The importance of community engagement on COVID-19 vaccination strategy: Lessons from two California pilot programs

Can communities be mobilised to build capacity to respond to the COVID-19 pandemic? A qualitative process evaluation

OBJECTIVES

Government guidance to manage COVID-19 was challenged by low levels of health and digital literacy and lack of information in different languages. 'Covid Confidence' sessions (CC-sessions) were evaluated to assess their effectiveness in counteracting misinformation and provide an alternative source of information about the pandemic.

DESIGN

We worked with community anchor organisations to co-ordinate online CC-sessions serving three economically deprived, ethnically mixed, neighbourhoods. We conducted a qualitative, participatory process evaluation, in tandem with the CC-sessions to explore whether a popular opinion leader/local champion model of health promotion could mobilise pandemic responses. Group discussions were supplemented by final interviews to assess changes in community capacity to mobilise.

SETTING

Sheffield, England, September 2020 to November 2021.

PARTICIPANTS

Community leaders, workers and volunteers representing a variety of local organisations resulted in 314 attendances at CC-sessions. A group of local health experts helped organisations make sense of government information.

RESULTS

CC-sessions fostered cross-organisational relationships, which enabled rapid community responses. Community champions successfully adapted information to different groups. Listening, identifying individual concerns and providing practical support enabled people to make informed decisions on managing exposure and getting vaccinated. Some people were unable to comply with self-isolation due to overcrowded housing and the need to work. Communities drew on existing resources and networks.

CONCLUSIONS

CC-sessions promoted stronger links between community organisations which reduced mistrust of government information. In future, government efforts to manage pandemics should partner with communities to codesign and implement prevention and control measures.

Barriers and enablers to implementation of COVID-19 vaccine programs in a rural and regional Queensland: A provider perspective

INTRODUCTION

Vaccines formed the core of Australia's National COVID-19 Plan in combination with other public health measures. Vaccine rates varied geographically, and lower uptake was seen in some regional and remote areas.

OBJECTIVE

Explore barriers and enablers to implementing COVID-19 vaccine programs and recommendations for improvement from a vaccine provider perspective in rural and regional Queensland (QLD).

DESIGN

Participants included eleven healthcare personnel (HCP) from rural (45%) and regional (55%) settings in the Wide Bay region, QLD, Australia. Semi-structured interviews were conducted to identify barriers and enabling factors HCP experienced implementing COVID-19 programs, in addition to their recommendations to optimise ongoing implementation of vaccine programs. Braun and Clarke's reflexive thematic analysis of interview transcripts was performed, and over-arching themes were identified.

FINDINGS

Four barrier themes were identified: 1. operational barriers, 2. communication issues, 3. financial constraints, and 4. leadership and coordination. Four enabler themes were also identified: 1. adaptability; 2. prior experience and knowledge; 3. collaboration and teamwork; and 4. community engagement. Recommendations for optimising ongoing vaccine rollout included reducing the administrative burden on providers, increasing involvement of primary care and the private sector in planning and decision making, improving communication methods, reviewing financial remuneration for private providers, and decentralising decision-making.

DISCUSSION

There were multiple barriers and enablers to implementation of COVID-19 programs experienced by rural and regional HCP in the Wide Bay region of QLD which were consistent with existing literature.

CONCLUSION

A range of actionable recommendations were identified that could optimise the COVID-19 vaccine program and future vaccine programs in rural and regional areas.

Black People Narrate Inequalities in Healthcare Systems that Hinder COVID-19 Vaccination: Evidence from the USA and the UK

The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented global health emergency. As a novel condition, there is no known definitive treatment for the condition, except for the use of vaccines as a control measure. In the literature, the issue of inequalities in healthcare systems has been documented as a hindrance to COVID-19 vaccination; however, the specific inequalities in healthcare systems that hinder COVID-19 vaccination are poorly understood. Guided by the fundamental cause theory (FCT), this study aims to address this gap among Black people, a minority group vulnerable to inequalities in healthcare systems. Thirty-five Black people (age range = 21-58 years) residing in either the United States of America (USA) or the United Kingdom (UK) participated in this study. Qualitative data were collected and analyzed using thematic analysis. Most USA participants and a few UK participants narrated that no inequalities in healthcare systems hinder them from receiving COVID-19 vaccines. Contrarily, most UK participants and a few USA participants narrated inequalities in healthcare systems that hinder them from receiving COVID-19 vaccines. These are mistrust of the healthcare system, health policies regarding COVID-19 vaccination, historical factors (such as historical abuse of Black bodies by health professionals), residential location, and dissatisfaction with health services. In terms of what governments must do to correct these inequalities, participants recommended the need for acknowledgment and community engagement. This is the first international collaboration to examine this problem. Important implications for theory, healthcare systems, and COVID-19 vaccination program planning are highlighted. Finally, there are members of other minority groups and vulnerable communities who are not Black people. Such groups could face unique inequalities that hinder COVID-19 vaccination. Therefore, future studies should include such groups.

"We left the crop there lying in the field": Agricultural worker experiences with the COVID-19 pandemic in a rural US-Mexico border region

California agricultural workers are predominately Latino/a, are medically underserved, and reside in larger households, placing them at elevated COVID-19 risk at work and at home. While some research has examined COVID-19 among agricultural workers in the interior of the United States, little research exists on experiences of COVID-19 along the US-Mexico border. Grounded in resilience thinking, this study aims to understand how agricultural workers navigated their heightened risk to COVID-19 at work and at home, and made use of available resources in the context of a bi-national community. Our study utilized qualitative interviews with 12 agricultural workers to understanding the COVID-19 experiences of resident and daily migrant agricultural workers in Imperial County, California, located along the US-Mexico border. Findings suggest that agricultural workers faced significant impacts and risks at work (work stoppages, stress about bringing COVID-19 home to family) and at home (contracting COVID-19, loss of friends and family, and mental health challenges). Agricultural workers and their employers often implemented COVID-19 precautions such as social distancing measures, personal protective equipment, hand washing and hand sanitizers, and isolation. Many agricultural workers did access testing resources on either side of the US-Mexico border and worked with US-based Spanish-speaking community-based organizations to register for vaccine appointments. To better support agricultural workers and their employers in the future, we recommend the following: 1. Prioritize agricultural workplace conditions to increase agricultural worker physical and mental health, 2. Extend public health services into agricultural work sites of transit and the workplace, and 3. Lastly, trusted Spanish-speaking community-based organizations can play a critical role in public health outreach.

