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Dunleavy VO, Ahn RJ, Grace LD, Mayo D. Acceptability and Feasibility of "Latinos Unidos": A Microgame Resource Combatting Health Misinformation for Latinos Living with HIV. J Health Commun 2024:1-12. [PMID: 38592967 DOI: 10.1080/10810730.2024.2339238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
COVID-19 mitigation strategies, including shelter-in-place orders, masking, and social distancing combined with the widespread "infodemic" may interact synergistically to worsen already compromised mental health outcomes of people living with HIV (PLWH). We developed a three-part microgame intervention, "Latino Unidos," targeting media health literacy education that could be mobilized to protect the mental health of Latinx PLWH as well as promote HIV care during the pandemic. We utilized a community-based approach by working with two local community partners and conducted interviews and focus groups from three perspectives: Latino PLWH, ID providers, and community health workers. Participants evaluated three microgame modules for literacy objectives, acceptability, and feasibility. Feedback offered from each round of module review indicated that each of the game experiences supported the aim of addressing health mis/disinformation. Results indicated relative success demonstrated by positive responses on module literacy goals, acceptability, and feasibility. Our approach illuminates the intersection between content development around media literacy and microgame modality as a novel mHealth resource. Study outcomes offer suggestions and strategies for optimizing content effectiveness and intervention material dissemination.
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Affiliation(s)
- Victoria Orrego Dunleavy
- Department of Communication Studies, School of Communication, University of Miami, Miami, Florida, USA
| | - Regina Jihea Ahn
- Department of Strategic Communication, School of Communication, University of Miami, Miami, Florida, USA
| | - Lindsay D Grace
- Department of Interactive Media, School of Communication, University of Miami, Miami, Florida, USA
| | - Daniel Mayo
- College of Public Health, National Taiwan University, Taipei, Taiwan
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Rodriguez-Diaz CE, Seager L, Navalta C, Lapointe L, Laino A, Wilhite D, Melin K, Varga L, Zea MC. Experiences of Latinx sexual and gender minorities with access to healthcare during COVID-19 stay-at-home orders. Am J Health Syst Pharm 2024; 81:297-305. [PMID: 38146952 PMCID: PMC10988101 DOI: 10.1093/ajhp/zxad330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Indexed: 12/27/2023] Open
Abstract
PURPOSE The coronavirus disease 2019 (COVID-19) pandemic affected all social systems, but healthcare services were particularly disrupted. The pandemic also had a disproportionate impact on populations made socially vulnerable. In this study, we documented the experiences of Latinx sexual and gender minority (SGM) individuals with access to care during COVID-19 stay-at-home orders. METHODS Semistructured qualitative interviews assessing experiences during the stay-at-home orders in response to the COVID-19 pandemic and patients' experiences accessing healthcare during this period were conducted with 21 Latinx SGM individuals from the Washington, DC, area. Data were analyzed using rapid qualitative analysis (RQA), and salient themes were identified. RESULTS The RQA revealed 3 themes reflecting participants' experiences with pharmaceutical care during COVID-19 stay-at-home orders: (1) challenges in accessing HIV services; (2) community engagement; and (3) providers supporting access to care. Participants experienced problems with adherence to medication, transportation, and technology, as well as delays in care and miscommunication with providers. Latinx SGM individuals demonstrated engagement in response to this emergency as a community and valued their providers and their efforts to facilitate access to care. CONCLUSION The COVID-19 pandemic strained healthcare services. Findings from this study show that the impact of the pandemic on the provision of care increased the vulnerability of Latinx SGM people. Future research should explore the impact of public health emergencies on the health of populations historically made socially vulnerable, and innovative solutions should be identified to eliminate these barriers to health equity.
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Affiliation(s)
| | - Loxley Seager
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Cassandra Navalta
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Lauren Lapointe
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Alanna Laino
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Daniel Wilhite
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Kyle Melin
- School of Pharmacy, University of Puerto Rico, San Juan, PR, USA
| | - Leah Varga
- DC Department of Health, Washington, DC, USA
| | - Maria Cecilia Zea
- Department of Psychology and Brain Sciences, George Washington University, Washington, DC, USA
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Al-Rawi A, Jamieson K. Characterizing the Gendered Twitter Discussion of COVID-19 Hoax. Health Commun 2023; 38:3366-3375. [PMID: 36411526 DOI: 10.1080/10410236.2022.2149112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
We collected data from Twitter and used content analysis to better understand the gendered discussion around COVID-19 as a hoax. We identified three main categories in the inductive stage of the research: (1) sympathetic to human rights & perceived injustice, (2) invincibility and superiority of COVID hoaxers, (3) conspiracies and/or hidden agendas. The findings of the study show that among all gender groups, the first category is the most dominant (44.4%), the third category is the second most frequent (35.6%), and the last category (19.9%) is the least frequent. However, when the discussion is centered on men (40.2%) and gender and sexual minorities (GSM; 69.6%) groups, the last category is the most dominant with regard to stigmatizing GSM groups by falsely associating them with progressive secret agendas. As for women's group, being sympathetic to human rights and the perceived injustice against them during the pandemic constitute the most dominant category (51.5%). We discuss the implications of the study in the conclusion.
