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Skuras A, Iseler J. Increasing COVID-19 Immunization Awareness in Rural Communities Through a Multimedia Campaign. CLIN NURSE SPEC 2023; 37:291-298. [PMID: 37870515 DOI: 10.1097/nur.0000000000000781] [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: 10/24/2023]
Abstract
PURPOSE/OBJECTIVES The purpose of this project was to implement a multimedia campaign to increase COVID-19 vaccine awareness and acceptance in rural communities. DESCRIPTION OF PROJECT This project was created and implemented in partnership with a public university in Michigan and targeted to rural Michigan communities. The campaign consisted of digital advertisements and video interviews with nurses from rural areas. Interview questions were developed using knowledge of the health belief model and allowed the nurses to share their COVID-19 stories. Video interviews were published to social media, and digital advertisements were targeted to rural areas via geofencing. A viewer response survey was provided to measure likelihood of behavior change after viewing. OUTCOME The campaign advertisements and videos reached 602 980 people during the implementation period, and 239 surveys were completed. Of the 53 unvaccinated respondents, 87% stated an increased likelihood to vaccinate. CONCLUSION This project supports the ability of the clinical nurse specialist to lead a multimedia campaign partnership that can reach thousands of people and increase the likelihood of vaccination. As the popularity of digital media continues to rise, clinical nurse specialists can embrace these channels to disseminate critical health information.
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Affiliation(s)
- Alexis Skuras
- Author Affiliations: Assistant Professor (Dr Skuras), University of Michigan-Flint; and Program Director and Clinical Nurse Specialist (Dr Iseler), Michigan State University, Grand Rapids
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Hester KA, Sakas Z, Ogutu EA, Dixit S, Ellis AS, Yang C, Chanda C, Freeman MC, Orenstein WA, Sarr M, Bednarczyk RA. Critical interventions for demand generation in Zambia, Nepal, and Senegal with regards to the 5C psychological antecedents of vaccination. Vaccine X 2023; 14:100341. [PMID: 37519776 PMCID: PMC10372309 DOI: 10.1016/j.jvacx.2023.100341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 04/21/2023] [Accepted: 06/28/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Childhood vaccination is an effective intervention for lowering the burden of infectious disease. Vaccine coverage has increased globally, but vaccine hesitancy and refusal threatens these gains. The 5C psychological antecedents of vaccination ("5C") provides a validated measure of "vaccine hesitancy or confidence" to assess individual thoughts and behaviors behind vaccination. We investigated population-level factors that contributed to high and sustained vaccination coverage in Zambia, Nepal, and Senegal, and alignment with the 5Cs. Methods Data was collected in the larger Exemplars in Vaccine Delivery study, from focus group discussions (FDGs) and key informant interviews (KIIs) at the national, regional, district, health facility, and community levels of health systems in Zambia, Nepal, and Senegal. We assessed the demand environment, as relayed by participants, and identified interventions reported as successful for demand generation, then retroactively aligned the interventions with the 5C constructs. Results Demand was positively correlated with high confidence and collective responsibility. Psychological constraints sometimes impacted demand. Physical constraints created barriers in some communities, particularly difficult to access (i.e., mountainous). Occasionally, physical constraints did not affect vaccination behavior - parents believed the benefits of vaccination worth pursuing. Factors negatively correlated with demand and intent, complacency and calculation, had limited impact. Critical interventions were: targeted and tailored health education activities (media partnerships, school outreach); community engagement; community ownership; and community involvement (community health workers, leaders, religious figures). Conclusion We found similar interventions used to generate demand, with strategies aligned with the 5C constructs. Categorizing interventions by drivers of demand may help strategic planning and the division of resources; decision makers may choose to implement our suggested interventions. Assessing the 5Cs allows decision-makers to operationalize demand generation into concrete interventions and policies, and determine the individual impact of these constructs on the population and focus efforts on interventions tailored to a specific need.
