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Newman PA, Dinh DA, Massaquoi N, Williams CC, Lacombe-Duncan A, Tepjan S, Nyoni T. "Going vaccine hunting": Multilevel influences on COVID-19 vaccination among racialized sexual and gender minority adults-a qualitative study. Hum Vaccin Immunother 2024; 20:2301189. [PMID: 38346919 PMCID: PMC10863362 DOI: 10.1080/21645515.2023.2301189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Abstract
High levels of COVID-19 vaccine hesitancy have been reported among Black and Latinx populations, with lower vaccination coverage among racialized versus White sexual and gender minorities. We examined multilevel contexts that influence COVID-19 vaccine uptake, barriers to vaccination, and vaccine hesitancy among predominantly racialized sexual and gender minority individuals. Semi-structured online interviews explored perspectives and experiences around COVID-19 vaccination. Interviews were recorded, transcribed, uploaded into ATLAS.ti, and reviewed using thematic analysis. Among 40 participants (mean age, 29.0 years [SD, 9.6]), all identified as sexual and/or gender minority, 82.5% of whom were racialized. COVID-19 vaccination experiences were dominated by structural barriers: systemic racism, transphobia and homophobia in healthcare and government/public health institutions; limited availability of vaccination/appointments in vulnerable neighborhoods; absence of culturally-tailored and multi-language information; lack of digital/internet access; and prohibitive indirect costs of vaccination. Vaccine hesitancy reflected in uncertainties about a novel vaccine amid conflicting information and institutional mistrust was integrally linked to structural factors. Findings suggest that the uncritical application of "vaccine hesitancy" to unilaterally explain undervaccination among marginalized populations risks conflating structural and institutional barriers with individual-level psychological factors, in effect placing the onus on those most disenfranchised to overcome societal and institutional processes of marginalization. Rather, disaggregating structural determinants of vaccination availability, access, and institutional stigma and mistrust from individual attitudes and decision-making that reflect vaccine hesitancy, may support 1) evidence-informed interventions to mitigate structural barriers in access to vaccination, and 2) culturally-informed approaches to address decisional ambivalence in the context of structural homophobia, transphobia, and racism.
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Affiliation(s)
- Peter A. Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Duy Anh Dinh
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Faculty of Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Notisha Massaquoi
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Department of Health and Society, University of Toronto, Scarborough, Ontario, Canada
| | - Charmaine C. Williams
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Thabani Nyoni
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- School of Social Work, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
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Johansen I, Selim M, J Hoffman S, Dawson-Hahn E, Yu K. Pivoting From Influenza to COVID-19 Vaccinations: How a Minnesota Vaccination Program Reduced Barriers for Refugee, Immigrant, and Migrant Communities Accessing Vaccines During the COVID-19 Pandemic. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024; 30:701-709. [PMID: 39041765 DOI: 10.1097/phh.0000000000001931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
The Minnesota Immunization Networking Initiative (MINI) led by Fairview Health Services has addressed barriers to accessing immunizations through partnerships with community organizations to provide free influenza vaccinations to historically underserved communities, especially refugee, immigrant, and migrant communities. Once the COVID-19 vaccine was available, MINI quickly pivoted operations to distribute the vaccine and provide technical assistance to community partners amidst rapidly evolving guidance. With infrastructure and a vaccination team in place, MINI responded to new and emerging needs, eg, implementing a more accessible and low-tech scheduling system, increasing staffing to meet growing needs, and expanding partnerships with community organizations and leaders. From February 2021 to September 2023, MINI organized 1120 community-based vaccine clinics and administered 43,123 COVID-19 vaccinations. Of those vaccine recipients, 88% identified as Black, Indigenous, and other people of color, and for preferred language, over half stated that they preferred a language other than English. These demographics are similar to those of the earlier influenza clinics, even as average annual clinics have tripled and average total vaccinations have quadrupled since the pivot to COVID-19 vaccination clinics. Some keys to success were: (1) consistent, bidirectional communication and shared decision-making with community partners; (2) prioritizing sustainable staffing models with the support of administrative leadership and resources; and (3) having a community-informed approach supported by the practice of hiring staff from communities served. Because of the effectiveness of this model, MINI is primed to respond to planned and unplanned emergent public health crises.
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Affiliation(s)
- Ingrid Johansen
- Community Clinical Care (Ms Johansen and Mr Selim), Fairview Health Services, Minneapolis, Minnesota; Population Health and Systems,University of Minnesota School of Nursing (Dr Hoffman); Division of General Pediatrics, University of Washington (Dr Dawson-Hahn), Seattle, Washington; and Center for Global Health and Social Responsibility Project, National Resource Center for Refugee, Immigrants, and Migrants (Ms Yu), University of Minnesota, Minneapolis, Minnesota
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Fruleux A, Gaudart J, Franke F, Nauleau S, Dutrey Kaiser A, Legendre E, Balma D, Lescaudron M, Tamalet L, Malfait P, Chaud P, Rebaudet S. Reviving health mediation during the COVID-19 crisis and beyond: an implementation study in deprived neighbourhoods of Marseille, France. Front Public Health 2024; 12:1313575. [PMID: 39022414 PMCID: PMC11251881 DOI: 10.3389/fpubh.2024.1313575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 05/31/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction In 2020, during France's COVID-19 response, healthcare professionals from a hospital and an association initiated health mediation interventions in Marseille's vulnerable neighbourhoods, funded by the regional health authorities. This mixed method research evaluates the CORHESAN program that lasted until June 2022. Methods We examined CORHESAN documents and reports, conducted interviews, and analysed activity data, comparing it to the COVID-19 hotspots identified on a weekly basis at the neighbourhood level, using generalised linear mixed models (GLMMs). Results CORHESAN was implemented by a team of up to nine health mediators, six private nurses hired on an ad hoc basis, supervised by a general coordinator and two part-time medical and nursing coordinators. Multiple partnerships were established with shelters, associations, social-housing landlords and local institutions. The team accompanied 6,253 people affected by COVID-19 or contact in the practical implementation of their isolation and contact tracing. Of the 5,180 nasopharyngeal samples for RT-PCR and 1,875 for antigenic testing: 12% were taken at home and 27% in partner facilities in the targeted neighbourhoods; 32% were taken from symptomatic patients and 30% in the context of contact tracing; and 40% were positive. Multiple awareness sessions on prevention methods and distributions of personal protection kits and self-diagnostic tests were conducted in the streets, in shelters, in associations or at home. A total of 5,929 doses of COVID-19 vaccine were administered in a walk-in vaccination centre, at temporary street vaccination posts, during operations at partner facilities, or during home-visits to patients with limited autonomy. GLMMs showed that the intervention significantly targeted its testing interventions in neighbourhoods with socioeconomic disadvantage and/or past under-testing (adjusted odds ratio (aOR), 2.75 [1.50-5.00]) and those with high hotspot level (aOR for level-3 versus level-0, 1.83 [1.24-2.71]). Discussion The pandemic emphasised the potential of health mediation interventions to address health disparities. Building on this, a new program began in July 2022, aiming at enhancing cancer screening and vaccinations in deprived areas of Marseille. Evaluations are ongoing to assess its activities and impact, and provide evidence to future implementation initiatives.
