COVID-19 Vaccine Decision-making Factors in Racial and Ethnic Minority Communities in Los Angeles, California.
COVID-19 Vaccine Decision-making Factors in Racial and Ethnic Minority Communities in Los Angeles, California.
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DOI：
10.1001/jamanetworkopen.2021.27582
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发表时间：
2021-09-01
影响因子：
13.8
通讯作者：
Brown AF
中科院分区：
文献类型：
--
作者：
Carson SL;Casillas A;Castellon-Lopez Y;Mansfield LN;Morris D;Barron J;Ntekume E;Landovitz R;Vassar SD;Norris KC;Dubinett SM;Garrison NA;Brown AF
加利福尼亚州洛杉矶县 COVID-19 感染和发病高风险的多种族社区成员认为哪些因素会影响疫苗决策和可接受性？在这项定性研究中，来自洛杉矶县种族和族裔社区的 70 名参与者描述了一个复杂的疫苗接种决策过程，该过程受到错误信息和政治化、对历史不平等和虐待的深切忧虑、与社会劣势相关的准入障碍以及对社区参与和值得信赖的信息传递者的需求的影响。这项研究表明，COVID-19 疫苗公平性需要多方面的政策和规划，尊重社区的关切和知情审议的需要，投资于社区参与，提高信息的可及性和透明度，并减少疫苗接种的结构性障碍。 COVID-19 大流行对种族和少数民族社区产生了不成比例的影响，这些社区先前存在的临床和社会条件扩大了健康和社会差距。其中许多社区报告称，疫苗信心较低，且 COVID-19 疫苗的接种率较低。了解影响疫苗接种多方面决策过程的因素对于缩小与 COVID-19 相关的差异至关重要。研究 COVID-19 感染和发病高风险的多种族社区成员报告的有助于疫苗决策的因素。这项定性研究使用社区参与的方法，从 2020 年 11 月 16 日到 2021 年 1 月 28 日与洛杉矶县居民进行虚拟焦点小组讨论。通过电子邮件、视频和电话联系社区合作伙伴网络招募潜在参与者。焦点小组根据自我认同的种族和民族以及年龄进行分层。使用反思性主题分析对成绩单进行分析。使用世界卫生组织的疫苗犹豫矩阵类别，根据背景、个人和疫苗特定影响对主题进行分类。总共进行了 13 个焦点小组，共有 70 名参与者（50 [71.4%] 女性），他们自认为是美洲印第安人 (n = 17 [24.3%])、黑人/非裔美国人 (n = 17 [24.3%])、菲律宾人/菲律宾人 (n = 11 [15.7%])、拉丁裔/拉丁裔(n = 15 [21.4%])，或太平洋岛民 (n = 10 [14.3%])。共有 39 名参与者（55.7%）是来自高贫困邮政编码的居民，34 名参与者（48.6%）是重要工作人员。由此产生的主题包括对公平疫苗分配的政策影响：背景影响（信息不明确和不可靠、对不公平获取或差别待遇的担忧、不道德研究的不信任、可及性和住宿障碍、资格不确定性以及对政治化或制药业影响的担忧）；社会和群体影响（与可信赖的信使或信息接触不足、利他动机、医疗不信任和自治愿望）；疫苗接种的具体影响（亚人群对疫苗证据的需求、对疫苗开发的误解、分配模糊性、疫苗接种安全偏好、认识疫苗公平性的重要性、疫苗安排的负担、成本不确定性以及对从业者建议的渴望）。在这项定性研究中，参与者报告了影响其疫苗决策的许多因素，包括对疫苗获取不公平的担忧。与会者认可了促进疫苗信心的政策建议和战略。这些结果表明，支持知情审议和实现疫苗公平需要采取多方面、多层次的政策方法，以提高 COVID-19 疫苗知识、增强信任并解决疫苗接种的社会文化和结构性障碍之间复杂的相互作用。这项定性研究进行了虚拟焦点小组，以探讨加利福尼亚州洛杉矶县受影响严重的多种族社区成员报告的 COVID-19 疫苗准备的障碍和促进因素。
What factors do members of multiethnic communities at high risk for COVID-19 infection and morbidity in Los Angeles County, California, cite as influencing vaccine decision-making and acceptability? In this qualitative study, 70 participants from racial and ethnic minority communities in Los Angeles County described a complex vaccination decision-making process influenced by misinformation and politicization, deep apprehension related to historical inequity and mistreatment, access barriers related to social disadvantage, and a need for community engagement and trusted messengers. This study suggests that COVID-19 vaccine equity will require multifaceted policies and programming that respect community concerns and the need for informed deliberation, invest in community-based engagement, improve accessibility and transparency of information, and reduce structural barriers in vaccination. The COVID-19 pandemic has had disproportionate effects on racial and ethnic minority communities, where preexisting clinical and social conditions amplify health and social disparities. Many of these communities report lower vaccine confidence and lower receipt of the COVID-19 vaccine. Understanding factors that influence the multifaceted decision-making process for vaccine uptake is critical for narrowing COVID-19–related disparities. To examine factors that members of multiethnic communities at high risk for COVID-19 infection and morbidity report as contributing to vaccine decision-making. This qualitative study used community-engaged methods to conduct virtual focus groups from November 16, 2020, to January 