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Zapata JP, Zamantakis A, Queiroz AAFLN. Identification of Determinants and Implementation Strategies to Increase Long-Acting Injectable PrEP for HIV Prevention Among Latino Men Who Have Sex with Men (MSM). J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01678-3. [PMID: 37347407 DOI: 10.1007/s40615-023-01678-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 06/05/2023] [Accepted: 06/08/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Latino men who have sex with men (LMSM) are disproportionally affected by HIV infections in the USA. The uptake rate of pre-exposure prophylaxis (PrEP) for HIV prevention has remained low among LMSM. Long-acting injectable PrEP (LAI-PrEP) may have the potential to improve structural, behavioral, and cognitive barriers to adherence. Given the potential benefits of LAI-PrEP and the limited data with this population, the aim of our study was to explore experiences and attitudes of LAI-PrEP among LMSM and identify implementation barriers compared to the standard oral presentation, align proposed implementation strategies, and propose outcomes to monitor and assess impact. METHODS In this qualitative study, guided by the Consolidated Framework for Implementation Research, we explored health care providers perspectives on facilitators and barriers to LAI-PrEP implementation strategies for LMSM. Interviews were recorded, transcribed, and analyzed using thematic content analysis. RESULTS Fear of immigration policies, ability to conceal PrEP medication, health insurance coverage, health information fatigue, lack of culturally adapted information, and provider's lack of knowledge were among the main barriers to LAI-PrEP. Most providers discussed the need for adapted and/or tailored training materials for and suggested designing marketing materials and specific clinical recommendations for LAI-PrEP. CONCLUSION In order to ensure an effective adaptation process that encompasses local and national goals of HIV prevention, future interventions should be designed in a way that incorporates culturally relevant information for LMSM. This study provides an implementation research logic model to guide future studies.
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Affiliation(s)
- Juan Pablo Zapata
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave. 14th Floor, Chicago, IL, 60611, USA.
| | - Alithia Zamantakis
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave. 14th Floor, Chicago, IL, 60611, USA
| | - Artur Acelino Francisco Luz Nunes Queiroz
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave. 14th Floor, Chicago, IL, 60611, USA
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Weinstein ER, Balise R, Metheny N, Jose Baeza Robba M, Mayo D, Michel C, Chan B, Safren SA, Harkness A. Factors associated with latino sexual minority men's likelihood and motivation for obtaining a COVID-19 vaccine: a mixed-methods study. J Behav Med 2023; 46:116-128. [PMID: 35476250 PMCID: PMC9043889 DOI: 10.1007/s10865-022-00315-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/29/2022] [Indexed: 01/01/2023]
Abstract
Minoritized communities are underreached by biomedical interventions, such as the COVID-19 vaccine. This mixed-methods study identified factors associated with vaccine likelihood (VL) and uptake (VU) among 187 Latino sexual minority men (LSMM) in South Florida. Regression models with LASSO variable selection and Classification and Regression Trees (CART) assessed determinants of VL and VU while open-ended questions were evaluated using thematic content analysis. VL (range 1-7; M = 6.00, SD = 1.84) and VU (63.6%) was high. LASSO modeling identified being insured, worrying about others, fear of transmitting COVID-19, and financial stress as the most influential factors for VL; working remotely from home was important for VU. Time (weeks) since addition of COVID-19 vaccination-related questions (December 2nd, 2020) was associated with both outcomes across both modeling techniques. Convergence between data suggests capitalizing on altruistic motivations and improving accessibility to vaccine campaigns are valuable assets to increase LSMM's vaccine confidence.
