A three-tiered approach to address barriers to COVID-19 vaccine delivery in the Black community

Abdul‐Mutakabbir, Jacinda C.; Casey, Samuel; Jews, Veatrice; King, Andrea C.; Simmons, Kelvin; Hogue, Michael D.; Belliard, Juan Carlos; Peverini, Ricardo; Veltman, Jennifer

doi:10.1016/s2214-109x(21)00099-1

Cited by 79 publications

(117 citation statements)

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“…These data are consistent with prior data on the positive impact of door todoor outreach [35] and endorsements from trusted community members on increasing vaccination from influenza [36], childhood vaccines [37], and HPV vaccines [38]. Our findings are also consistent with a multicomponent intervention involving mobile clinics and religious leaders as vaccine ambassadors that led to high uptake among COVID-19 vaccines among Black people living in a community in Southern California [34]. Multi-pronged approaches to community-led education and outreach can increase trust in vaccine safety, effectiveness, and the healthcare system, and are fundamental to facilitating forward movement along the entire continuum of vaccine hesitancy [36][37][38][39][40][41].…”

Section: Discussionsupporting

confidence: 91%

“…Our survey results are consistent with recent national surveys that highlighted the importance of access-related barriers among Latinx persons who had not yet received the vaccine, with concerns about missing work, transport to the site, and information gaps about cost and impact on legal status [10]. Placing vaccine sites in central locations such as such as in Grand Central Station in New York, or trusted community sites such as churches has also yielded promising results [31][32][33][34]. While convenience was an important feature of the vaccine site, it alone is likely insufficient, and ensuring trust in the vaccine itself is the first step to getting people to come to the site.…”

Section: Discussionmentioning

confidence: 99%

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A multi-component, community-based strategy to facilitate COVID-19 vaccine uptake among Latinx populations: from theory to practice

Marquez

Kerkhoff

Naso

et al. 2021

Preprint

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Background COVID-19 vaccine coverage in the Latinx community depends on delivery systems that overcome barriers such as institutional distrust, misinformation, and access to care. We hypothesized that a community-centered vaccination strategy that included mobilization, vaccination, and "activation" components could successfully reach an underserved Latinx population, utilizing its social networks to boost vaccination coverage. Methods and Findings Our community-academic-public health partnership, "Unidos en Salud," utilized a theory-informed approach to design our "Motivate, Vaccinate, and Activate" COVID-19 vaccination strategy. Our strategy's design was guided by the PRECEDE Model and sought to address and overcome predisposing, enabling, and reinforcing barriers to COVID-19 vaccination faced by Latinx individuals in San Francisco. We evaluated our prototype outdoor, "neighborhood" vaccination program located in a central commercial and transport hub in the Mission District in San Francisco, using the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework during a 16-week period from February 1, 2021 to May 19, 2021. Programmatic data, city-wide COVID-19 surveillance data, and a survey conducted between May 2, 2021 and May 19, 2021 among 997 vaccinated clients at least 16 years old were used in the evaluation. There were 20,792 COVID-19 vaccinations administered at the neighborhood site during the 16-week evaluation period. Vaccine recipients had a median age of 43 (IQR 32-56) years, 53.9% were male and 70.5% were Latinx, 14.1% white, 7.7% Asian, 2.4% Black, and 5.3% other. Latinx vaccinated clients were substantially more likely than non-Latinx clients to have an annual household income of less than $50,000 a year (76.1% vs. 33.5%), be a first-generation immigrant (60.2% vs. 30.1%), not have health insurance (47.3% vs. 16.0%), and not have access to primary care provider (62.4% vs. 36.2%). The most frequently reported reasons for choosing vaccination at the site were its neighborhood location (28.6%), easy and convenient scheduling (26.9%) and recommendation by someone they trusted (18.1%); approximately 99% reported having an overall positive experience, regardless of ethnicity. Notably, 58.3% of clients reported that they were able to get vaccinated earlier because of the neighborhood vaccination site, 98.4% of clients completed both vaccine doses, and 90.7% said that they were more likely to recommend COVID-19 vaccination to family and friends after their experience; these findings did not substantially differ according to ethnicity. There were 40.3% of vaccinated clients who said they still knew at least one unvaccinated person (64.6% knew 3 or more). Among clients who received both vaccine doses (n=729), 91.0% said that after their vaccination experience, they had personally reached out to at least one unvaccinated person they knew (61.6% reached out to 3 or more) to recommend getting vaccinated; 83.0% of clients reported that one or more friends, and/or family members got vaccinated as a result of their outreach, including 18.9% who reported 6 or more persons got vaccinated as a result of their influence. Conclusions A multi-component, "Motivate, Vaccinate, and Activate" community-based strategy addressing barriers to COVID-19 vaccination for the Latinx population reached the intended population, and vaccinated individuals served as ambassadors to recruit other friends and family members to get vaccinated.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