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Affiliation(s)
- Alix Fruleux
- Ville de Marseille, Direction de la Santé publique et de l'Inclusion, Marseille, France
| | - Jean Gaudart
- Aix-Marseille Université, Inserm, IRD, UMR1252 SESSTIM, ISSPAM, Marseille, France
- Santé publique France, Saint-Maurice, France
| | | | - Steve Nauleau
- Agence régionale de santé Provence-Alpes-Côte d'Azur (ARS Paca), Marseille, France
| | | | | | | | | | | | | | | | - Stanislas Rebaudet
- Aix-Marseille Université, Inserm, IRD, UMR1252 SESSTIM, ISSPAM, Marseille, France
- Hôpital Européen, Marseille, France
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Nawaz S, Moon KJ, Anagbonu F, Trinh A, Escobedo L, Montiel GI. Evaluation of the COVID-19 Vaccination Campaign ¡Ándale! ¿Qué Esperas? in Latinx Communities in California, June 2021-May 2022. Public Health Rep 2024; 139:44S-52S. [PMID: 37957827 DOI: 10.1177/00333549231204043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023] Open
Abstract
OBJECTIVES The 12-month vaccination campaign ¡Ándale! ¿Qué Esperas? was launched to increase COVID-19 vaccination rates in Latinx populations in California by expanding community outreach. The objectives of this evaluation were to (1) determine predictors of vaccination rates and (2) identify barriers to vaccination and potential solutions. METHODS Five community partners in California serving Latinx populations with high social vulnerability participated in the ¡Ándale! ¿Qué Esperas? campaign. Community health workers were hired to deliver outreach (virtual, one-on-one, group based, and information dissemination), vaccinations, and supportive services. We collected data on outreach strategy used (method and location), number of vaccinations provided and reasons for delay, and number of times that supportive services were provided. We used regression models to assess significant predictors of vaccinations and supportive services. RESULTS Community health workers (N = 146) hired from June 1, 2021, through May 31, 2022, performed outreach engagements (n = 6297) and supportive services (n = 313 796), resulting in 130 413 vaccinations and 28 660 vaccine appointments. The number of vaccinations administered was significantly higher at events in which supportive services were provided versus not provided (coefficient = 34.02; 95% CI, 3.34-64.68; P = .03). The odds ratio of supportive services was 3.67 (95% CI, 1.76-7.55) during virtual outreach and 2.95 (95% CI, 2.37-3.69) during one-on-one outreach (P < .001 for both) as compared with information dissemination encounters. Vaccination concerns were reported among 55.0% of vaccinated survey respondents (67.7%, vaccine confidence; 51.7%, access). CONCLUSIONS Supportive services facilitate vaccinations, ease transportation and time barriers, and instill confidence among working-class racial and ethnic minority populations.
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Affiliation(s)
- Saira Nawaz
- Center for Health Outcomes and Policy Evaluation Studies, College of Public Health, The Ohio State University, Columbus, OH, USA
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Kyle J Moon
- Center for Health Outcomes and Policy Evaluation Studies, College of Public Health, The Ohio State University, Columbus, OH, USA
- Geisel School of Medicine at Dartmouth College, Hanover, NH, USA
| | - Francis Anagbonu
- Center for Health Outcomes and Policy Evaluation Studies, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Anne Trinh
- Center for Health Outcomes and Policy Evaluation Studies, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Lizette Escobedo
- AltaMed Institute for Health Equity, AltaMed Health Services, Los Angeles, CA, USA
| | - Gloria Itzel Montiel
- AltaMed Institute for Health Equity, AltaMed Health Services, Los Angeles, CA, USA
- Claremont Graduate University, Claremont, CA, USA
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Gréaux M, Chadd K, Gheewala F, Pang V, Katsos N, Gibson JL. Amplifying the voices of underrepresented speech-language pathologists: A scoping review using the transformative research paradigm. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-20. [PMID: 38826148 DOI: 10.1080/17549507.2024.2347251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
PURPOSE To investigate the characteristics of studies that included underrepresented speech-language pathologists (SLPs) as research participants. METHOD A scoping review was conducted using the principles of the transformative research paradigm, which promotes the meaningful involvement and empowerment of marginalised groups. Co-production with minority SLPs was facilitated. The search strategy was run in six databases, and the transformative checklist used for analysis. RESULT Twenty studies were included. Bilingual and male SLPs were among the most commonly included underrepresented SLPs. Most studies were conducted in the USA (n = 16), and used survey methods. The studies provided valuable insights into the experiences and practices of underrepresented SLPs, and yielded practical solutions to foster inclusion and diversity in the profession. Most studies demonstrated a transformative potential, but the active engagement of underrepresented SLP participants in the research cycle was rarely demonstrated. CONCLUSION This review calls for a shift in how and why research is conducted when including underrepresented SLP participants. Through the lens of the transformative research paradigm, we can rethink the broader aim of research and the role of researchers and participants. Using research as a platform to give visibility, voice, and agency to minority groups can stimulate change and equity in the profession.