Assessment of Attitudes and Intentions towards COVID-19 Vaccines and Associated Factors among General Populations of Pakistan: A Cross-Sectional Study

OBJECTIVE

The goal of public health in combatting COVID-19 is to increase herd immunity. However, vaccine reluctance makes attaining herd immunity a worldwide challenge. This investigation aimed to identify negative and positive attitudes and intentions about COVID-19 vaccinations.

METHODS

A cross-sectional online survey was conducted once free COVID-19 vaccines became available in Pakistan in 2021. 4392 Pakistanis aged 18 and older were surveyed from seven administrative units between 1 July and 30 August 2021. Online structured questionnaires were utilized to collect data using a simple sampling procedure. The questionnaires were divided into three major sections: sociodemographic, health factors, and attitudes toward COVID-19.

RESULTS

The survey link was shared with approximately 4500 participants. 97.6%(4392) completed the survey once begun. Frequency, percentage and Chi-square tests were used to analyze statistical data. Most of the participants in the research were men (2703 (61.54%)), 3277 (74.61%) were aged 18-29 years, and 1824 (41.53%) were residents of the Khyber Pakhtunkhwa province. (18.69%) Respondents expressed COVID-19 vaccine hesitancy, whereas 36.66% of participants liked getting the Sinopharm and Sinovac vaccines and (35.84%) of participants preferred the Pfizer vaccine. A significant number of participants (38.05%) were concerned about the vaccine's unexpected side effects Thus, it is essential to realize that many participants were concerned about the vaccine's unexpected side effects.

CONCLUSIONS

The overall high level of concern about the unforeseen side effects of COVID-19 vaccines, as well as widespread vaccine hesitancy among Pakistani populations and its predictors, should be taken into account if public health intervention campaigns in Pakistan are changing negative attitudes and improving compliance with regard to COVID-19 vaccines.

Community engagement to support COVID-19 vaccine uptake: a living systematic review protocol

INTRODUCTION

Widespread vaccination against COVID-19 is one of the most effective ways to control, and ideally, end the global COVID-19 pandemic. Vaccine hesitancy and vaccine rates vary widely across countries and populations and are influenced by complex sociocultural, political, economic and psychological factors. Community engagement is an integral strategy within immunisation campaigns and has been shown to improve vaccine acceptance. As evidence on community engagement to support COVID-19 vaccine uptake is emerging and constantly changing, research that lessens the knowledge-to-practice gap by providing regular and up-to-date evidence on current best-practice is essential.

METHODS AND ANALYSIS

A living systematic review will be conducted which includes an initial systematic review and bimonthly review updates. Searching and screening for the review and subsequent updates will be done in four streams: a systematic search of six databases, grey literature review, preprint review and citizen sourcing. The screening will be done by a minimum of two reviewers at title/abstract and full-text in Covidence, a systematic review management software. Data will be extracted across predefined fields in an excel spreadsheet that includes information about article characteristics, context and population, community engagement approaches, and outcomes. Synthesis will occur using the convergent integrated approach. We will explore the potential to quantitatively synthesise primary outcomes depending on heterogeneity of the studies.

ETHICS AND DISSEMINATION

The initial review and subsequent bimonthly searches and their results will be disseminated transparently via open-access methods. Quarterly briefs will be shared on the reviews' social media platforms and across other interested networks and repositories. A dedicated web link will be created on the Community Health-Community of Practice site for sharing findings and obtaining feedback. A mailing list will be developed and interested parties can subscribe for updates.

PROSPERO REGISTRATION NUMBER

CRD42022301996.

How Can Mobile Health Technology Improve Usage and Delivery of the COVID-19 Vaccine in Low- and Middle-Income Countries?

Background: Mobile health projects have been implemented all over the world, using mobile phones for record keeping, data collection, or patient communication. Further, mobile health tools have been used to promote behavior change in health workers and/or patients. For example, text message reminders have been shown to increase health care seeking behavior or medication adherence in some patients, and mobile data collection and communication tools for health workers have improved follow-up of patients and data reporting. Methods: This literature review was conducted through a keyword search of the following databases to identify relevant peer-reviewed articles: Google Scholar, PubMed, Embase, and EKB. Keywords used in these searches included mHealth, mobile health, mobile phone, coverage, usage, delivery, vaccination, immunization and COVID-19. Results: Eleven studies satisfied the inclusion criteria were included. They examined awareness, applications, challenges and strengths of Mobile-Health applications. All studies showed some evidence that mHealth intervention had a positive impact on increasing the coverage and use of COVID-19 vaccine. Bad awareness of people was strongly associated with declines in vaccination intent. The use of mobile applications has made a great revolution in tracking and data gathering about vaccination status. The main limitations were reporting bias and malfunctioning of mobile applications. The main strengths were getting real-time data, improving surveillance, using geographic mapping to monitor populations. Conclusion: Growing usage of smartphone and internet penetration in African countries opens the door to mHealth applications such as health literacy, vaccine supply and control, disease monitoring and intervention, and virtual consultations with health professionals around the world.