Leveraging Black pharmacists to promote equity in COVID‐19 vaccine uptake within Black communities: A framework for researchers and clinicians

White coats, Black lives-racial trauma in Black pharmacists

BACKGROUND

Race-based traumatic stress, or racial trauma, can negatively impact the health and wellbeing of Black health professionals. However, the effects of racial trauma among Black pharmacists have not been thoroughly explored.

OBJECTIVE

The purpose of this study is to explore Black pharmacist experiences of race-based traumatic stress and its effects in the workplace.

METHODS

This qualitative study utilized focus groups among a convenience sample of Black pharmacist attendees of a national convention for an organization dedicated to serving underserved communities and minoritized pharmacy professionals. The data were analyzed with inductive coding and thematic analysis as proposed by Braun and Clark.

RESULTS

Three focus groups were conducted with a total of 22 participants. The majority of participants were female (77%), and the average age of the participants was 48.3 years old. Three themes related to racial trauma were identified. The participants described racial trauma as an ever-present phenomenon, tension with coworkers and institutions, and internal and external structures of support. The Black pharmacists in this study provided context and recommendations for employers to support their wellbeing.

CONCLUSIONS

An awareness of the hidden wounds that Black pharmacists carry with them to work every day is an important factor in creating diverse and inclusive workplaces. The results of this study give Black pharmacists a voice and a chance to share with colleagues their distinct realities. Employers and institutions should assess individual needs and implement strategies to support Black pharmacists in creating more inclusive work and professional environments.

Vaccination equity and the role of community pharmacy in the United States: A qualitative study

OBJECTIVES

To identify strategies community pharmacists utilized to support equitable vaccination in their communities.

STUDY DESIGN

Qualitative, descriptive design.

METHODS

Key informant interviews were conducted virtually via teleconference using a mix of purposeful and snowball sampling of Pennsylvania community pharmacy personnel who participated in COVID-19 vaccination efforts. Interviews were conducted from March until August 2022 when thematic saturation was reached. A qualitative, inductive thematic data analysis was utilized to identify major themes and strategies that emerged from the data.

RESULTS

Pharmacists utilized three philosophies: (1) prioritizing trust, (2) meeting people where they are at, and (3) building capacity within their teams and communities to create "safe spaces" for people to receive vaccinations. Nine discrete strategies used in practice exemplify how respondents implemented these philosophies: (1) Build Community Partnerships; (2) Establish Trust to Build Credibility; (3) Address Transportation Issues; (4) Provide Patient Education and Address Health Literacy Barriers; (5) Address Language Barriers; (6) Create a Safe and Accessible Space for Those with Individualized Needs; (7) Provide Patient-Centered and Culturally-Sensitive Care; (8) Train Staff on Health Equity and Patient Engagement; and (9) Advocate for Community Pharmacy Policy and Payment Reform. Definitions for these philosophies and key examples that illustrate how each strategy was employed in practice are provided.

CONCLUSION

The findings highlight unique strategies respondent community-based pharmacy teams use to contribute to equitable vaccination efforts in communities and further emphasizes the importance of their role in public health initiatives.

COVID-19 Vaccination Messengers, Communication Channels, and Messages Trusted Among Black Communities in the USA: a Review

Black and African American adults exhibited higher levels of mistrust and vaccine hesitancy and lower levels of vaccination throughout the COVID-19 pandemic. Vaccination and booster uptake remains disproportionately low among Black adults. We conducted a systematic review of empirical research published between February 2021 and July 2022 from five electronic databases and the grey literature. We screened studies that assessed COVID-19 vaccination information needs and preferences as well as communication strategies among Black adults in the USA. We extracted data, then analyzed and synthesized results narratively. Twenty-two articles were included: 2 interventions, 3 experimental surveys, 7 observational surveys, 8 qualitative inquiries, and 2 mixed methods studies. Studies reported credible and preferred COVID-19 vaccination information sources/messengers, channels, and content. Commonly trusted messengers included personal health care providers, social network connections, and church/faith leaders. Electronic outreach (e.g., email, text messages), community events (e.g., forums, canvassing), and social media were popular. Black communities wanted hopeful, fact-based messages that address racism and mistrust; persuasive messages using collective appeals about protecting others may be more influential in changing behavior. Future communication strategies aiming to increase vaccine confidence and encourage COVID-19 booster vaccination among Black communities should be developed in partnership with community leaders and local health care providers to disseminate trauma-informed messages with transparent facts and collective action appeals across multiple in-person and electronic channels.

Examining Black and Hispanic physicians and other healthcare providers' attitudes toward the COVID-19 vaccine

OBJECTIVES

Recognizing that the voice delivering the message is as important as the information being shared, we examined vaccine perceptions and willingness to encourage patients to obtain COVID-19 vaccinations among Black and Hispanic healthcare providers.

METHODS

We conducted a cross-sectional, online survey of Black and Hispanic healthcare providers who were members of the National Medical Association (NMA), National Hispanic Medical Association (NHMA), and National Pharmaceutical Association (NPhA) between January 11 - March 3, 2021, shortly after emergency use authorization (EUA) for the Pfizer and Moderna COVID-19 vaccines. Three multivariable logistic regression models were used to determine factors associated with the willingness to encourage COVID-19 vaccination.

RESULTS

The analytic sample consisted of 542 fully completed surveys. Pharmacists reported intent to take the vaccine (75.0% "as soon as you can" vs 91.4% for MD/DOs; p<0.001) and encouraged patients to get vaccinated (78.6% vs 91.0% for MD/DOs; p = 0.01). Providers in a suburban practice location were less likely to recommend vaccines to patients (OR=0.43, 95%CI: 0.22-0.87) and personal family (OR=0.45, 95%CI: 0.22-0.92) compared to those practicing in urban areas. Providers over age 45 were also more likely to report intent to take the vaccine themselves as soon as it was available (OR=3.72, 95%CI: 1.30-10.64).

CONCLUSIONS

This is likely the first cross-sectional study in the United States demonstrating the substantial vaccine confidence among Black and Hispanic healthcare providers who serve minoritized communities that have borne the greatest risk of adverse COVID-related outcomes.