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Vernon-Wilson E, Tetui M, DeMarco M, Grindrod K, Waite NM. Connect, collaborate and tailor: a model of community engagement through infographic design during the COVID-19 pandemic. BMC Public Health 2024; 24:2551. [PMID: 39300382 DOI: 10.1186/s12889-024-20037-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 09/10/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Across the globe, racial and ethnic minorities have been disproportionately affected by COVID-19 with increased risk of infection and burden from disease. Vaccine hesitancy has contributed to variation in vaccine uptake and compromised population-based vaccination programs in many countries. Connect, Collaborate and Tailor (CCT) is a Public Health Agency of Canada funded project to make new connections between public health, healthcare professionals and underserved communities in order to create culturally adapted communication about COVID-19 vaccines. This paper describes the CCT process and outcomes as a community engagement model that identified information gaps and created tailored tools to address misinformation and improve vaccine acceptance. METHODS Semi-structured interviews with CCT participants were undertaken to evaluate the effectiveness of CCT in identifying and addressing topics of concern to underserved and ethnic minority communities. Interviews also explored CCT participants' experiences of collaboration through the development of new partnerships between ethnic minority communities, public health and academic researchers, and the evolution of co-operation sharing ideas and creating infographics. Thematic analysis was used to produce representative themes. The activities described were aligned with the levels of public engagement described in the IAP2 spectrum (International Association for Public Participation). RESULTS Analysis of interviews (n = 14) revealed that shared purpose and urgency in responding to the COVID-19 pandemic motivated co-operation among CCT participants. Acknowledgement of past harm, present health, and impact of social inequities on public service access was an essential first step in establishing trust. Creating safe spaces for open dialogue led to successful, iterative cycles of consultation and feedback between participants; a process that not only helped create tailored infographics but also deepened engagement and collaboration. Over time, the infographic material development was increasingly directed by community representatives' commentary on their groups' real-time needs and communication preferences. This feedback noticeably guided the choice, style, and presentation of infographic content while also directing dissemination strategies and vaccine confidence building activities. CONCLUSIONS The CCT process to create COVID-19 vaccine communication materials led to evolving co-operation between groups who had not routinely worked together before; strong community engagement was a key driver of change. Ensuring a respectful environment for open dialogue and visibly using feedback to create information products provided a foundation for building relationships. Finally, our data indicate participants sought reinforcement of close cooperative ties and continued investment in shared responsibility for community partnership-based public health.
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Affiliation(s)
- Elizabeth Vernon-Wilson
- School of Pharmacy, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada
| | - Moses Tetui
- School of Pharmacy, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Mathew DeMarco
- School of Pharmacy, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada
| | - Nancy M Waite
- School of Pharmacy, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada.
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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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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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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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Martinez Leal I, Njoh J, Chen TA, Foreman-Hays F, Reed BC, Haley SA, Chavez K, Reitzel LR, Obasi EM. Exploring COVID-19 Vaccine Attitudes among Racially and Ethnically Minoritized Communities: Community Partners' and Residents' Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3372. [PMID: 36834067 PMCID: PMC9964615 DOI: 10.3390/ijerph20043372] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/11/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
COVID-19 has disproportionately affected Black, Indigenous, and People of Color (BIPOC) communities, yet rates of COVID-19 vaccination remain low among these groups. A qualitative study was undertaken to better understand the factors contributing to low vaccine acceptance among these communities. Seventeen focus groups were conducted in English and Spanish from 8/21 to 9/22, with representatives from five critical community sectors: (1) public health departments (n = 1); (2) Federally Qualified Health Centers (n = 2); (3) community-based organizations (n = 1); (4) faith-based organizations (n = 2); and (5) BIPOC residents in six high-risk, underserved communities in metropolitan Houston (n = 11), for a total of 79 participants, comprising 22 community partners and 57 community residents. A social-ecological model and anti-racism framework were adopted to guide data analysis using thematic analysis and constant comparison, which yielded five key themes: (1) legacy of structural racism: distrust and threat; (2) media misinformation: mass and social; (3) listening and adapting to community needs; (4) evolving attitudes towards vaccination; and (5) understanding alternative health belief systems. Although structural racism was a key driver of vaccine uptake, a notable finding indicated community residents' vaccine attitudes can be changed once they are confident of the protective benefits of vaccination. Study recommendations include adopting an explicitly anti-racist lens to: (1) listen to community members' needs and concerns, acknowledge their justified institutional distrust concerning vaccines, and learn community members' healthcare priorities to inform initiatives built on local data; (2) address misinformation via culturally informed, consistent messaging tailored to communal concerns and delivered by trusted local leaders through multimodal community forums; (3) take vaccines to where people live through pop-up clinics, churches, and community centers for distribution via trusted community members, with educational campaigns tailored to the needs of distinct communities; (4) establish vaccine equity task forces to continue developing sustainable policies, structures, programs and practices to address the structural issues driving vaccine and health inequities within BIPOC communities; and (5) continue investing in an effective infrastructure for healthcare education and delivery, essential for competently responding to the ongoing healthcare and other emergency crises that impact BIPOC communities to achieve racial justice and health equity in the US. Findings underscore the crucial need to provide culturally tailored health education and vaccination initiatives, focused on cultural humility, bidirectionality, and mutual respect to support vaccine re-evaluation.
