Navajo NARCH Partnership

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PROJECT ABSTRACT Navajo Nation (NN) has been a leader in the launch of COVID-19 vaccines. On April 9, 2021, NN reported 37.4% of the Nation’s residents as full vaccinated. In comparison on the same date, CDC reported 19.9% of US adults as being fully vaccinated. Yet vaccine hesitancy does exist in NN. Based on interviews conducted by the media and review of digital platform discussions, vaccine hesitancy is grounded in historical mistrust of the government and more recently, misinformation and conspiracies theories promulgated in social media. In other cases, some are concerned they would be “stealing a spot” from an elder or fellow citizen with underlying health conditions. Trusted health messengers and culturally centered information are effective means of health education leading to behavior change in NN. The proposed study, Diné Teachings and Public Health Students Informing Peers and Relatives about Vaccine Education (RAVE), will integrate these two determinants, trust and culture, to address adults’ vaccine concerns and hesitancy. The objective is to increase their knowledge of vaccine safety and shift their intention to get vaccinated. Trusted messengers, Diné (Navajo) public health students will be trained to deliver culturally centered, scientifically accurate vaccine safety information and use Diné specific relationality and etiquette to talk to peers and relatives who self-identify as vaccine hesitant. Traditional Knowledge Holders will be interviewed to document cultural teachings that address individual and collective health behaviors. This cultural knowledge will guide the adaptation of state available materials developed for lay health educators. The goal of this Administrative Supplement is to assess Diné public health students’ ability to use culturally centered vaccine safety education to shift vaccine hesitancy to intention in their Diné peers and relatives. This goal aligns with the workforce capacity building mission of the parent award, the Navajo Native American Research Center for Health Partnership, a collaboration between Diné College, a tribal college of the NN, and Northern Arizona University. RAVE proposes three aims to address this goal: 1) Document a minimum of 25% of Diné College student, faculty, and staff’s own vaccine hesitancy and their perception of their peers and family members’ vaccine hesitancy; 2) Train Diné College a minimum of 35 public health students as health messengers able to provide culturally centered, scientifically valid education about vaccine safety to a minimum of 10 NN residents, each; and 3) Document change in a minimum of 350 Diné adults’ knowledge of vaccine safety after receiving the education provided by a health messenger. The Navajo NARCH team is uniquely positioned to assess vaccine hesitancy in a subgroup within the NN and to prepare students as health messengers to leverage their education and relationships to provide vaccine safety information to their peers and relatives. Achieving the study aims will inform health information delivery strategies in NN specifically and Native Nations, generally, and document the role of the messenger and the culturally centered approaches to yielding change in health behavior intention.