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Kaufman J, Overmars I, Fong J, Tudravu J, Devi R, Volavola L, Vodonaivalu L, Jenkins K, Leask J, Seale H, Mohamed Y, Joshi K, Datt H, Sagan S, Dynes M, Hoq M, Danchin M. Training health workers and community influencers to be Vaccine Champions: a mixed-methods RE-AIM evaluation. BMJ Glob Health 2024; 9:e015433. [PMID: 39251236 DOI: 10.1136/bmjgh-2024-015433] [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] [Received: 02/26/2024] [Accepted: 08/22/2024] [Indexed: 09/11/2024] Open
Abstract
INTRODUCTION Increasing trust and confidence in vaccines is a global priority, as countries have grappled with delivering COVID-19 vaccines, maintaining routine childhood vaccination rates and introducing new vaccines. Community-based vaccine promotion interventions are commonly implemented, but effectiveness evidence is limited. In 2022, supported by the Australian Government and in partnership with Fiji's Ministry of Health and UNICEF, we codesigned, delivered and comprehensively evaluated a vaccine education and communication training programme for health workers and community influencers to promote COVID-19 and routine immunisation. METHODS The Vaccine Champions programme included three phases: (1) codesign with Fiji stakeholders; (2) vaccine education and communication training for Vaccine Champions and (3) support for Champions to deliver community vaccine discussion sessions over 6 months.The RE-AIM framework evaluation measured programme reach, effectiveness, adoption, implementation and maintenance. Mixed-methods data were collected through interviews, surveys and field notes, integrating qualitative and quantitative data to triangulate findings. Primary outcomes included Champions' knowledge, communication self-efficacy, trust in COVID-19 vaccines, programme satisfaction and community members' intention to vaccinate. RESULTS We trained 35 Champions (27/35 female), including health workers, faith and community influencers. Half had a health background (17/35). Champions conducted 54 discussion sessions, reaching 1717 community members. Most Champions (22/35) conducted at least 1 session, with 16 running 3 or more. Champions who did not run sessions reported barriers like lack of confidence and competing duties. Training increased Champions' communication self-efficacy and trust in COVID-19 vaccines. Community member intention to vaccinate increased from 41% (394/960) to 83% (822/991) before and after a session. The programme was well received with interest in continued engagement. CONCLUSION Training health workers and community Vaccine Champions can promote vaccine confidence. Programmes require government support and engagement for sustainability. Robust evaluation frameworks are needed to build the evidence base.
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Affiliation(s)
- Jessica Kaufman
- Vaccine Uptake Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- The University of Melbourne Department of Paediatrics, Parkville, Victoria, Australia
| | - Isabella Overmars
- Vaccine Uptake Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - James Fong
- Republic of Fiji Ministry of Health, Suva, Rewa, Fiji
| | | | - Rachel Devi
- Republic of Fiji Ministry of Health, Suva, Rewa, Fiji
| | | | - Luisa Vodonaivalu
- Vaccine Uptake Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Kylie Jenkins
- Vaccine Uptake Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Julie Leask
- School of Public Health, The University of Sydney Faculty of Medicine and Health, Camperdown, New South Wales, Australia
| | - Holly Seale
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Yasmin Mohamed
- Vaccine Uptake Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | | | | | | | - Michelle Dynes
- UNICEF East Asia and Pacific Regional Office, Bangkok, Thailand
| | - Monsurul Hoq
- Vaccine Uptake Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Clinical Epidemiology and Biostatistics, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Margie Danchin
- Vaccine Uptake Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- The University of Melbourne Department of Paediatrics, Parkville, Victoria, Australia
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Carosella EA, Su M, Testa MA, Arzilli G, Conni A, Savoia E. COVID-19 Vaccine Hesitancy and Misinformation Endorsement among a Sample of Native Spanish-Speakers in the US: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:1545. [PMID: 39120248 PMCID: PMC11311759 DOI: 10.3390/healthcare12151545] [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: 06/10/2024] [Revised: 07/25/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024] Open
