The role of community leaders and other information intermediaries during the COVID-19 pandemic: insights from the multicultural sector in Australia

The paper addresses how community, religious, and other natural leaders from culturally and linguistically diverse (CaLD) backgrounds in Australia function as information intermediaries during the COVID-19 pandemic. CaLD communities face heightened risks from COVID-19 due to factors such as public-facing employment, multigenerational housing, and cultural caregiving norms. Communication barriers and limited inclusion in public health planning exacerbate inequities. While governments proposed engaging community leaders as gateways for vaccine communication, gaps remained in understanding these intermediaries’ capacity, roles, reach, and influence. The study aims to explore the perceptions of stakeholders serving CaLD communities regarding the role and impact of such intermediaries in COVID-19 public health communication and engagement.

Prior research shows CaLD communities often rely on interpersonal and social networks for health information, preferring sources perceived as similar and trustworthy. Traditional strategies like translated materials may not suffice due to varying health literacy and distribution challenges. The gatekeeper model, historically used in social and mental health settings, positions non-professional community members (e.g., leaders, workers, natural leaders) to identify needs and connect people to services, with effectiveness shaped by their education, language skills, and community involvement. Studies indicate information intermediaries may adapt or filter messages, affecting accuracy and timeliness; trust and reliability are therefore crucial. WHO’s infodemic framework acknowledges the role of credible intermediaries but provides limited guidance on supporting them. Evidence also suggests youth can act as effective cultural brokers due to digital and linguistic capital, yet are often underutilized. The review underscores the need for training and structured support akin to gatekeeper programs in suicide prevention to strengthen intermediaries’ capabilities in pandemics.

Design: Qualitative study using semi-structured, in-depth telephone interviews (~30–40 minutes each) conducted between January and April 2021. Ethics approval: University of New South Wales Human Research Ethics Advisory Panel (HC200776); informed verbal consent obtained. Sampling and participants: Key informants actively delivering services to CaLD communities via migrant resource centres, refugee health services, settlement services, community-based organisations, translation services, and primary care. Stakeholders included those in advocacy, policy/program development, or research (e.g., government agencies, CaLD peak bodies/councils, CEOs of community groups). Recruitment used a mix of online searches and email invitations, snowball referrals from interested candidates, and outreach via research team contacts. Efforts were made to recruit across Australian states and territories; no participants were recruited from the Northern Territory. No identifiable personal information was collected. Data collection: An interview guide (developed and reviewed by HS, BHR, AH, IK, AM) covered perceptions of government communication approaches, factors affecting communication and engagement with CaLD communities, roles and influences of different agencies, and suggested improvements for COVID-19 vaccine programme communication. Open-ended questions allowed exploration; member checking occurred during interviews to validate emerging ideas. Analysis: Thematic analysis using constant comparison. Coding and theme development were conducted by HS and AC using NVivo, with themes compared within and across interviews and structured around interview topics while allowing inductive themes to emerge. Discrepancies were resolved through team discussion to ensure rigour. Sample size: 46 interviews with key stakeholders and informants across Australia. Characteristics of participants/interviews described in Supplementary Appendix 1 (COREQ format).

- Forty-six stakeholders described community leaders and other actors (faith leaders, bilingual workers, youth leaders, bilingual health professionals, translators/interpreters, local council members, and natural leaders with health backgrounds) as critical information intermediaries that can bridge gaps and enable COVID-19 information to reach CaLD communities. - Intermediaries’ roles extend beyond message transmission to establishing support structures (e.g., homework groups, Zoom forums on mental health, family violence, finances), and facilitating testing uptake via word-of-mouth. - Concerns emerged about intermediaries’ variable capacity, representativeness, and potential for misinterpretation, mistranslation, selective filtering, or blocking of messages due to personal beliefs or power dynamics. To mitigate, participants recommended using multiple channels and multiple intermediaries, especially in multilingual/dialect-diverse groups. - Participants perceived delayed recognition by government agencies of intermediaries’ importance, with minimal early consultation and tokenistic or extractive engagement. Some improvement occurred from late 2020–2021, including funding bicultural workers for contact tracing and information dissemination, yet involvement was often limited to scripted messaging rather than co-development. - Training, briefing quality, and support were inconsistent or lacking, particularly for regional/remote areas. Ad hoc briefings and absence of guidance left leaders unprepared. Locally organised leaders’ forums (e.g., regular Zoom briefings with experts) helped harmonise messaging and surface community concerns. - Burnout and emotional burden were prominent. Many leaders volunteered significant unpaid time, facing pressure to translate, interpret, synthesise, disseminate, and answer questions. Participants advocated for remuneration, public recognition, and capacity building to sustain engagement. - Participants recommended ongoing structured engagement (e.g., standing committees), broader identification of intermediaries (including youth and medically trained but unregistered community members), and investment in training to enhance critical appraisal of information, counter misinformation, and improve referral and networking skills.

Findings confirm that community leaders and other information intermediaries are central conduits for COVID-19 communication in CaLD communities but that their impact is contingent on trust, competencies, and structural support. Delays in government recognition and reliance on one-way, scripted communication limited reach and resonance of public health messages. Risks of misinterpretation and selective filtering underscore the need for training in accurate message interpretation, critical appraisal, and referral pathways. Adapting established gatekeeper training frameworks (preparing, connecting, understanding, assisting, networking) could build intermediaries’ efficacy in pandemic contexts, including skills to counter misinformation and use tools like plain-language glossaries. Broadening the intermediary base to include youth (with strong digital and linguistic capital) and medically trained but unregistered community members can reduce burnout and expand reach. Formal ambassador programmes that include training and remuneration exemplify supportive models. Overall, proactive, ongoing, and co-designed engagement with intermediaries—rather than episodic, extractive interactions—can strengthen equitable crisis communication and vaccine confidence in CaLD communities.

Community leaders and other information intermediaries play a vital role in pandemic communication for CaLD communities. To enhance and sustain their contributions, pandemic plans should include structured, ongoing engagement; training tailored to interpretation, critical appraisal, misinformation management, and referral; resourcing and, where feasible, financial remuneration; and public recognition. Diversifying intermediaries to include youth and medically trained community members can expand reach and mitigate burnout. Future research should assess the reach, influence, and cost-effectiveness of intermediary-based strategies versus traditional channels, and determine best practices for support, training, and co-design to improve community understanding, motivation, and adherence to public health recommendations.

- The study focused on a select group of stakeholders and informants; other perspectives may reveal additional themes. - Snowball sampling may have limited the diversity of opinions. - Participant role details were not collected, constraining subgroup analyses. - Recruitment did not include the Northern Territory, potentially limiting geographic representativeness. - CaLD communities are heterogeneous; not all migrant groups in Australia were represented.