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Affiliation(s)
| | - Raymond Balise
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, USA
| | - Nicholas Metheny
- School of Nursing and Health Studies, University of Miami, Miami, USA
| | | | - Daniel Mayo
- College of Public Health, National Taiwan University, Taipei, Taiwan
| | | | - Bill Chan
- Department of Psychology, University of Miami, Miami, USA
| | | | - Audrey Harkness
- School of Nursing and Health Studies, University of Miami, Miami, USA
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St. George SM, Harkness AR, Rodriguez-Diaz CE, Weinstein ER, Pavia V, Hamilton AB. Applying Rapid Qualitative Analysis for Health Equity: Lessons Learned Using "EARS" With Latino Communities. Int J Qual Methods 2023; 22:10.1177/16094069231164938. [PMID: 38463016 PMCID: PMC10923582 DOI: 10.1177/16094069231164938] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Qualitative research amplifies the voices of marginalized communities and thus plays a critical role in shaping our understanding of health inequities and their social determinants. Traditional qualitative approaches, such as grounded theory or thematic analysis, require extensive training and are time- and labor-intensive; as such, they may not be adequately suited to address healthy equity issues that require a swift response. Rapid qualitative analysis (RQA) is an action-oriented approach to qualitative data analysis that may be used when findings are needed to quickly inform practice. RQA capitalizes on using a team to summarize key points from qualitative data into matrices to explore relevant themes efficiently and systematically. In this paper, we provide case examples from our work applying RQA to health equity research with Latino communities to address community needs, such as responses to public health emergencies and the development of service delivery and technology interventions for infectious and chronic diseases. We draw from our collective experiences to share lessons learned and provide the following specific recommendations ("EARS") to researchers interested in applying RQA for health equity research: (1) Employ RQA to address rapidly evolving, urgent, health equity challenges; (2) Assure quality and rigor throughout the RQA process; (3) Respond to barriers and problem-solve as needed; and (4) Strengthen community relationships before, during, and after using RQA. Overall, we advocate for the use of RQA to promote health equity due to its ability to integrate the vital perspectives of marginalized communities and efficiently respond to their needs.
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Affiliation(s)
- Sara M. St. George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Audrey R. Harkness
- University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA
| | - Carlos E. Rodriguez-Diaz
- Department of Prevention and Community Health and Gill-Lebovic Center for Community Health in the Caribbean and Latin America, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | | | - Vanina Pavia
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alison B. Hamilton
- VA Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
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Harkness A, Morales V, Defreitas W, Atuluru P, Jaramillo J, Weinstein ER, Feaster DJ, Safren S, Balise R. Impact of COVID-19 on HIV service delivery in Miami-Dade County: a mixed methods study. BMC Health Serv Res 2022; 22:1476. [PMID: 36463177 PMCID: PMC9719219 DOI: 10.1186/s12913-022-08849-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 11/16/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Facilitating access to HIV prevention and treatment is imperative in Miami-Dade County (MDC), a U.S. HIV epicenter. With COVID-19, disruptions to these services have occurred, leading HIV organizations to innovate and demonstrate resilience. This study documented COVID-19 related disruptions and resilient innovations in HIV services within MDC. METHODS This mixed methods cross-sectional study included HIV test counselors in MDC. In the quantitative component (N=106), participants reported COVID-19 impacts on HIV service delivery. Data visualization examined patterns within organizations and throughout the study period. Generalized estimating equation modeling examined differences in service disruptions and innovations. In the qualitative component, participants (N=20) completed interviews regarding COVID-19 impacts on HIV services. Rapid qualitative analysis was employed to analyze interviews. RESULTS Quantitative data showed that innovations generally matched or outpaced disruptions, demonstrating resilience on HIV service delivery during COVID-19. HIV testing (36%, 95%CI[28%, 46%]) and STI testing (42%, 95%CI[33%, 52%]) were most likely to be disrupted. Sexual/reproductive health (45%, 95%CI[35%, 55%]), HIV testing (57%, 95%CI[47%,66%]), HIV case management (51%, 95%CI[41%, 60%]), PrEP initiation (47%, 95%CI[37%,57%]), and STI testing (47%, 95%CI[37%, 57%]) were most likely to be innovated. Qualitative analysis revealed three orthogonal themes related to 1) disruptions (with five sub-components), 2) resilient innovations (with four sub-components), and 3) emerging and ongoing health disparities. CONCLUSIONS HIV organizations faced service disruptions during COVID-19 while also meaningfully innovating. Our findings point to potential changes in policy and practice that could be maintained beyond the immediate impacts of COVID-19 to enhance the resilience of HIV services. Aligning with the US Ending the HIV Epidemic Plan and the National Strategy for HIV/AIDS, capitalizing on the observed innovations would facilitate improved HIV-related health services for people living in MDC and beyond.
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Affiliation(s)
- Audrey Harkness
- School of Nursing and Health Studies, University of Miami, 5030 Brunson Drive, Miami, FL, 33146, USA.
