Alaska Native Communities Advancing Vaccine Uptake

项目总结 阿拉斯加土著和美国印第安人(Anai)社区正在经历不成比例的SARS- 美国的CoV-2感染及其后遗症。截至2021年9月，阿奈人的累计发病率为 每10万例新冠肺炎病例中有9,256例，而非西班牙裔白人中这一比例为5,445例。当前的增长率 每10万人中与新冠肺炎相关的死亡人数为220人，而阿奈人为137人 非西班牙裔白人。广泛接种疫苗仍然是控制新冠肺炎发病率和发病率的最佳策略 死亡率，但美国是世界上疫苗接受率最低的国家之一，地区差异很大。 很少有研究试图了解或解决阿奈人接种新冠肺炎疫苗的障碍， 尽管独特的地理、历史和文化因素可能会影响这一地区的疫苗接种 人口。我们已经成立了一个由阿拉斯加各地的部落卫生领袖组成的联盟，以更好地了解 疫苗态度和意图，包括犹豫不决，以及增加阿拉斯加阿奈州的疫苗接种率 社区。与社区顾问一起，我们将制定和实施一项以理论为导向的 以关系和尊重的价值观为基础的干预。首先，我们将使用疫苗接种跟踪 评估当前疫苗接种率并分析先前存在的定量和定性数据的数据 关于阿拉斯加农村和城市地区阿奈人的疫苗态度、意图和行为。 我们还将在阿拉斯加中南部进行一项调查，为干预设计提供信息。第二，我们将与 全州部落卫生领袖和地区社区咨询委员会创建教育信息， 故事和信息与驱动疫苗行为的信念和感知规范有关。此内容将 整合到电子健康工具包中，供社区成员和受过专门培训的社区使用 疫苗倡导者，自愿为其提供信息和激励/情感支持的外行 朋友、家人和社区。第三，我们将在阿拉斯加中南部地区启动干预 并使用覆盖范围、有效性、采用、实施和维护(RE- Aim)框架。将根据计划数据和参与者反馈进行细化，然后细化 干预措施将部署在阿拉斯加的两个农村地区并进行评估。这个项目将增加有限的 关于成人疫苗态度、意图和行为的证据基础。它保存着 有可能在受灾严重的人群中增加疫苗接种，并为未来的疫苗接种建立支持，因为 SARS-CoV2病毒继续进化。我们的研究结果将更广泛地适用于疫苗推广和 让Anai社区参与利用同行关系、他们的社交网络和eHealth来促进 健康教育和行为改变。

PROJECT SUMMARY Alaska Native and American Indian (ANAI) communities are experiencing a disproportionate share of SARS- CoV-2 infection and its sequelae in the US. As of September 2021, ANAI people had a cumulative incidence of 9,256 COVID-19 cases per 100,000, compared with 5,445 among non-Hispanic Whites. The current rate of COVID-19 associated deaths per 100,000 population is 220 among ANAI people, compared with 137 among non-Hispanic Whites. Widespread vaccination remains the best strategy to control COVID-19 morbidity and mortality, but the US has one of the lowest vaccine acceptance rates in the world with wide regional variability. Little research has attempted to understand or address barriers to COVID-19 vaccination in ANAI people, despite unique geographical, historical, and cultural factors that could influence vaccine uptake in this population. We have formed a consortium of Tribal health leaders from across Alaska to better understand vaccine attitudes and intentions, including hesitancy, and to increase vaccine uptake in Alaskan ANAI communities. In conjunction with community advisors, we will develop and implement a theory-driven intervention that is grounded in ANAI values of relationality and respect. First, we will use vaccination tracking data to assess current rates of vaccine uptake and analyze preexisting quantitative and qualitative data regarding vaccine attitudes, intentions, and behavior among ANAI people in rural and urban areas of Alaska. We will also conduct a survey in southcentral Alaska to inform intervention design. Second, we will work with statewide Tribal health leaders and regional Community Advisory Boards to create educational information, stories, and messages keyed to the beliefs and perceived norms that drive vaccine behavior. This content will be incorporated into an eHealth toolkit for use by community members and specially trained community vaccine advocates, laypeople who volunteer to provide information and motivational/emotional support to their friends, families, and communities. Third, we will launch the intervention in the southcentral region of Alaska and evaluate effectiveness using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE- AIM) framework. Refinements based on program data and participant feedback will be made, then the refined intervention will be deployed in two rural regions of Alaska and evaluated. This project will add to the limited evidence base regarding adult vaccine attitudes, intentions, and behaviors among ANAI people. It holds the potential to increase vaccination in a hard-hit population and build support for future vaccination as SARS-CoV2 continues to evolve. Our findings will have broader applicability to vaccine outreach and engaging ANAI communities in leveraging peer relationships, their social networks, and eHealth to promote health education and behavior change.