and followed up in 2021 as the pandemic was winding down. All types of data were integrated, synthesized, and analyzed. Thematic analysis was performed using NVivo 12. Key constructs in contingency theory and resource dependence theory informed the construction of the codebook and coding structure.
Findings
Multiple evidences suggested a high level of unmet psychosocial needs among older Chinese immigrants during the COVID-19 pandemic. The psychosocial needs of older Chinese immigrants and the citywide pandemic measures forced SSOs to modify protocols, shifting from on-site health and mental health services to online or hybrid format. In addition, SSOs had to establish (or strengthen) collaborative relationships with medical providers and other community-based organizations. Services and programs were increasingly coordinated across various agencies and providers, including delivering services in the same setting. The care integration for older Chinese existed prior to and during the pandemic and continued to propel service program transformation. There were growing efforts within SSOs to address the social determinants of health and provide a community care continuum; services such as screening, community education, and referral were funded. The intensity and sustainability of such transformations varied across SSOs in this study and largely depended on financial and human resources, payment model, and existing collaboration prior to the pandemic.
Conclusions
Derived from the contingency theory, COVID-19 responses include SSOs’ transformations in both organizational structures (e.g., collaboration) and operational activities (e.g. telehealth) were to help SSOs effectively and efficiently achieve their goals. However, successful transformations of certain SSOs were primarily due to the fact that these SSOs had been adaptive to the larger system reform of integrated care and assured needed resources before the pandemic; these SSOs’ transformation reflects orderly organizational progress rather than a temporary management strategy. For other SSOs, to what extent their transformations are sustainable renders further study.