28, 2021, with Los Angeles County residents. Potential participants were recruited through email, video, and telephone outreach to community partner networks. Focus groups were stratified by self-identified race and ethnicity as well as age. Transcripts were analyzed using reflexive thematic analysis. Themes were categorized by contextual, individual, and vaccine-specific influences using the World Health Organization’s Vaccine Hesitancy Matrix categories. A total of 13 focus groups were conducted with 70 participants (50 [71.4%] female) who self-identified as American Indian (n = 17 [24.3%]), Black/African American (n = 17 [24.3%]), Filipino/Filipina (n = 11 [15.7%]), Latino/Latina (n = 15 [21.4%]), or Pacific Islander (n = 10 [14.3%]). A total of 39 participants (55.7%) were residents from high-poverty zip codes, and 34 (48.6%) were essential workers. The resulting themes included policy implications for equitable vaccine distribution: contextual influences (unclear and unreliable information, concern for inequitable access or differential treatment, references to mistrust from unethical research studies, accessibility and accommodation barriers, eligibility uncertainty, and fears of politicization or pharmaceutical industry influence); social and group influences (inadequate exposure to trusted messengers or information, altruistic motivations, medical mistrust, and desire for autonomy); and vaccination-specific influences (need for vaccine evidence by subpopulation, misconceptions on vaccine development, allocation ambiguity, vaccination safety preferences, the importance of perceiving vaccine equity, burden of vaccine scheduling, cost uncertainty, and desire for practitioner recommendation). In this qualitative study, participants reported a number of factors that affected their vaccine decision-making, including concern for inequitable vaccine access. Participants endorsed policy recommendations and strategies to promote vaccine confidence. These results suggest that support of informed deliberation and attainment of vaccine equity will require multifaceted, multilevel policy approaches that improve COVID-19 vaccine knowledge, enhance trust, and address the complex interplay of sociocultural and structural barriers to vaccination. This qualitative study conducted virtual focus groups to explore barriers and facilitators to COVID-19 vaccine readiness reported by members of disproportionately affected multiethnic communities in Los Angeles County, California.
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影响因子：
5.9
作者：
Khubchandani J;Sharma S;Price JH;Wiblishauser MJ;Sharma M;Webb FJ
通讯作者：
Webb FJ
DOI：
10.15585/mmwr.mm6948a2
发表时间：
2020-12-04
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Center KE;Da Silva J;Hernandez AL;Vang K;Martin DW;Mazurek J;Lilo EA;Zimmerman NK;Krow-Lucal E;Campbell EM;Cowins JV;Walker C;Dominguez KL;Gallo B;Gunn JKL;McCormick D;Cochran C;Smith MR;Dillaha JA;James AE
通讯作者：
James AE
DOI：
10.1016/j.socscimed.2020.113638
发表时间：
2021-03
期刊：
Social science & medicine (1982)
影响因子：
--
作者：
Callaghan T;Moghtaderi A;Lueck JA;Hotez P;Strych U;Dor A;Fowler EF;Motta M
通讯作者：
Motta M
DOI：
10.1016/s0140-6736(20)32642-8
发表时间：
2021-01-02
期刊：
Lancet (London, England)
影响因子：
--
作者：
Burgess RA;Osborne RH;Yongabi KA;Greenhalgh T;Gurdasani D;Kang G;Falade AG;Odone A;Busse R;Martin-Moreno JM;Reicher S;McKee M
通讯作者：
McKee M
影响因子：
5.5
作者：
Griffith DM;Bergner EM;Fair AS;Wilkins CH
通讯作者：
Wilkins CH