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Affiliation(s)
- Kyra A. Hester
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Zoe Sakas
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Sameer Dixit
- Center for Molecular Dynamics Nepal, Katmandu, Nepal
| | - Anna S. Ellis
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Chenmua Yang
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Chama Chanda
- Center for Family Health Research in Zambia, Lusaka, Zambia
| | | | | | - Moussa Sarr
- Institut de Recherche en Santé de Surveillance Epidemiologique et de Formation (IRESSEF), Dakar, Senegal
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Kite J, Chan L, MacKay K, Corbett L, Reyes-Marcelino G, Nguyen B, Bellew W, Freeman B. A Model of Social Media Effects in Public Health Communication Campaigns: Systematic Review. J Med Internet Res 2023; 25:e46345. [PMID: 37450325 PMCID: PMC10382952 DOI: 10.2196/46345] [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: 02/07/2023] [Revised: 03/27/2023] [Accepted: 04/19/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Social media platforms are frequently used in health communication campaigns. Common understandings of campaign effects posit a sequential and linear series of steps from exposure to behavior change, commonly known as the hierarchy of effects model (HOE). These concepts need to be reevaluated in the age of social media, which are interactional and communal. OBJECTIVE This review aims to update the traditional HOE for health communication campaigns in the context of social media, including identifying indicators of effectiveness and how these are conceptualized to lead to health-related outcomes. METHODS We conducted a systematic review of studies following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines reporting on the use of social media as part of health communication campaigns, extracting campaign information such as objectives, platforms used, and measures of campaign performance. We used these data, combined with our understanding of the HOE, to develop an updated conceptual model of social media campaign effects. RESULTS We identified 99 eligible studies reporting on 93 campaigns, published between 2012 and 2022. The campaigns were conducted in over 20 countries, but nearly half (n=42) were conducted in the United States. Campaigns targeted a variety of health issues and predominantly used Facebook, Twitter, Instagram, and YouTube. Most campaigns (n=81) set objectives targeting awareness or individual behavior change. Process measures (n=68; eg, reach and impressions) and engagement measures (n=73; eg, likes and retweets) were reported most frequently, while two-fifths (n=42) did not report any outcomes beyond engagement, such as changes in knowledge, behavior, or social norms. Most campaigns (n=55) collected measures that did not allow them to determine if the campaign objective had been met; that is, they were process evaluations only. Based on our review, our updated model suggests that campaign exposure can lead to individual behavior change and improved health outcomes, either through a direct or indirect pathway. Indirect pathways include exposure through social and policy changes. "Engagement" is positioned as critical to success, replacing awareness in the traditional HOE, and all types of engagement are treated as equal and good. No consideration is being given to potential negative engagement, such as the distribution of misinformation. Additionally, the process is no longer linear and sequential, with circular pathways evident, such as engagement not only influencing behavior change but also generating additional exposure to campaign messages. CONCLUSIONS Our review has highlighted a change in conventional understandings of how campaigns can influence health outcomes in the age of social media. The updated model we propose provides social media campaigners with a starting point to develop and tailor campaign messages and allows evaluators to identify critical assumptions to test, including the role and value of "engagement." TRIAL REGISTRATION PROSPERO CRD42021287257; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=287257.
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Affiliation(s)
- James Kite
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | - Lilian Chan
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | - Kathryn MacKay
- Sydney Health Ethics, Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | - Lucy Corbett
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | - Gillian Reyes-Marcelino
- Sydney School of Public Health, The University of Sydney, Camperdown, Australia
- The Daffodil Centre, The University of Sydney and Cancer Council New South Wales, Camperdown, Australia
| | - Binh Nguyen
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | - William Bellew
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | - Becky Freeman
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, Australia
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Ponce-Gonzalez IM, Jimenez N, Rodriguez E, Srivastava A, Parchman ML. Community Health Worker-led Implementation of the Stanford Youth Diabetes Coaching Program in Underserved Latinx Communities. J Prim Care Community Health 2023; 14:21501319231158285. [PMID: 36905316 PMCID: PMC10009028 DOI: 10.1177/21501319231158285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND The Stanford Youth Diabetes Coaching Program (SYDCP) is an evidence-based program led by health care professionals to teach healthy youth who then coach family members with diabetes or other chronic conditions. This purpose of this study is to evaluate a Community Health Worker (CHW)-led implementation of the SYDCP for low-income Latinx students from underserved agricultural communities. METHOD CHWs were trained and virtually led 10 training sessions virtually during the COVID-19 for Latinx students who were recruited from high schools in agricultural regions of Washington state. Feasibility measures include recruitment, retention, class attendance, and successful coaching of a family member or friend. Acceptability was measured by responses on the post-training survey. Effectiveness was evaluated by pre-post changes in measures used in prior studies of the SYDCP such as level of activation and diabetes knowledge. RESULTS Thirty-four students were recruited, 28 completed the training and 23 returned both pre- and post-surveys. Over 80% of students attended 7 or more classes. All met with a family or friend and 74% met with them weekly. Approximately 80% of the students rated the program's usefulness as "very good" or "excellent." Pre-post increases in diabetes knowledge, nutrition-related behaviors, resilience, and activation were significant and similar to those observed in prior published studies of the SYDCP. CONCLUSIONS Findings support the feasibility, acceptability, and effectiveness of a CHW-led implementation of the SYDCP in underserved Latinx communities using a virtual remote model.
