Understanding Hesitant Adopters

摘要 COVID-19已成为美国（US）的主要死亡原因之一，种族和民族 少数群体因COVID-19而暴露、住院和死亡的风险更高。人口 通过接种疫苗获得免疫力对于阻止COVID-19的传播至关重要;然而， 疫苗犹豫的种族差异引起了人们对疫苗接种计划是否会进一步扩大的担忧 COVID-19差异。据报道，少数群体对接种COVID-19疫苗更为犹豫， 一些有色人种社区接种COVID-19疫苗的可能性是白人的一半。减少 在COVID-19相关的发病率和死亡率的差异，我们必须了解和解决种族差异， 疫苗行为拟议的研究将采用混合方法嵌套研究方法，包括两个步骤 数据收集。将使用随机数字拨号收集数据，以进行手机和固定电话调查 阿肯色州成年人（N=1800）。然后，我们将利用从电话中抽取的有目的/随机样本（N=50） 调查犹豫不决的采用者的参与者（即，表示既犹豫又收到了新冠病毒- 19种疫苗）进行定性数据收集。定性部分的有目的的样本将提供丰富的 关于犹豫不决的采用者的定性数据。两种抽样方法都将对黑人/非裔美国人进行过度抽样， 西班牙裔/拉丁裔参与者。我们的具体目标是：目标1。检查与疫苗相关的特征 犹豫/意愿和疫苗行为（例如，接种与否）之间和种族/族裔群体内 使用定量方法（随机样本N=1800），由增加疫苗接种模型提供信息。目标二。 使用定量分析来研究区分犹豫的采用者和犹豫的非采用者的特征。 方法（随机样本N=1800）由增加疫苗接种模型告知。目标3：检查的作用 的思想和感情，社会进程，动机和实际问题的过程中，成为 对于那些犹豫不决并使用定性方法（有目的的随机）接种疫苗的人，他们会遵守规定 样本N= 50），采用递增接种模型进行嵌套设计。虽然有很多 记录疫苗犹豫问题和基于种族的犹豫差异的研究， 种族，几乎没有研究提供信息，可以做些什么。检查那些谁是 犹豫但接种疫苗是更好地理解可能增加吸收的因素的关键， 犹豫这项研究将提供新的和可操作的信息，研究人员和医疗保健提供者 可以用来创建干预措施，以增加犹豫不决者的疫苗接种率。

ABSTRACT COVID-19 has become one of the leading causes of death in the United States (US), and racial and ethnic minority groups experience higher risks of exposure, hospitalization, and death due to COVID-19. Population immunity through the uptake of a vaccine is critical to stopping the spread of COVID-19; however, racial and ethnic disparities in vaccine hesitancy raise concerns about whether vaccination programs will further widen COVID-19 disparities. Minority populations have reported greater hesitancy to get the COVID-19 vaccine, with some communities of color half as likely to get the COVID-19 vaccine compared to Whites. To reduce disparities in COVID-19-related morbidity and mortality, we must understand and address racial disparities in vaccine behavior. The proposed study will utilize a mixed-methods nested-study approach including two steps of data collection. Data will be collected using random digit dialing to conduct a cell and landline phone survey of adult Arkansans (N=1800). Then, we will utilize a purposeful/random sample (N=50) drawn from the phone survey participants who are hesitant adopters (i.e., expressing both hesitancy and having received the COVID- 19 vaccination) for qualitative data collection. The purposeful sample for the qualitative portion will provide rich qualitative data on hesitant adopters. Both sampling methods will oversample Black/African American and Hispanic/Latino participants. Our specific aims are: Aim 1. Examine characteristics associated with vaccine hesitancy/willingness and vaccine behavior (e.g., vaccinated or not) between and within racial/ethnic groups using quantitative methods (random sample of N=1800) informed by the Increasing Vaccination Model. Aim 2. Examine the characteristics that distinguish hesitant adopters from hesitant non-adopters using quantitative methods (random sample of N=1800) informed by the Increasing Vaccination Model. Aim 3. Examine the role of thoughts and feelings, social processes, motivations and practical issues in the process of becoming compliant among those who are hesitant and get vaccinated using qualitative methods (purposeful random sample N= 50) in a nested design informed by the Increasing Vaccination Model. Although there is much research documenting the problem of vaccine hesitancy and differences in hesitancy based on race and ethnicity, almost no studies provide information about what might be done about it. Examining those who are hesitant but are vaccinated is key to better understanding factors which might increase uptake despite hesitancy. This study will provide new and actionable information that researchers and healthcare providers can use to create interventions to increase vaccination uptake among the hesitant.