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Affiliation(s)
- Mélanie Gréaux
- Faculty of Education, University of Cambridge, Cambridge, UK
| | - Katie Chadd
- School of Health and Social Care, University of Essex, Colchester, UK
| | - Fatima Gheewala
- Oldham Care Organisation, Northern Care Alliance, Salford, UK
| | - Voon Pang
- Private Practice, Skill Builders Speech Language Therapy, Auckland, New Zealand, and
| | - Napoleon Katsos
- Department of Theoretical and Applied Linguistics, University of Cambridge, Cambridge, UK
| | - Jenny L Gibson
- Faculty of Education, University of Cambridge, Cambridge, UK
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Urich TJ, Lee W, Po J, Bookstein A, Barahona R, Baezconde-Garbanati L. From art to health action: lessons from a community-based, culturally tailored arts-meets-health educational campaign in Hispanic communities. Front Public Health 2024; 12:1385916. [PMID: 38680937 PMCID: PMC11045963 DOI: 10.3389/fpubh.2024.1385916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/01/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction Robust digital and community-led approaches are needed to combat health misinformation, as highlighted by the COVID-19 pandemic. Such gaps in public health outreach, compounded by systemic health barriers, contributed to higher rates of COVID-19 infection, mortality, and mental health effects among Hispanics during the peak of the pandemic. Thus, we conducted a community-based art-meets-health intervention [Stay Connected Los Angeles (SCLA)] to address the impacts of the COVID-19 pandemic in Hispanic communities. Methods Led by local artists in collaboration with public health specialists and community members, SCLA used multimedia to promote infection mitigation behaviors and psychological well-being among the 120,000 residents of Eastern Los Angeles. Campaign materials were designed with input from community representatives and included digital media, large-scale murals, and comic-book style pieces. Two semi-structured focus groups (one in English and another in Spanish) were conducted to solicit participants' views on attributes of the campaign. Independent coders analyzed transcripts and applied thematic analysis to summarize key learnings regarding central health and mitigation messages, media modalities, how health information would be communicated, and the ideal spokespersons for delivering health-related messages. Results Focus group participants emphasized the effectiveness of social media, GIFs, and references to popular media. Further, youth involvement in the creative process was deemed to be important. Participants highlighted the need for clarity in public health messaging and adaptation of visual campaigns to the preferences of diverse age groups through different art styles. Finally, community leaders were found to be critical health information sources. Discussion As a model of a culturally tailored arts-meets health public education campaign, SCLA yielded valuable information on how to structure future public health messaging and media to create a meaningful improvement in health knowledge, mental well-being, and compliance with mitigation behaviors in communities that are often overlooked. Contributions from local artists can heighten appeal and acceptability of messages.
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Affiliation(s)
- Thomas J. Urich
- Dana and David Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, United States
| | - Woori Lee
- Georgetown University School of Medicine, Washington, DC, United States
| | - Justine Po
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States
| | - Arthur Bookstein
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States
| | - Rosa Barahona
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States
| | - Lourdes Baezconde-Garbanati
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, CA, United States
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Kasting ML, Laily A, Burney HN, Head KJ, Daggy JK, Zimet GD, Schwab-Reese LM. County-Level Factors Associated With Influenza and COVID-19 Vaccination in Indiana, 2020‒2022. Am J Public Health 2024; 114:415-423. [PMID: 38386970 PMCID: PMC10937598 DOI: 10.2105/ajph.2023.307553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 02/24/2024]
Abstract
Objectives. To assess COVID-19 and influenza vaccination rates across Indiana's 92 counties and identify county-level factors associated with vaccination. Methods. We analyzed county-level data on adult COVID-19 vaccination from the Indiana vaccine registry and 2021 adult influenza vaccination from the Centers for Disease Control and Prevention. We used multiple linear regression (MLR) to determine county-level predictors of vaccinations. Results. COVID-19 vaccination ranged from 31.2% to 87.6% (mean = 58.0%); influenza vaccination ranged from 33.7% to 53.1% (mean = 42.9%). In MLR, COVID-19 vaccination was significantly associated with primary care providers per capita (b = 0.04; 95% confidence interval [CI] = 0.02, 0.05), median household income (b = 0.23; 95% CI = 0.12, 0.34), percentage Medicare enrollees with a mammogram (b = 0.29; 95% CI = 0.08, 0.51), percentage uninsured (b = -1.22; 95% CI = -1.57, -0.87), percentage African American (b = 0.31; 95% CI = 0.19, 0.42), percentage female (b = -0.97; 95% CI = -1.79, ‒0.15), and percentage who smoke (b = -0.75; 95% CI = -1.26, -0.23). Influenza vaccination was significantly associated with percentage uninsured (b = 0.71; 95% CI = 0.22, 1.21), percentage African American (b = -0.07; 95% CI = -0.13, -0.01), percentage Hispanic (b = -0.28; 95% CI = -0.40, -0.17), percentage who smoke (b = -0.85; 95% CI = -1.06, -0.64), and percentage who completed high school (b = 0.54; 95% CI = 0.21, 0.87). The MLR models explained 86.7% (COVID-19) and 70.2% (influenza) of the variance. Conclusions. Factors associated with COVID-19 and influenza vaccinations varied. Variables reflecting access to care (e.g., insurance) and higher risk of severe disease (e.g., smoking) are notable. Programs to improve access and target high-risk populations may improve vaccination rates. (Am J Public Health. 2024;114(4):415-423. https://doi.org/10.2105/AJPH.2023.307553).
