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Yale School of Public Health Alumni Using Targeted Digital Messaging to Address Health Care Inequities

August 02, 2021
by Colin Poitras

The COVID-19 pandemic has proven to be a perfect case study for supporting the need for targeted health communications. With people managing their health from home, health services moving temporarily online or remote, vaccine access and hesitancy issues and a flood of viral misinformation, providers and health systems have had to search for new ways to deliver timely and accurate information to the communities they serve.

InOn Health, an innovative startup company co-founded by two Yale School of Public Health alumni, Kaakpema “KP” Yelpaala, M.P.H. ’06, and his partner, Sara (Shamos) Yelpaala, M.P.H. ’07, was well-positioned to provide essential care communications and continued engagement. The health communication needs of InOn Health clients expanded seemingly overnight, and as the pandemic highlighted long-standing health disparities, InOn Health partnered with leading organizations across the country to deliver critical information.

Launched in the U.S. in mid-2018, InOn Health is a digital health communications company that specializes in delivering targeted health messaging via text, social media and other digital platforms with a focus on historically underserved populations in the United States including communities of color and people living in remote and rural areas.

“Our goal is to provide people with the information that they perceive is most important to them at that particular point in time,” said Kaakpema Yelpaala, known to many as simply “KP,” who was born in the United States and whose family is from Ghana. “When we send people information that’s most relevant to them, they are more likely to engage and take action.”

Making health care more accessible

After 10 years of improving health care access for hundreds of thousands of people in South Africa and 12 other African countries under the brand access.mobile International, the Yelpaalas brought their data-driven strategies to the U.S. under a new company and brand, InOn Health. Their focus remains the same: increase people’s engagement with health care, improve health outcomes and reduce inequities.

“In the U.S. setting, health care systems have required people to log into web portals or download mobile apps to access important health information,” said KP. “But when you think about digital inclusion and you think about multicultural or low-income populations, they may be less able to connect through these tools. So what you find is that text messaging actually ends up being a very convenient and scalable way to connect with diverse populations.”

Kaakpema is the chief executive officer of InOn Health. During his time at Yale, KP was a member of the Clinton Foundation’s Health Access Initiative (CHAI) and has more than 15 years of global health experience. He oversees the business growth and investment. Sara, meanwhile, is the company’s chief experience officer and leads client experience, marketing, and strategic initiatives. She is a health strategy and communication expert with 15 years of experience in digital health, complex client program delivery and global public health.

More Than Texts

Targeted digital health communications is much more involved than sending out simple text messaging blasts.

“At InOn Health, we look first at population analytics and try to identify the challenges and obstacles people face and why they have not engaged,” Sara said. “From there, we develop an adaptive communications platform using multi-channel outreach such as text messaging, social media and Spanish media. We are always looking to deliver information based on a population’s preferred communication channels and what is accessible.”

Context is also important. Using census data, health records, insurance claims and other population insights, InOn Health aims to create content that is tailored to a particular community’s needs, while also maintaining full HIPAA and TCPA compliance. Beyond COVID, InOn Health’s messaging platforms can deliver care compliance information for patients with chronic conditions, promote wellness checks and provide important information about such health issues as diabetes, maternal and child health, obesity and heart health.

“We have a large repository of content that has been created and reviewed by doctors and behavioral scientists,” Sara said. “We don’t just translate in terms of language, but in terms of reading literacy, digital literacy and certainly health literacy, as well as cultural context. Our goal is to make it as easy as possible for people to engage.” Emory University Health DesignED is one of InOn Health’s partners.

InOn Health’s messages are also respectful of different cultures.

“We’ve worked in 13 African countries over the history of our company and we’ve engaged with lots of different cultures,” KP said. “Even within one African country, there may be lots of different languages. The same is true in the U.S. If you look at rural populations, the way the communities live and interact are different then urban populations. The models we use allow us to bridge across different cultural contexts and engage with people in the way that resonates best with them.”

Yale Connections and Early Impact

InOn Health’s initial outreach campaigns in the U.S. have made an impact.

Our goal is to provide people with the information that they perceive is most important to them at that particular point in time.

Kaakpema Yelpaala

One of InOn Health’s first U.S. clients was Cascade Comprehensive Care, a health care management company in Klamath Falls, Oregon, serving Medicaid and Medicare members in Klamath County. InOn Health’s messaging provided the predominately rural population with important information about service changes, food resources, urgent transport out of fire danger and more. InOn Health also kept the community informed of the latest virus news as well where services were available for testing, treatment and more recently vaccination.

“As we looked to enhance our customer experience … customer activation and engagement was crucial to us. InOn Health’s digital communication platform was the right solution to activate, engage and deepen the relationship with the members that we serve,” said Tayo Akins, CEO and president of Cascade Comprehensive Care. “InOn Health platform’s value was clearly apparent during the COVID-19 pandemic, as we used the communication platform to inform and educate our members.” Cascade Comprehensive Care is also an investor in the company.

At their home base in Denver, Colorado, the Yelpaalas and InOn Health have played important roles in the state’s response to the COVID-19 crisis.

Early in the pandemic, InOn Health worked with COVIDCheck Colorado to bring widespread SalivaDirect™ COVID testing (developed at the Yale School of Public Health) to Colorado communities and school districts statewide. InOn Health also worked with COVIDCheck Colorado and the Colorado School of Public Health to survey 8,000 state residents about vaccine hesitancy and barriers to care. The survey found the main barriers were access issues, with people unsure of how to make an appointment, where to go or what the possible side effects might be.

"We are focused on statewide, equitable COVID-19 response and InOn Health has been one of our lead partners in achieving that,” said Eric Parrie, COVIDCheck Colorado’s CEO and a Yale Law School alum, J.D. ’13. “Their strategic approach and multi-channel communications catalyzed testing and vaccination for tens of thousands of people across Colorado.”

In the It’s-A-Small-Yale-World category, COVIDCheck Colorado is an initiative of Gary Community Ventures, a certified B Corporation. whose president and CEO also happens to be a Yale alum: Mike Johnston, J.D. Law ’03, BA (English and Philosophy) ’97. Gary Community Ventures leverages business, policy and philanthropy to deliver breakthrough solutions to the problems facing Colorado’s children and families.

Outside of work, KP Yelpaala continues to be active in the Yale School of Public Health community, where he is a seven-year member of the school’s Leadership Council. He was also recently appointed by Colorado Governor Jared Polis to serve on the state’s eHealth Commission, which provides guidance on advancing health information technology in Colorado. KP is the lead within the commission for digital health equity and inclusion.

Both KP and Sara credit their time at the YSPH with preparing them for their current roles. They met when they were students in the school’s global health track.

“The behavioral science and health communications classes I took have come in handy in terms of framing messages and understanding how to create strategies to reach different people,” Sara said.

KP said the global health program gave him perspective.

“Going to a school of public health and learning the fundamentals of public health clearly play a role in the work that we do,” he said. “In global health, you’re always thinking about how the programs you design can improve outcomes for individuals in a challenging environment.”

With all signs showing that the COVID-19 pandemic isn’t ending any time soon, the Yelpaalas’ experience working in challenging environments couldn’t be more in demand.

For more information about InOn Health, including access to the company’s new health equity podcasts, visit the company website inonhealth.com. Yale School of Public Health alumna Sara Dash, M.P.H. ’01, president and CEO of the Alliance for Health Policy, is featured.