A multi-component, community-based strategy to facilitate COVID-19 vaccine uptake among Latinx populations: from theory to practice

Marquez

Kerkhoff

Naso

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…For example, Loma Linda University, which serves as the largest vaccination site in San Bernardino, California, developed a three-tiered approach to effectively reach the Black community. This approach involves “the engagement of Black faith leaders, the delivery of education about COVID-19 vaccinations by a Black health-care professional, and the development of a multidisciplinary mobile vaccination effort, by holding the vaccination clinic in a church parking area in a mostly Black community” ( Abdul-Mutakabbir et al, 2021 ). Considering the unprecedented efforts on public communication and administrative support for the COVID-19 vaccination process, the gradual decline in vaccine hesitancy that we observed over time sends an optimistic signal.…”

Section: Discussionmentioning

confidence: 99%

Hesitancy in the time of coronavirus: Temporal, spatial, and sociodemographic variations in COVID-19 vaccine hesitancy

Ran

2021

SSM - Population Health

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Leveraging nationally representative survey data on 443,680 respondents from January to March 2021, this study examines the temporal, spatial, and sociodemographic variations in COVID-19 vaccine hesitancy in the U.S. Findings reveal multidimensional determinants of vaccination intentions involving confidence, complacency, and circumspection factors. Using descriptive analyses and multilevel mixed-effects regression models, we find persistent partisan divide across states and significant racial disparities, with Blacks more likely to develop vaccine hesitancy due to confidence and circumspection than Whites. Vaccine hesitancy among Blacks declines dramatically across time but varies little across states, indicating new directions to effectively address inequalities in vaccination. Results also show nuanced gender differences, with women more likely to develop hesitancy due to circumspection and men more likely to have hesitancy due to complacency. Moreover, we find important intersection between race, gender, and education that calls for efforts to adequately address the concerns of the most vulnerable and disadvantaged groups.

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“…Be non-defensive and acknowledge that some of the messaging has been confusing (remember when we were told that masking did not help?) You can serve as a bridge to bring your health organization to the community and increase access and harness their credibility by sharing information in non-jargon language, having their location become a vaccination site (17), be it in their church, school, gym.…”

Section: -mentioning

confidence: 99%

The Psychology of Vaccine Hesitancy: How Health Providers May Help

Fayard

2021

Neonatology Today

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Health care providers have correctly been called "heroes" during this pandemic. As vaccines have become available, they are now able to continue to save lives by encouraging their patients to get vaccinated. Are there ways to help overcome vaccine hesitancy?" "Collective responsibility refers to the willingness to protect others by one's own vaccination ("I'll let others get vaccinated to achieve herd immunity," putting one's interest ahead of those of the community)." 45 NEONATOLOGY TODAYtwww.NeonatologyToday.nettMay 2021 NEONATOLOGY TODAY is interested in publishing manuscripts from Neonatologists, Fellows, NNPs and those involved in caring for neonates on case studies, research results, hospital news, meeting announcements, and other pertinent topics.

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A three-tiered approach to address barriers to COVID-19 vaccine delivery in the Black community

Cited by 79 publications

References 1 publication

A multi-component, community-based strategy to facilitate COVID-19 vaccine uptake among Latinx populations: from theory to practice

A multi-component, community-based strategy to facilitate COVID-19 vaccine uptake among Latinx populations: from theory to practice

Hesitancy in the time of coronavirus: Temporal, spatial, and sociodemographic variations in COVID-19 vaccine hesitancy

The Psychology of Vaccine Hesitancy: How Health Providers May Help

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