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Affiliation(s)
- Monica L Kasting
- Monica L. Kasting, Alfu Laily, and Laura M. Schwab-Reese are with the Department of Public Health at Purdue University, West Lafayette, IN. Heather N. Burney and Joanne K. Daggy are with the Department of Biostatistics and Health Data Science at the Indiana University School of Medicine, Indianapolis. Katharine J. Head is with the Department of Communication Studies at Indiana University‒Purdue University, Indianapolis. Gregory D. Zimet is professor emeritus of Pediatrics and Psychiatry at the Indiana University School of Medicine, Indianapolis
| | - Alfu Laily
- Monica L. Kasting, Alfu Laily, and Laura M. Schwab-Reese are with the Department of Public Health at Purdue University, West Lafayette, IN. Heather N. Burney and Joanne K. Daggy are with the Department of Biostatistics and Health Data Science at the Indiana University School of Medicine, Indianapolis. Katharine J. Head is with the Department of Communication Studies at Indiana University‒Purdue University, Indianapolis. Gregory D. Zimet is professor emeritus of Pediatrics and Psychiatry at the Indiana University School of Medicine, Indianapolis
| | - Heather N Burney
- Monica L. Kasting, Alfu Laily, and Laura M. Schwab-Reese are with the Department of Public Health at Purdue University, West Lafayette, IN. Heather N. Burney and Joanne K. Daggy are with the Department of Biostatistics and Health Data Science at the Indiana University School of Medicine, Indianapolis. Katharine J. Head is with the Department of Communication Studies at Indiana University‒Purdue University, Indianapolis. Gregory D. Zimet is professor emeritus of Pediatrics and Psychiatry at the Indiana University School of Medicine, Indianapolis
| | - Katharine J Head
- Monica L. Kasting, Alfu Laily, and Laura M. Schwab-Reese are with the Department of Public Health at Purdue University, West Lafayette, IN. Heather N. Burney and Joanne K. Daggy are with the Department of Biostatistics and Health Data Science at the Indiana University School of Medicine, Indianapolis. Katharine J. Head is with the Department of Communication Studies at Indiana University‒Purdue University, Indianapolis. Gregory D. Zimet is professor emeritus of Pediatrics and Psychiatry at the Indiana University School of Medicine, Indianapolis
| | - Joanne K Daggy
- Monica L. Kasting, Alfu Laily, and Laura M. Schwab-Reese are with the Department of Public Health at Purdue University, West Lafayette, IN. Heather N. Burney and Joanne K. Daggy are with the Department of Biostatistics and Health Data Science at the Indiana University School of Medicine, Indianapolis. Katharine J. Head is with the Department of Communication Studies at Indiana University‒Purdue University, Indianapolis. Gregory D. Zimet is professor emeritus of Pediatrics and Psychiatry at the Indiana University School of Medicine, Indianapolis
| | - Gregory D Zimet
- Monica L. Kasting, Alfu Laily, and Laura M. Schwab-Reese are with the Department of Public Health at Purdue University, West Lafayette, IN. Heather N. Burney and Joanne K. Daggy are with the Department of Biostatistics and Health Data Science at the Indiana University School of Medicine, Indianapolis. Katharine J. Head is with the Department of Communication Studies at Indiana University‒Purdue University, Indianapolis. Gregory D. Zimet is professor emeritus of Pediatrics and Psychiatry at the Indiana University School of Medicine, Indianapolis
| | - Laura M Schwab-Reese
- Monica L. Kasting, Alfu Laily, and Laura M. Schwab-Reese are with the Department of Public Health at Purdue University, West Lafayette, IN. Heather N. Burney and Joanne K. Daggy are with the Department of Biostatistics and Health Data Science at the Indiana University School of Medicine, Indianapolis. Katharine J. Head is with the Department of Communication Studies at Indiana University‒Purdue University, Indianapolis. Gregory D. Zimet is professor emeritus of Pediatrics and Psychiatry at the Indiana University School of Medicine, Indianapolis
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González-Salinas AI, Andrade EL, Abroms LC, Gómez K, Favetto C, Gómez VM, Collins KK. Latino Parents' Reactions to and Engagement With a Facebook Group-Based COVID-19 Vaccine Promotion Intervention: Mixed Methods Pilot Study. JMIR Form Res 2024; 8:e51331. [PMID: 38483457 PMCID: PMC10979334 DOI: 10.2196/51331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/26/2023] [Accepted: 01/24/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Misinformation in Spanish on social media platforms has contributed to COVID-19 vaccine hesitancy among Latino parents. Brigada Digital de Salud was established to disseminate credible, science-based information about COVID-19 in Spanish on social media. OBJECTIVE This study aims to assess participants' reactions to and engagement with Brigada Digital content that sought to increase COVID-19 vaccine uptake among US Latino parents and their children. METHODS We conducted a 5-week intervention in a private, moderator-led Facebook (Meta Platforms, Inc) group with Spanish-speaking Latino parents of children aged ≤18 years (N=55). The intervention participants received 3 to 4 daily Brigada Digital posts and were encouraged to discuss the covered topics through comments and polls. To assess participants' exposure, reactions, and engagement, we used participants' responses to a web-based survey administered at 2 time points (baseline and after 5 weeks) and Facebook analytics to calculate the average number of participant views, reactions, and comments. Descriptive statistics were assessed for quantitative survey items, qualitative responses were thematically analyzed, and quotes were selected to illustrate the themes. RESULTS Overall, 101 posts were published. Most participants reported visiting the group 1 to 3 times (22/55, 40%) or 4 to 6 (18/55, 33%) times per week and viewing 1 to 2 (23/55, 42%) or 3 to 4 (16/55, 29%) posts per day. Facebook analytics validated this exposure, with 36 views per participant on average. The participants reacted positively to the intervention. Most participants found the content informative and trustworthy (49/55, 89%), easy to understand, and presented in an interesting manner. The participants thought that the moderators were well informed (51/55, 93%) and helpful (50/55, 91%) and praised them for being empathic and responsive. The participants viewed the group environment as welcoming and group members as friendly (45/55, 82%) and supportive (19/55, 35%). The 3 most useful topics for participants were the safety and efficacy of adult COVID-19 vaccines (29/55, 53%), understanding child risk levels (29/55, 53%), and the science behind COVID-19 (24/55, 44%). The preferred formats were educational posts that could be read (38/55, 69%) and videos, including expert (28/55, 51%) and instructional (26/55, 47%) interviews. Regarding engagement, most participants self-reported reacting to posts 1 to 2 (16/55, 29%) or 3 to 4 (15/55, 27%) times per week and commenting on posts 1 to 2 (16/55, 29%) or <1 (20/55, 36%) time per week. This engagement level was validated by analytics, with 10.6 reactions and 3 comments per participant, on average, during the 5 weeks. Participants recommended more opportunities for engagement, such as interacting with the moderators in real time. CONCLUSIONS With adequate intervention exposure and engagement and overall positive participant reactions, the findings highlight the promise of this digital approach for COVID-19 vaccine-related health promotion.
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Affiliation(s)
| | | | | | - Kaitlyn Gómez
- California State University, Fullerton, CA, United States
| | - Carla Favetto
- George Washington University, Washington, DC, United States
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Tyler S, Abuogi L, Vannoni V, Silveira L, Lang S, Smith C, DeCamp LR. Mixed Methods Evaluation of the Impact of the COVID-19 Pandemic on Immigrant Families. HISPANIC HEALTH CARE INTERNATIONAL 2024; 22:11-24. [PMID: 37981744 DOI: 10.1177/15404153231214707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Introduction: Little is known about the experiences of immigrant families with COVID-19 illness. This mixed methods study compared child and household experiences at the time of a child's COVID-19 diagnosis between immigrant and US-born parents and explored immigrant Latino perspectives on underlying causes of COVID-19 disparities between immigrant and US-born families. Methods: Study data includes surveys of parents of a child with a positive SARS-CoV2 test resulting at Children's Hospital Colorado and focus groups with Latino immigrant adults. We compared household COVID-19 experiences, use of mitigation measures, vaccine intention and sociodemographic information between survey participants stratified by nativity and completed thematic qualitative data analysis. Results: Findings from quantitative data were reinforced by qualitative data including: lower socio-economic status and higher employment in essential services increased infections and spread in immigrant families and higher risk of limited information access related to language barriers and prevalent misinformation. Survey results showed no difference in COVID-19 vaccine intention by nativity. Focus group participants reported limited access to non-English language culturally-tailored vaccine information and competing work demands decreased uptake. Conclusion: Avoiding exacerbating disparities in the face of another public health emergency requires focused investments in policies and approaches specifically directed at immigrant communities.