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
- Department of Psychology, University of Miami, Coral Gables, FL, USA.
| | - Vanessa Morales
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Wayne Defreitas
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Pranusha Atuluru
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jahn Jaramillo
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Daniel J Feaster
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Steven Safren
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Raymond Balise
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
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Weinstein ER, Glynn TR, Simmons EM, Safren SA, Harkness A. Structural Life Instability and Factors Related to Latino Sexual Minority Men's Intention to Engage with Biomedical HIV-Prevention Services. AIDS Behav 2022; 26:3914-3924. [PMID: 35661015 PMCID: PMC9166207 DOI: 10.1007/s10461-022-03718-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2022] [Indexed: 02/07/2023]
Abstract
Latino sexual minority men (LSMM) experience high rates of HIV and co-occurring health inequities. Structural and psychosocial factors may lead to mental health problems and decreased engagement with biomedical HIV-prevention behaviors. This cross-sectional study assessed the extent to which structural life instability is related to biomedical HIV-prevention services engagement (HIV-testing and PrEP uptake) indirectly through psychological distress among 290 LSMM living in Greater Miami. Using hybrid structural equation modeling, significant direct effects from structural life instability to psychological distress emerged, as did effects from psychological distress (i.e., depression and anxiety) to HIV-prevention engagement. Structural life instability had a significant indirect effect to HIV-prevention engagement via psychological distress. Findings show a possible mechanism explaining the relationship between structural life instability and biomedical HIV-prevention engagement among a group of LSMM, a subpopulation at increased susceptibility for HIV acquisition in an U.S. HIV epicenter.
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Affiliation(s)
| | - Tiffany R Glynn
- Department of Psychology, University of Miami, Miami, FL, USA
| | - Ervin M Simmons
- Department of Psychology, University of Miami, Miami, FL, USA
| | - Steven A Safren
- Department of Psychology, University of Miami, Miami, FL, USA
| | - Audrey Harkness
- Department of Psychology, University of Miami, Miami, FL, USA
- School of Nursing and Health Studies, University of Miami, Miami, FL, USA
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Alessi EJ, Cheung SP, Sarna V, Dentato MP, Eaton A, Craig SL. Experiences of COVID‐19 pandemic‐related stress among sexual and gender minority emerging adult migrants in the United States. Stress Health 2022; 39:414-428. [PMID: 36070206 PMCID: PMC9539256 DOI: 10.1002/smi.3198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 08/03/2022] [Accepted: 09/01/2022] [Indexed: 11/07/2022]
Abstract
There is a dearth of research that examines COVID-19-related stress among multiply marginalised individuals who are in the developmental phase of emerging adulthood. This qualitative study investigated how the intersection of emerging adulthood, sexual and gender minority (SGM) identity, and migrant status were reflected in the experiences of SGM individuals (n = 37; ages 20-25 years old) who migrated to various parts of the United States in the last 5 years. Data were collected online using semi-structured interviews. Thematic analysis revealed that participants' developmental processes (e.g., identity exploration, building financial independence) were shaped by pandemic-related stressors, especially unemployment and financial instability. Participants who were able to maintain employment did so but at the risk of their health and safety. Findings also showed that participants experienced feelings of anxiety and depression due to social isolation, but online communication played an important role in combatting loneliness. Findings highlight the potential for trauma-informed and intersectional approaches to practice with SGM emerging adult migrants and expanded health services and temporary entitlement programs to mitigate the pandemic's effects on this population's psychosocial and financial well-being.
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Affiliation(s)
- Edward J. Alessi
- RutgersThe State University of New JerseyNew BrunswickNew JerseyUSA
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Andrasik MP, Maunakea AK, Oseso L, Rodriguez-Diaz CE, Wallace S, Walters K, Yukawa M. Awakening: The unveiling of historically unaddressed social inequities during the COVID-19 pandemic in the United States. Infect Dis Clin North Am 2022; 36:295-308. [PMID: 35636901 PMCID: PMC8806123 DOI: 10.1016/j.idc.2022.01.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Michele P Andrasik
- Vaccine and Infectious Disease Division, Fred Hutchinson, 1100 Eastlake Avenue, E3-300, Seattle, WA 98109, USA.
| | - Alika K Maunakea
- Department of Anatomy, Biochemistry, and Physiology, John A. Burns School of Medicine, University of Hawaii, 651 Ilalo Street, BSB-222K, Honolulu, HI 96813, USA
| | - Linda Oseso
- Vaccine and Infectious Disease Division, Fred Hutchinson, 1100 Eastlake Avenue, E3-300, Seattle, WA 98109, USA
| | - Carlos E Rodriguez-Diaz
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Suite 300, Washington, DC 20052, USA
| | - Stephaun Wallace
- Vaccine and Infectious Disease Division, Fred Hutchinson, 1100 Eastlake Avenue, E3-300, Seattle, WA 98109, USA
| | - Karina Walters
- Indigenous Wellness Research Institute, University of Washington, 4101 15th Avenue NE Box 354900, Seattle, WA 98105, USA
| | - Michi Yukawa
- Division of Geriatrics, University of California San Francisco, San Francisco, CA 94121, USA; Geriatric Palliative and Extended Care, San Francisco VA Medical Center, 490 Illinois Street, Floor 8, UCSF BOX 1265, San Francisco, CA 94143, USA
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