Using human-centred design to tackle COVID-19 vaccine hesitancy for children and youth: a protocol for a mixed-methods study in Montreal, Canada

Abstract

IntroductionTo successfully combat COVID-19 vaccine hesitancy and increase uptake, research has demonstrated that interventions are most effective when tailored to meet local needs through active engagement and co-development with communities. This mixed-methods project uses a human-centred design (HCD) approach to understand local perspectives of COVID-19 vaccine hesitancy and develop strategies to enhance vaccine confidence for children and adolescents.Methods and analysisProject ECHO (Étude Communautaire sur l’Hésitation vaccinale contre la COVID-19) combines population-based surveys of parents and adolescents with community-based participatory action research to design and pilot strategies to enhance COVID-19 vaccine confidence in two underserved and ethnoculturally diverse neighbourhoods of Montreal, Canada. Two surveys conducted 6 months apart through primary and secondary schools are used to monitor vaccine acceptance and its social determinants among children and youth. Analyses of survey data include descriptive and inferential statistical approaches. Community-led design teams of parents and youth from the two participating neighbourhoods, supported by academic researchers, design thinking experts and community partners, use an HCD approach to: (1) gather data to understand COVID-19 vaccine decision-making among parents and youth in their community and frame a design challenge (inspiration phase); (2) develop an intervention to address the design challenge (ideation phase) and (3) pilot the intervention (implementation phase). Strategies to evaluate the community-led interventions will be co-developed during the implementation phase.Ethics and disseminationThis study has been approved by the research ethics boards of the Sainte-Justine University Hospital Centre and the University of Montreal. Community design teams will be involved in the dissemination of findings and the design of knowledge translation initiatives that foster dialogue related to COVID-19 vaccination for children and adolescents among community, school and public health stakeholders. Findings will be disseminated through peer-reviewed publications, conference presentations, community forums, policy briefs, and social media content.

Community-Based Approaches to Increase COVID-19 Vaccine Uptake and Demand: Lessons Learned from Four UNICEF-Supported Interventions

“…UNICEF employs the HCD approach to activate previously overlooked connections and leverage points, including nudging and normalizing immunization behaviour [ 11 ]. In recent years, the approach has been increasingly applied to co-design solutions that go beyond immunization to address other public health issues like maternal and child health interventions by centering the person and community experiencing the barrier or problem [ 21 , 22 , 23 ]. UNICEF has supported countries to institutionalize the use of HCD including integrating it into training curriculums of national health institutes, paving way for some Governments to establish behavioral science centers anchored on the HCD approach.…”

Perspectives on COVID-19 Vaccination and Vaccine Passports in a Diverse Urban Adolescent Population: A Youth Participatory Mixed Methods Study

“…Data presented were collected as part of the ECHO study (Étude Communautaire sur l’Hésitation vaccinale contre la COVID-19) ( www.projet-echo-mtl.ca ). Led by parent and youth community research teams, the ECHO study used a human-centered design (HCD) approach to “understand local perspectives of COVID-19 vaccine hesitancy for children and adolescents in two underserved and ethnoculturally diverse neighbourhoods, and to co-develop tailored strategies with parents, youth, and their communities to enhance vaccine confidence [ 13 ].” Further details of the ECHO study are presented in the published protocol[ 13 ] and a summary of the context and methods for this convergent parallel mixed-methods analysis is provided here.…”

“…This study used data collected from January to March 2022 as part of an ongoing community-based participatory research project in two ethnoculturally diverse, lower-income neighbourhoods of Montreal, Canada [ 13 ]. Compared to existing literature on COVID-19 vaccine hesitancy among youth [ 12 ], the study context is unique in that: 1) individuals aged 14 and older have legal authorization to make autonomous medical decisions [ 14 ]; 2) a relatively strict vaccine passport policy was in place that limited unvaccinated adolescents’ access to certain non-essential services (e.g., restaurants, cinemas) and extracurricular activities (e.g., sports teams)[ 15 ]; and 3) data were collected during the initial Omicron wave, approximately 9 months after COVID-19 vaccination became widely available for youth aged 12 to 17 in Quebec.…”

Study Protocol for a type 2 hybrid effectiveness-implementation evaluation of a multisite community-based participatory project to achieve full childhood immunization coverage in Mozambique and Malawi (Let’s talk about vaccines project)

“…Emerging evidence suggests that community-based participatory research (CBPR) and human-centered design (HCD) can be effective approaches to creating tailored public health programs to improve health outcomes and trust in services (11)(12)(13)(14). CBPR is an inclusive and collaborative approach to research that involves researchers and community stakeholders in the research process with shared power between researchers and participants and recognition of experiential understanding and a focus on improvement in circumstances and implementation.…”