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Affiliation(s)
- Sydney Tyler
- Children's Hospital Colorado, Aurora, Colorado, CO, USA
| | - Lisa Abuogi
- Children's Hospital Colorado, Aurora, Colorado, CO, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, CO, USA
| | - Valentina Vannoni
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, CO, USA
| | - Lori Silveira
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, CO, USA
| | - Sean Lang
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, CO, USA
| | - Christiana Smith
- Children's Hospital Colorado, Aurora, Colorado, CO, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, CO, USA
| | - Lisa Ross DeCamp
- Children's Hospital Colorado, Aurora, Colorado, CO, USA
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, CO, USA
- ACCORDS (Adult and Child Center for Health Outcomes Research and Delivery Science), Aurora, Colorado, CO, USA
- Latino Research and Policy Center, Colorado School of Public Health, Aurora, Colorado, CO, USA
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Rukchart N, Hnuploy K, Eltaybani S, Sonlom K, Chutipattana N, Le CN, Patthanasak Khammaneechan, Jongjit W, Supaviboolas S. Prevalence and determinants of COVID-19 vaccine acceptance among vulnerable populations in Thailand: An application of the health belief model. Heliyon 2024; 10:e26043. [PMID: 38384553 PMCID: PMC10878938 DOI: 10.1016/j.heliyon.2024.e26043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/23/2024] Open
Abstract
Background Assessing the acceptance of vaccinations among vulnerable populations is essential to ensure proper coronavirus disease 2019 (COVID-19) control. This study used the Health Belief Model to examine the intention to vaccinate against COVID-19 among vulnerable populations in Thailand. Methods This analytical cross-sectional study was conducted in Thailand between October and November 2021. Using multistage random sampling, 945 individuals from vulnerable populations (i.e., older adults, pregnant women, market or street vendors, and individuals with chronic diseases) were selected and invited to complete a self-reported questionnaire. The questionnaire assessed participants' socioeconomic characteristics, COVID-19 preventive measures, knowledge, preventative health beliefs, and vaccine intention. A generalized linear mixed model was used to identify factors associated with the intention to receive the vaccine. Results The prevalence of intent to accept the COVID-19 vaccine was 75.03% (95% confidence interval [CI]: 72.16-77.68). The Health Belief Model factors associated with vaccine acceptance were cue to action (adjusted odds ratio [AOR] = 3.13; 95% CI: 2.07-4.71), perceived benefits (AOR = 2.04; 95% CI: 1.38-3.01), and perceived severity (AOR = 1.77; 95% CI: 1.18-2.65). Significant other covariates were wearing a face mask in the previous month (AOR = 2.62; 95% CI: 1.59-4.31), being 1-2 m away from other people (AOR = 1.58; 95% CI: 1.11-2.24), trust in government (AOR = 1.44; 95% CI: 1.03-2.02). Additionally, women were more likely to accept the COVID-19 vaccine compared to men (AOR = 1.43; 95% CI: 1.02-2.01). Conclusions Approximately one quarter of vulnerable individuals do not intend to be vaccinated. Health Belief Models can explain vaccine acceptance, and aid the Ministry of Public Health in planning future efforts to increase vaccine uptake. Healthcare professionals' advice, village health volunteers' information, and partnership collaborations are critical. Facilitating mobile community units, launching educational campaigns, maintaining a distance of 1-2 m from others, and wearing masks may increase COVID-19 vaccine acceptability. This research can help prepare for future pandemics.
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Affiliation(s)
- Navarat Rukchart
- School of Nursing, Walailak University, Nakhon Si Thammarat, 80161, Thailand
| | - Kanit Hnuploy
- Suratthani Rajabhat University, Suratthani, 84100, Thailand
| | - Sameh Eltaybani
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-0033, Japan
| | | | - Nirachon Chutipattana
- Department of Community Public Health, School of Public Health, Walailak University, Nakhon Si Thammarat, 80161, Thailand
- Excellent Centre for Dengue and Community Public Health (E.C. for DACH), School of Public Health, Walailak University, Nakhon Si Thammarat, 80161, Thailand
| | - Cua Ngoc Le
- Department of Community Public Health, School of Public Health, Walailak University, Nakhon Si Thammarat, 80161, Thailand
- Excellent Centre for Dengue and Community Public Health (E.C. for DACH), School of Public Health, Walailak University, Nakhon Si Thammarat, 80161, Thailand
| | - Patthanasak Khammaneechan
- Department of Community Public Health, School of Public Health, Walailak University, Nakhon Si Thammarat, 80161, Thailand
- Excellent Centre for Dengue and Community Public Health (E.C. for DACH), School of Public Health, Walailak University, Nakhon Si Thammarat, 80161, Thailand
| | - Wajinee Jongjit
- Department of Public Health Strategy Development, Nakhon Si Thammarat Provincial Public Health Office, Nakhon Si Thammarat, 80000, Thailand
| | - Suttakarn Supaviboolas
- Southern Border Regional Center for Primary Health Care Development, Nakhon Si Thammarat, 80000, Thailand
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Martin MA, Cook S, Spring B, Echeverria Garcia JC, Moskowitz D, Delaughter-Young J, Silva A, Hartstein M, De Pablo M, Peek M, Lynch E, Battalio S, Vu M. Delivering COVID-19 Vaccine via Trusted Social Services: Program Evaluation Results from the Chicagoland CEAL Program. J Community Health 2024; 49:61-69. [PMID: 37438456 PMCID: PMC10996394 DOI: 10.1007/s10900-023-01242-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2023] [Indexed: 07/14/2023]
Abstract
To describe the reach, implementation, and sustainability of COVID-19 vaccination programs delivered by social service community organizations. Five academic institutions in the Chicagoland CEAL (Community Engagement Alliance) program partnered with 17 community organizations from September 2021-April 2022. Interviews, community organizations program implementation tracking documents, and health department vaccination data were used to conduct the evaluation. A total of 269 events were held and 5,432 COVID-19 vaccines delivered from May 2021-April 2022. Strategies that worked best included offering vaccinations in community settings with flexible and reliable hours; pairing vaccinations with ongoing social services; giving community organizations flexibility to adjust programs; offering incentives; and vaccinating staff first. These strategies and partnership structures supported vaccine uptake, community organization alignment with their missions and communities' needs, and trust. Community organizations delivering social services are local community experts and trusted messengers. Pairing social service delivery with COVID-19 vaccination built individual and community agency. Giving COs creative control over program implementation enhanced trust and vaccine delivery. When given appropriate resources and control, community organizations can quickly deliver urgently needed health services in a public health crisis.