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Affiliation(s)
| | | | | | | | - Michael L Parchman
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
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Daniels D, Imdad A, Buscemi-Kimmins T, Vitale D, Rani U, Darabaner E, Shaw A, Shaw J. Vaccine hesitancy in the refugee, immigrant, and migrant population in the United States: A systematic review and meta-analysis. Hum Vaccin Immunother 2022; 18:2131168. [PMID: 36332155 PMCID: PMC9746503 DOI: 10.1080/21645515.2022.2131168] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Refugees, immigrants, and migrants (RIM) in the United States (US) have been identified as an underimmunized population prior to the COVID-19 pandemic. Vaccine acceptance is critical to combat the public health threat incited by COVID-19 and other vaccine-preventable disease. To better understand escalating vaccine hesitancy among US RIM, a comprehensive evaluation of the problem and solutions is necessary. In this systematic review, we included 57 studies to describe vaccination rates, barriers, and interventions addressing vaccine hesitancy over the past decade. Meta-analysis was performed among 22 studies, concluding that RIM represent an underimmunized population compared to the general US population. Narrative synthesis and qualitative methods were used to identify critical barriers, including gaps in knowledge, poor access to medical care, and heightened distrust of the medical system. Our results demonstrate the need for effective, evidence-based interventions to increase vaccination rates among diverse RIM populations.
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Affiliation(s)
- Danielle Daniels
- Department of Pediatrics, Division of Infectious Diseases, Upstate Golisano Children’s Hospital, SUNY Upstate Medical University, Syracuse, NY, USA,CONTACT Danielle Daniels 750 East Adams St. Room 5400, Syracuse, NY13210, USA
| | - Aamer Imdad
- Department of Pediatrics, Karjoo Family Center for Pediatric Gastroenterology, SUNY Upstate Medical University, Syracuse, NY, USA
| | | | - Danielle Vitale
- Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Uzma Rani
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Ellen Darabaner
- Hunter-Rice Health Sciences Library, Samaritan Medical Center, Watertown, NY, USA
| | - Andrea Shaw
- Department of Pediatrics, Department of Internal Medicine, Institute for Global Health and Translational Science, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jana Shaw
- Department of Pediatrics, Division of Infectious Diseases, Upstate Golisano Children’s Hospital, SUNY Upstate Medical University, Syracuse, NY, USA
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Al Janabi T, Petrillo G, Chung S, Pino M. Predictors of Vaccine Uptake among Migrants in the United States: A Rapid Systematic Review. EPIDEMIOLOGIA (BASEL, SWITZERLAND) 2022; 3:465-481. [PMID: 36547256 PMCID: PMC9777676 DOI: 10.3390/epidemiologia3040035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 12/24/2022]
Abstract
Evaluating challenges to vaccine uptake in non-US-born individuals is necessary for increasing national vaccination rates. This rapid review was conducted to investigate predictors of vaccine utilization among US migrants. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) checklist was utilized, along with the Rayyan webtool, to facilitate the process of identifying primary research articles. Data were independently extracted by using a piloted, customized form. This was tabulated and the results were reported. Of the 186 abstracts reviewed, nine articles were included. Populations included in this review were refugees (n = 1), undocumented migrants (n = 1), migrants crossing the US-Mexico border (n = 2), Blacks (n = 1), and US-born vs. non-US-born adults (n = 1). Three studies focused on "foreign-born" children. The vaccines included in the literature reviewed were both combined series and individual, with one study addressing immunization instead of specific vaccines. Detailed characteristics of these studies and their quality evaluations were also reported. This review identified gaps in research regarding immunization among different migrant groups. Multilevel interventions should be considered to leverage the existing facilitators and address the known modifiable barriers to creating an accessible and supportive environment for marginalized populations.
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