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Affiliation(s)
- Isabel Martinez Leal
- Department of Health Disparities Research, MD Anderson Cancer Center, Houston, TX 77230, USA
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA
| | - Journa Njoh
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA
- HEALTH Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA
| | - Tzuan A. Chen
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA
- HEALTH Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA
| | - Faith Foreman-Hays
- Houston Health Department, 8000 North Stadium Dr., Houston, TX 77054, USA
| | - Brian C. Reed
- Department of Clinical Sciences, Tillman J. Fertitta Family College of Medicine, The University of Houston, 5055 Medical Circle, Houston, TX 77204, USA
| | - Sean A. Haley
- Center for Civic & Public Policy Improvement, 5445 Almeda Rd., Suite 504, Houston, TX 77004, USA
| | - Kerry Chavez
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA
- HEALTH Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA
| | - Lorraine R. Reitzel
- Department of Health Disparities Research, MD Anderson Cancer Center, Houston, TX 77230, USA
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA
| | - Ezemenari M. Obasi
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA
- HEALTH Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA
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Teklu Y, Monangai KE, Abdul‐Mutakabbir JC, Gosser RA. Promoting health equity in pharmacy postgraduate training programs: A call to action for clinical pharmacists. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2023. [DOI: 10.1002/jac5.1719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Yodit Teklu
- VA Greater Los Angeles Healthcare System Los Angeles California USA
| | | | - Jacinda C. Abdul‐Mutakabbir
- Department of Pharmacy Practice Loma Linda University School of Pharmacy Loma Linda California USA
- Department of Basic Sciences Loma Linda University School of Medicine Loma Linda California USA
| | - Rena A. Gosser
- Department of Pharmacy Harborview Medical Center Seattle Washington USA
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Abdul-Mutakabbir JC, Tillman F, Marcelin JR, Saunders IM, Arya V. Slowed progression: The utility of Test to Treat initiatives in improving the neglected inequities of COVID-19 among racially/ethnically minoritized groups. J Am Pharm Assoc (2003) 2023; 63:424-429. [PMID: 36470731 PMCID: PMC9625842 DOI: 10.1016/j.japh.2022.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/22/2022] [Accepted: 10/27/2022] [Indexed: 11/13/2022]
Abstract
In the United States, coronavirus disease 2019 (COVID-19) has resulted in more than 95 million infections and 1 million deaths (as of September 2022), with individuals of racially/ethnically minoritized groups being disproportionately represented among these numbers. Despite the apparent pandemic fatigue in many communities, systemic and structural racism continue to place racially/ethnically minoritized groups at a disadvantage for overcoming the virus, especially as it relates to receiving vaccinations and COVID-19 targeted therapeutics. Test to Treat programs have the potential to mitigate these disparities by rapidly identifying the presence of a COVID-19 infection and readily offering treatment options. Nonetheless, Test to Treat programs must be optimized to adequately address the limitations to care within racially/ethnically minoritized communities.
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Affiliation(s)
- Jacinda C. Abdul-Mutakabbir
- Correspondence: Jacinda C. Abdul-Mutakabbir, PharmD, MPH, Assistant Professor, Loma Linda University School of Pharmacy, 24745 Stewart St., Loma Linda, CA 92350
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