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Affiliation(s)
| | - Sara Cook
- University of Illinois Chicago, Chicago, USA
| | | | | | | | | | | | | | | | | | | | | | - Milkie Vu
- Northwestern University, Chicago, USA
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12
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Crane JT, Fabi R, Pacia D, Neuhaus CP, Berlinger N. "We're Here to Take Care of Our Community": Lessons Learned From the U.S. Federal Health Center Covid-19 Vaccine Program. Health Promot Pract 2024; 25:137-144. [PMID: 36688376 PMCID: PMC9902785 DOI: 10.1177/15248399221151178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Equitable access to vaccination is crucial to mitigating the disproportionate impact of Covid-19 on low-income communities and people of color in the United States. As primary care clinics for medically underserved patients, Federally Qualified Health Centers (FQHCs) emerged as a success story in the national effort to vaccinate the U.S. public against Covid-19. In February 2021, the Federal Health Center Covid-19 Vaccine Program began allocating vaccine supply directly to FQHCs in an effort to improve vaccine equity. This qualitative study documents how FQHCs in two states successfully mitigated barriers to vaccine access, responded to patient concerns about vaccination, and worked to maintain and grow community trust in a climate of uncertainty and fear during early vaccine roll-out to the general population. Using a socio-ecological model, we show how FQHCs intervened at multiple levels to advance vaccine equity, revealing valuable lessons for health promotion practice in primary care settings or underserved communities. Our findings provide descriptive context for existing quantitative evidence showing FQHCs' greater success in vaccinating people of color, and foreground valuable and innovative strategies for trustworthy health communication practices and equitable resource allocation to medically underserved patients and populations.
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Affiliation(s)
| | - Rachel Fabi
- SUNY Upstate Medical University, Syracuse, NY, USA
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13
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Newman PA, Dinh DA, Nyoni T, Allan K, Fantus S, Williams CC, Tepjan S, Reid L, Guta A. Covid-19 Vaccine Hesitancy and Under-Vaccination among Marginalized Populations in the United States and Canada: A Scoping Review. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01882-1. [PMID: 38117443 DOI: 10.1007/s40615-023-01882-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Amid persistent disparities in Covid-19 vaccination and burgeoning research on vaccine hesitancy (VH), we conducted a scoping review to identify multilevel determinants of Covid-19 VH and under-vaccination among marginalized populations in the U.S. and Canada. METHODS Using the scoping review methodology developed by the Joanna Briggs Institute, we designed a search string and explored 7 databases to identify peer-reviewed articles published from January 1, 2020-October 25, 2022. We combine frequency analysis and narrative synthesis to describe factors influencing Covid-19 VH and under-vaccination among marginalized populations. RESULTS The search captured 11,374 non-duplicated records, scoped to 103 peer-reviewed articles. Among 14 marginalized populations identified, African American/Black, Latinx, LGBTQ+, American Indian/Indigenous, people with disabilities, and justice-involved people were the predominant focus. Thirty-two factors emerged as influencing Covid-19 VH, with structural racism/stigma and institutional mistrust (structural)(n = 71) most prevalent, followed by vaccine safety (vaccine-specific)(n = 62), side effects (vaccine-specific)(n = 50), trust in individual healthcare provider (social/community)(n = 38), and perceived risk of infection (individual)(n = 33). Structural factors predominated across populations, including structural racism/stigma and institutional mistrust, barriers to Covid-19 vaccine access due to limited supply/availability, distance/lack of transportation, no/low paid sick days, low internet/digital technology access, and lack of culturally- and linguistically-appropriate information. DISCUSSION We identified multilevel and complex drivers of Covid-19 under-vaccination among marginalized populations. Distinguishing vaccine-specific, individual, and social/community factors that may fuel decisional ambivalence, more appropriately defined as VH, from structural racism/structural stigma and systemic/institutional barriers to vaccination access may better support evidence-informed interventions to promote equity in access to vaccines and informed decision-making among marginalized populations.
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Affiliation(s)
- Peter A Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada.
| | - Duy A Dinh
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
- Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Thabani Nyoni
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Kate Allan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Sophia Fantus
- School of Social Work, University of Texas at Arlington, Arlington, TX, USA
| | - Charmaine C Williams
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | | | - Luke Reid
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Adrian Guta
- School of Social Work, University of Windsor, Windsor, ON, Canada
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14
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Fernandez JR, Strassle PD, Richmond J, Mays VM, Forde AT. County-level barriers in the COVID-19 vaccine coverage index and their associations with willingness to receive the COVID-19 vaccine across racial/ethnic groups in the U.S. Front Public Health 2023; 11:1192748. [PMID: 37900019 PMCID: PMC10602638 DOI: 10.3389/fpubh.2023.1192748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 08/22/2023] [Indexed: 10/31/2023] Open
Abstract
Background County-level vaccination barriers (sociodemographic barriers, limited healthcare system resources, healthcare accessibility barriers, irregular healthcare seeking behaviors, history of low vaccination) may partially explain COVID-19 vaccination intentions among U.S. adults. This study examined whether county-level vaccination barriers varied across racial/ethnic groups in the U.S. and were associated with willingness to receive the COVID-19 vaccine. In addition, this study assessed whether these associations differed across racial/ethnic groups. Methods This study used data from the REACH-US study, a large online survey of U.S. adults (N = 5,475) completed from January 2021-March 2021. County-level vaccination barriers were measured using the COVID-19 Vaccine Coverage Index. Ordinal logistic regression estimated associations between race/ethnicity and county-level vaccination barriers and between county-level vaccination barriers and willingness to receive the COVID-19 vaccine. Models adjusted for covariates (age, gender, income, education, political ideology, health insurance, high-risk chronic health condition). Multigroup analysis estimated whether associations between barriers and willingness to receive the COVID-19 vaccine differed across racial/ethnic groups. Results American Indian/Alaska Native, Black/African American, Hispanic/Latino ELP [English Language Preference (ELP); Spanish Language Preference (SLP)], and Multiracial adults were more likely than White adults to live in counties with higher overall county-level vaccination barriers [Adjusted Odd Ratios (AORs):1.63-3.81]. Higher county-level vaccination barriers were generally associated with less willingness to receive the COVID-19 vaccine, yet associations were attenuated after adjusting for covariates. Trends differed across barriers and racial/ethnic groups. Higher sociodemographic barriers were associated with less willingness to receive the COVID-19 vaccine (AOR:0.78, 95% CI:0.64-0.94), whereas higher irregular care-seeking behavior was associated with greater willingness to receive the vaccine (AOR:1.20, 95% CI:1.04-1.39). Greater history of low vaccination was associated with less willingness to receive the COVID-19 vaccine among Black/African American adults (AOR:0.55, 95% CI:0.37-0.84), but greater willingness to receive the vaccine among American Indian/Alaska Native and Hispanic/Latino ELP adults (AOR:1.90, 95% CI:1.10-3.28; AOR:1.85, 95% CI:1.14-3.01). Discussion Future public health emergency vaccination programs should include planning and coverage efforts that account for structural barriers to preventive healthcare and their intersection with sociodemographic factors. Addressing structural barriers to COVID-19 treatment and preventive services is essential for reducing morbidity and mortality in future infectious disease outbreaks.
