Community-engaged research to promote SARS-CoV-2 vaccine uptake in Montana's American Indian and rural communities

项目摘要/摘要 种族和少数民族以及包括农村成年人在内的其他医疗服务不足的群体一直受到 尤其是导致新冠肺炎疾病的SARS-CoV-2病毒的重创。在美国， 农村地区的新冠肺炎病例死亡率比城市地区高出25%。在蒙大拿州，一个大型的农村西部 在该州，美国印第安人(AIS)占总人口的7%，但却占新冠肺炎死亡人数的18%。自.起 2021年4月，SARS-CoV-2疫苗在全州范围内为符合条件的成年人广泛提供；然而，只有 蒙大拿州33%的成年人完全接种了疫苗，对疫苗的需求正在减弱。当我们从 对于长期提供这些疫苗的初始实施，初级保健提供者(PCP)将 负责推荐加强剂量，向新符合条件的人群提供疫苗，如 并说服以前未接种疫苗的人接种疫苗。在这个人口中心 健康研究(CPHR)社区参与研究项目，我们的长期目标是从文化上识别 增加SARS-CoV-2的具体和社区称职的卫生系统和提供者级别的战略 人工智能和农村人口对疫苗的接受度。为了实现这一目标，我们将与所有国家卫生组织合作 位于密苏拉的Missoula中心对已接种和未接种的AI和农村成年人进行定性访谈 确定SARS-CoV-2疫苗信心和犹豫的原因(目标1)。使用定性内容 分析，我们还将确定可信的疫苗信息来源和参与者生成的想法 促进这些社区对疫苗的信心和接受程度。我们还将在全州范围内对 初级合作伙伴，以确定应对SARS-CoV-2疫苗迟疑的准备情况(目标2)。这项调查将包括 关于SARS-CoV-2疫苗的知识、态度和信念的模块，包括问题 关于解决患者的疫苗问题和关注的信心，以及以下问题 对未来儿童疫苗授权的看法。由于我们与蒙大拿州的合作历史 公共卫生和公共服务部免疫科和整个卫生系统 国家，我们的定位是促进这项研究结果迅速转化为免疫服务 交付实践。此外，我们预计这项研究的结果将推广到其他州 我们的团队将成为关于有效的国家对话的关键贡献者 应对易感染禽流感和农村人群中SARS-CoV-2疫苗迟疑的策略。

Project Summary/Abstract Racial and ethnic minorities, and other medically underserved groups, including rural adults, have been particularly hard hit by SARS-CoV-2, the virus that causes COVID-19 disease. In the United States, the COVID-19 case fatality rate is 25% higher in rural versus urban areas. In Montana, a large, rural Western state, American Indians (AIs) are 7% of the population but have accounted for 18% of COVID-19 deaths. As of April 2021, SARS-CoV-2 vaccines are widely available to eligible adults throughout the state; however, only 33% of Montana adults are fully vaccinated, and demand for the vaccine is waning. As we transition from initial implementation to long-term delivery of these vaccines, primary care providers (PCPs) will be responsible for recommending booster doses, offering the vaccine to newly eligible populations such as children, and convincing previously unvaccinated people to get the vaccine. In this Center for Population Health Research (CPHR) community-engaged research project, our long-term goal is to identify culturally specific and community competent health systems- and provider-level strategies for increasing SARS-CoV-2 vaccine acceptance in AI and rural populations. To achieve this goal, we will collaborate with All Nations Health Center in Missoula, MT to conduct qualitative interviews with vaccinated and unvaccinated AI and rural adults to identify causes of SARS-CoV-2 vaccine confidence and hesitancy (Aim 1). Using qualitative content analyses, we will also identify trusted sources of vaccine information and participant-generated ideas for promoting vaccine confidence and uptake in these communities. We will also conduct a statewide survey of PCPs to determine readiness for addressing SARS-CoV-2 vaccine hesitancy (Aim 2). The survey will include a module regarding knowledge, attitudes, and beliefs about the SARS-CoV-2 vaccines, including questions about confidence in addressing patients’ vaccine questions and concerns, as well as questions regarding perceptions of future vaccine authorization for children. Due to our collaborative history with the Montana Department of Public Health and Human Services Immunization Section and health systems throughout the state, we are positioned to facilitate the rapid translation of this study’s results into immunization services delivery practice. Furthermore, we anticipate that findings from this study will be generalizable to other states with similar populations, and our team will serve as a key contributor to the national conversation on effective strategies to address SARS-CoV-2 vaccine hesitancy among vulnerable AI and rural populations.