| Title: | Understanding Barriers and Facilitators of COVID-19 Vaccine Confidence and Access among Black and Latinx Communities in Connecticut |
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| Status: | Completed |
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| Topic: | COVID-19 Vaccine |
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| Funding Source: | Centers for Disease Control and Prevention (CDC) |
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| Funding Period: | 2021-2022 |
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| Study Design: | Mixed-method approach using qualitative and quantitative research |
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| Purpose: | The Prevention Research Network (consisting of 26 PRCs across the U.S.) was utilized to disperse supplemental CDC funding for rapid-response efforts to inform effective solutions to improve uptake of COVID-19 vaccines. The Yale-Griffin PRC’s efforts were intended to improve vaccine uptake in New Haven and the Lower Naugatuck Valley, especially among Black/African-American and Hispanic/Latinx residents. COVID-19 vaccination rates had been disproportionately low among Black and Latinx people in CT, despite the fact that their age-adjusted COVID-19 death rates had exceeded those of their White counterparts. Our primary objective was to co-design and implement behavioral change interventions to increase confidence in, access to, and equitable uptake of COVID-19 vaccines among residents of these communities. |
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| Further Study Details: | We conducted this project in partnership with the Community Alliance for Research & Engagement (CARE). It built upon work focusing on vaccine hesitancy and communication that CARE had been conducting with Racial and Ethnic Approaches to Community Health (REACH) grant supplemental funding from the CDC.In collaboration with our community partners, our project activities included: conducting listening sessions and surveys with community residents and vaccine providers to (1) understand the beliefs, perceptions, and perceived risks/benefits that influence confidence in the vaccine, and (2) identify key barriers and facilitators to vaccine access;creating and revising a Program Implementation Pathways (PIP) diagram, with feedback from community partners, to guide us in assessing and identifying critical quality control points to address levers for change at the individual, health department, and health care systems level;developing culturally-appropriate strategies with community partners to increase confidence in the vaccine and address barriers to its delivery;using feedback loops to improve and refine vaccine promotion messages, message delivery, and other strategies to promote uptake. |
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| Findings: | In New Haven:Formative research in collaboration with governmental, clinic and community partners identified a shared need for increased collaboration and an increased need to provide the community with standard messaging.The PRC then designed, implemented, and evaluated an Outreach Worker Training program with modules on: COVID-19 prevention and vaccination education; influenza prevention and vaccination education; health communications; and conducting outreach in the field. Attendees of the training program reported increased confidence in conducting vaccine-related community outreach and showed the greatest gains in knowledge about: (1) why the COVID-19 vaccine was developed so quickly, (2) the COVID-19 mRNA technology; and (3) responding to misinformation and hesitancy.The PRC also designed, implemented, and evaluated a Vaccine Clinic and Outreach Collaboration Tool. It included details about outreach and mobile vaccine events, e.g., organization, date, location, type of outreach, description of event, flyer, and a request for partner support. The Tool was widely used, with seven partner organizations entering 442 vaccine clinics and outreach events from December 2021 through August 2022. Partners reported using data from the Tool to strategically coordinate partner outreach in ensuring equitable services among priority neighborhoods They said that use of the Tool enhanced a broader sense of trust and collaboration across the partnership.In the Lower Naugatuck Valley:Griffin Hospital administrators and community partners expressed a shared need for a communications toolkit through which partners serving children, parents/guardians, and adults in general could download and distribute messages promoting vaccines for children ages 5-11 and booster vaccines.We applied theoretical frameworks to create a COVID-19 Messaging Toolkit with flyers and social media images designed to foster behavior change regarding vaccine uptake among our populations of focus. We initially shared the toolkit with our partners via a link to Canva (an online software program that allows customization of documents). We found limited uptake of the initial Toolkit by our partners, partly due to perceived barriers related to the need to: (1) create a Canva account to access and customize the flyers and images, and (2) download and complete an online survey to track usage of the Toolkit. In addition, our partners requested a Spanish translation of the Toolkit, and a greater representation of diverse audiences in the flyers and images.We subsequently revised the Toolkit to address the feedback from our partners, which led to improved uptake of the revised Toolkit.Overall:The role of the Yale-Griffin PRC as an organization and resource for COVID-19 vaccine communications through this project led to additional partnerships that expanded beyond our original geographic range, enabling the PRC to expand its public health impact. |
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| Eligibility: | Residents of New Haven and the Lower Naugatuck Valley, especially persons who identified as Black/African-American, Hispanic/LatinxCOVID-19 vaccine “providers” (community-based providers, clinicians, community health workers, and vaccine outreach workers involved with COVID-19 vaccine promotion and delivery) in New Haven and the Lower Naugatuck Valley |
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| Evaluation: | Our formative research included the listening sessions, surveys, and PIP diagram. We applied an implementation science research framework to test the effectiveness of interventions co-developed with community partners. |
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