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Affiliation(s)
- Jessica R. Fernandez
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States
| | - Paula D. Strassle
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States
| | - Jennifer Richmond
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Vickie M. Mays
- Departments of Psychology and Health Policy and Management, UCLA Fielding School of Public Health and the UCLA BRITE Center for Science, Research and Policy, University of California, Los Angeles, Los Angeles, CA, United States
| | - Allana T. Forde
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States
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15
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Poghosyan H, Dinan MA, Tamamyan G, Nelson L, Jeon S. Racial and Ethnic Variation in COVID-19 Vaccination Uptake Among Medicare Beneficiaries with Cancer History. J Racial Ethn Health Disparities 2023; 10:2354-2362. [PMID: 36149576 PMCID: PMC9510246 DOI: 10.1007/s40615-022-01415-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND The purpose of this study was to estimate COVID-19 vaccination rate among Medicare beneficiaries with cancer history and determine whether COVID-19 vaccine uptake is higher among non-Hispanic White beneficiaries compared with racially and ethnically minoritized beneficiaries. METHODS We used US representative, cross-sectional data from the Medicare Current Beneficiary Survey COVID-19 Winter 2021 Rapid Response Community Supplement Survey. A total of 1,863 respondents with self-reported cancer history (other than skin cancer) were included. The outcome was self-reported receipt of at least one coronavirus vaccine dose since vaccines became available. The key independent variable of interest was self-reported race and ethnicity. We applied sample weights to account for the survey design and provide population estimates to 9.6 million beneficiaries with cancer history. Weighted descriptive statistics and multivariable logistic regression analyses were conducted. RESULTS During the first 4 months of vaccine availability, 69.6% of beneficiaries received at least one vaccine dose of which 65.4% had two vaccine doses. A larger proportion of non-Hispanic White beneficiaries (71.9%) had at least one vaccine dose compared with non-Hispanic Black (60.4%) and Hispanic (57.4%) beneficiaries. An estimated 30.4% of beneficiaries were still unvaccinated, that represents approximately 2.9 million unvaccinated beneficiaries with cancer history. Hispanic beneficiaries were 42% (OR: 0.58; 95% CI: 0.33-0.99; p = .048) less likely to be vaccinated compared with non-Hispanic White beneficiaries. CONCLUSIONS Results indicate racial and ethnic differences in vaccine uptake among Medicare beneficiaries with cancer history. Effective strategies are needed to help increase vaccine confidence and uptake among adults with cancer history.
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Affiliation(s)
- Hermine Poghosyan
- Yale School of Nursing, Yale University, New Haven, CT USA
- Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Cancer Center and Yale University School of Medicine, New Haven, CT USA
| | - Michaela A. Dinan
- Yale School of Public Health, Co-Leader of the Cancer Prevention and Control Research Program, Yale Comprehensive Cancer Center, Yale School of Medicine, New Haven, CT USA
| | - Gevorg Tamamyan
- Institute of Cancer and Crisis, Yerevan, Armenia
- Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center After Prof. R.H. Yeolyan, Yerevan, Armenia
- Department of Pediatric Oncology and Hematology, Yerevan State Medical University, Yerevan, Armenia
- Immune Oncology Research Institute, Yerevan, Armenia
| | - LaRon Nelson
- Yale School of Nursing, Yale University, New Haven, CT USA
- Global Affairs & Planetary Health Independence Foundation, Yale School of Nursing, Yale University, New Haven, CT USA
| | - Sangchoon Jeon
- Yale School of Nursing, Yale University, New Haven, CT USA
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16
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Titus-Lay E, Nehira J, Courtney J, Jee J, Kumar M, Tiet J, Le V, Durbin-Johnson B, Chen MS, Vinall R. A pharmacist-led community-based survey study: Determining the impact of the Covid-19 pandemic on actionable factors associated with worse cancer outcomes and cancer health disparities. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 11:100311. [PMID: 37533758 PMCID: PMC10392607 DOI: 10.1016/j.rcsop.2023.100311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/12/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023] Open
Abstract
Purpose The goals of this cross-sectional community-based survey study were to assess the impact of the Covid-19 pandemic on actionable factors which are known to contribute to worse cancer outcomes, and to determine whether race and ethnicity-based differences exist. Methods A survey study which captured demographic information and changes in cancer outcomes-related factors since the start of the Covid-19 pandemic, was conducted at a public Covid-19 vaccination clinic over a period of 10 days during March 2021. Surveys were administered in multiple languages. Chi-square tests and ANOVA followed by post-hoc Dunnett testing assessed for race and ethnicity-based differences. Results A total of 949 people participated (61.6% participation rate). Ninety-three surveys were removed based on inclusion criteria giving a final participant number of 856. Many participants reported postponing cancer screenings (17.8%) and cancellation of medical appointments (22.8% and 25.8% reported cancelled appointments by providers or themselves, respectively) due to the pandemic. Participants also reported decreased physical activity (44.7%) and increased tobacco and/or marijuana usage (7.0%). Conversely, participants reported consuming more fruits and vegetables (21.4%) and decreasing alcohol consumption (21.4%). Several race-related differences but no ethnicity-related differences were observed. Conclusion Our data can be used to help guide pharmacist-led targeted outreach in our community which will help mitigate Covid-19 pandemic-driven changes in behaviors associated with worse cancer outcomes and exacerbation of cancer health disparities. To our knowledge, this is the first cancer outcomes-related study to be conducted at a public Covid-19 vaccination site and is the first pharmacist-led study in this area.