Abstract
Research on COVID-19 vaccine hesitancy and misinformation endorsement among Spanish-speaking Americans is limited. This cross-sectional study used a Spanish-language survey from May-August 2021 among 483 Spanish speakers living in the US and Puerto Rico. We applied multivariable Poisson regression with robust error variances to assess the association between independent variables and binary outcomes for vaccine acceptance versus hesitance, as well as misinformation endorsement. Vaccine acceptance was associated with COVID-19 risk perception score (PR = 1.7 high vs. low perceived risk), opinion of government transparency (PR = 2.2 very transparent vs. not transparent), and trust in vaccine information (PR = 1.8 high vs. low). There was also an interaction between time spent on social media and social media as a main source of COVID-19 information (p = 0.0484). Misinformation endorsement was associated with opinion about government transparency (PR = 0.5 moderately vs. not transparent), trust in vaccine information (PR = 0.5 high vs. low trust), social media impact on vaccine confidence (PR = 2.1 decreased vs. increased confidence), distrust vaccines (PR = 1.9 distrust vs. trust), using vaccine information from Facebook (PR = 1.4 yes vs. no), and time spent on social media by those using social media as main source of COVID-19 vaccine information (p = 0.0120). Vaccine acceptance in respondents with high misinformation endorsement scores was 0.7 times those with low scores. These findings highlight the importance of effective information dissemination, the positive role of social media, and government transparency in boosting vaccine uptake among Spanish speakers in the US.
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Affiliation(s)
- Elizabeth A. Carosella
- Emergency Preparedness Research Evaluation & Practice Program (EPREP), Division of Policy Translation & Leadership Development, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; (E.A.C.); (M.S.); (M.A.T.)
- Mathematica Policy Research, Mathematica, Princeton, NJ 08540, USA
| | - Maxwell Su
- Emergency Preparedness Research Evaluation & Practice Program (EPREP), Division of Policy Translation & Leadership Development, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; (E.A.C.); (M.S.); (M.A.T.)
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Marcia A. Testa
- Emergency Preparedness Research Evaluation & Practice Program (EPREP), Division of Policy Translation & Leadership Development, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; (E.A.C.); (M.S.); (M.A.T.)
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Guglielmo Arzilli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy;
| | - Alice Conni
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy;
| | - Elena Savoia
- Emergency Preparedness Research Evaluation & Practice Program (EPREP), Division of Policy Translation & Leadership Development, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; (E.A.C.); (M.S.); (M.A.T.)
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
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Enria L, Dwyer H, Marchant M, Beckmann N, Schmidt-Sane M, Conteh A, Mansaray A, N'Jai A. Political dimensions of misinformation, trust, and vaccine confidence in a digital age. BMJ 2024; 385:e079940. [PMID: 38901859 DOI: 10.1136/bmj-2024-079940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Affiliation(s)
- Luisa Enria
- London School of Hygiene and Tropical Medicine, London UK
| | - Harriet Dwyer
- London School of Hygiene and Tropical Medicine, London UK
| | - Mark Marchant
- London School of Hygiene and Tropical Medicine, London UK
| | | | | | - Abu Conteh
- Sierra Leone Urban Research Centre, Freetown, Sierra Leone
| | | | - Alhaji N'Jai
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
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Astuti SI, Sufehmi H, Wilhelm E. Centring health workers and communities is key to building vaccine confidence online. BMJ 2024; 384:q82. [PMID: 38228338 DOI: 10.1136/bmj.q82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Affiliation(s)
- Santi Indra Astuti
- Islamic University of Bandung, Bandung, Indonesia
- MAFINDO (Masyarakat Anti Fitnah Indonesia), Jakarta, Indonesia
| | - Harry Sufehmi
- MAFINDO (Masyarakat Anti Fitnah Indonesia), Jakarta, Indonesia
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