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Affiliation(s)
- Erika Titus-Lay
- California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA
| | - Jeffrey Nehira
- California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA
| | - Jennifer Courtney
- California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA
| | - Jacquelyn Jee
- California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA
| | - Marissa Kumar
- California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA
| | - Jenny Tiet
- California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA
| | - Vivi Le
- California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA
| | - Blythe Durbin-Johnson
- Department of Public Health Sciences, School of Medicine, University of California Davis, One Shields Avenue, Davis, CA 95616, USA
| | - Moon S. Chen
- Division of Hematology and Oncology, UC Davis School of Medicine, Sacramento, CA 95817, USA
| | - Ruth Vinall
- California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA
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Andrade EL, Abroms LC, González AI, Favetto C, Gomez V, Díaz-Ramírez M, Palacios C, Edberg MC. Assessing Brigada Digital de Salud Audience Reach and Engagement: A Digital Community Health Worker Model to Address COVID-19 Misinformation in Spanish on Social Media. Vaccines (Basel) 2023; 11:1346. [PMID: 37631914 PMCID: PMC10457949 DOI: 10.3390/vaccines11081346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 08/29/2023] Open
Abstract
U.S. Spanish-speaking populations experienced gaps in timely COVID-19 information during the pandemic and disproportionate misinformation exposure. Brigada Digital de Salud was established to address these gaps with culturally tailored, Spanish-language COVID-19 information on social media. From 1 May 2021 to 30 April 2023, 495 Twitter, 275 Facebook, and 254 Instagram posts were published and amplified by 10 trained community health workers. A qualitative content analysis was performed to characterize the topics and formats of 251 posts. To assess reach and engagement, page analytics and advertising metrics for 287 posts were examined. Posts predominantly addressed vaccination (49.45%), infection risks (19.12%), and COVID-related scientific concepts (12.84%). Posts were educational (48.14%) and aimed to engage audiences (23.67%), promote resources (12.76%), and debunk misinformation (9.04%). Formats included images/text (55.40%), carousels (27.50%), and videos (17.10%). By 9 June 2023, 394 Facebook, 419 Instagram, and 228 Twitter followers included mainly women ages 24-54. Brigada Digital reached 386,910 people with 552,037 impressions and 96,868 engagements, including 11,292 likes, 15,240 comments/replies, 9718 shares/retweets, and 45,381 video play-throughs. The most engaging posts included videos with audio narration, healthcare providers, influencers, or music artists. This community-based model to engage Spanish-speaking audiences on social media with culturally aligned content to counter misinformation shows promise for addressing public health threats.
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Affiliation(s)
- Elizabeth L. Andrade
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave, NW, Washington, DC 20052, USA; (L.C.A.); (A.I.G.); (C.F.); (V.G.); (M.C.E.)
| | - Lorien C. Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave, NW, Washington, DC 20052, USA; (L.C.A.); (A.I.G.); (C.F.); (V.G.); (M.C.E.)
| | - Anna I. González
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave, NW, Washington, DC 20052, USA; (L.C.A.); (A.I.G.); (C.F.); (V.G.); (M.C.E.)
| | - Carla Favetto
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave, NW, Washington, DC 20052, USA; (L.C.A.); (A.I.G.); (C.F.); (V.G.); (M.C.E.)
| | - Valeria Gomez
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave, NW, Washington, DC 20052, USA; (L.C.A.); (A.I.G.); (C.F.); (V.G.); (M.C.E.)
| | | | - César Palacios
- Proyecto Salud, 11002 Veirs Mill Rd, Silver Spring, MD 20902, USA;
| | - Mark C. Edberg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave, NW, Washington, DC 20052, USA; (L.C.A.); (A.I.G.); (C.F.); (V.G.); (M.C.E.)
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Silesky MD, Panchal D, Fields M, Peña AS, Diez M, Magdaleno A, Frausto-Rodriguez P, Bonnevie E. A Multifaceted Campaign to Combat COVID-19 Misinformation in the Hispanic Community. J Community Health 2022; 48:286-294. [PMID: 36399238 PMCID: PMC9673890 DOI: 10.1007/s10900-022-01170-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2022] [Indexed: 11/19/2022]
Abstract
At the height of the COVID-19 pandemic, the Public Good Projects, Hispanic Communications Network and World Voices Media joined forces to launch a nationwide, multifaceted campaign which aimed to increase vaccine confidence and decrease misinformation on social media within Hispanic communities. We created a Spanish vaccine misinformation tracking system to detect and assess misinformation circulating in online Spanish conversations. We used our media monitoring findings to work with Hispanic social media (SM) influencers, volunteers, and celebrities to spread pro-vaccine messaging online. We created misinformation-responsive SM assets, newsletters, talking points and trainings for Hispanic-serving community-based organizations (CBOs) to help them respond to misinformation and increase vaccine uptake. We used our misinformation findings to inform the creation of mass media communications such as radio PSAs and op-eds. In Year 1, our new Spanish monitoring system captured and organized 35 M Spanish and 212.7 M English posts about COVID-19 misinformation. We recruited 496 paid influencers, 2 Hispanic celebrities and 1,034 digital volunteers. We sent 70 newsletters to an average of 1539 CBO subscribers, containing 206 talking points and 344 resources (SM assets, toolkits, videos) in English and Spanish to support their outreach. Our radio PSAs reached 26.9 M people and the op-eds reached 2.9 M people. This project shows the proliferation of misinformation circulating in online Spanish conversations. It also shows we were effective at reaching our target audience with fact-based COVID-19 misinformation prebunk and debunk messaging.
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Affiliation(s)
| | - Darshana Panchal
- Public Good Projects, 2308 Mt Vernon Ave, Suite 758, Alexandria, VA 22301 USA
| | - Megan Fields
- grid.474959.20000 0004 0528 628XCDC Foundation, Atlanta, GA USA
| | | | - Mariana Diez
- Hispanic Communications Network, Washington, DC USA
| | | | | | - Erika Bonnevie
- Public Good Projects, 2308 Mt Vernon Ave, Suite 758, Alexandria, VA 22301 USA
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