Trusted Messengers: Supporting Physicians in Promoting COVID-19 Vaccination

项目总结/摘要 严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）及其相关冠状病毒病 2019年（COVID-19）疫情是毁灭性的。在美国，超过2500万人 已经感染，导致超过43万人死亡。黑人和拉丁裔社区承受了 COVID-19造成的严重不成比例的影响，加剧了现有的健康差距。多个批准 有效的COVID-19疫苗带来了恢复“正常”生活的希望，但要实现全面的 疫苗的好处需要广泛接受和吸收。我们和其他人的工作表明， 很大一部分美国人不愿意接种疫苗。相关因素之间的重叠 患有COVID-19疾病和COVID-19疫苗犹豫症，包括黑人或拉丁裔种族/民族，以及 社会经济不利因素，有可能严重加剧现有的健康差距。总体目标 该提案的一个重要目的是克服对COVID-19疫苗的犹豫，特别是在脆弱人群中。 在现有的强大社区合作伙伴关系的基础上，我们将完善，实施和评估多方面的 采取干预措施，支持初级保健提供者和社区组织作为可信赖的信使， 马萨诸塞州伍斯特市及其附近的脆弱患者接种COVID-19疫苗。我们的干预将包括：（1） 一个解决常见疫苗问题的在线视频库，由PCP和当地 社区组织;（2）PCP向患者发送基于证据的短信， 关于COVID-19疫苗接种的建议和信息;以及（3）简明的教育材料， PCP支持他们与患者就COVID-19疫苗进行对话。落实和 通过在两个联邦合格的健康中心进行的大型实用临床试验评估干预措施， 麻省大学纪念健康中心。这三个临床系统共同服务于大量的种族人群， 和/或少数民族群体（黑人，拉丁美洲人，非英语母语者）和社会经济 弱势患者。我们的具体目标是：（1）完善和调整工具，以支持有效的PCP PCP和社区对COVID-19疫苗接种和信息传播的建议 （2）实施并评估对COVID-19的干预措施的影响 在最初未接种疫苗的患者中的疫苗摄取和（3）根据RE- 目的框架，纳入患者，初级保健提供者和诊所领导人的观点。我们将 在干预期间之前、期间和之后，描述当地社区环境的特点， 确定环境支持或抑制干预有效性的方式。这项研究将产生 如何在弱势人群中有效推广COVID-19疫苗接种的关键证据。我们 研究结果可用于促进其他疫苗（包括可能的COVID-19疫苗“助推器”）的吸收 在面临疫苗犹豫和健康差距风险的人群中。

PROJECT SUMMARY/ABSTRACT The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and associated coronavirus disease 2019 (COVID-19) pandemic have been devastating. In the United States (US), more than 25 million people have been infected, resulting in more than 430,000 deaths. Black and Latino communities have borne a starkly disproportionate impact of COVID-19, compounding existing health disparities. The approval of multiple effective COVID-19 vaccines has raised hope that a return to “normal” life may be at hand, but realizing the full benefits of vaccines will require widespread acceptance and uptake. Our work and that of others indicate a significant proportion of the US population are reluctant to be vaccinated. Overlap between factors associated with COVID-19 disease and COVID-19 vaccine hesitancy, including being of Black or Latino race/ethnicity, and socioeconomic disadvantage, threaten to severely exacerbate existing health disparities. The overarching goal of this proposal is to overcome COVID-19 vaccine hesitancy, particularly among vulnerable populations. Building on strong existing community partnerships, we will refine, implement, and evaluate a multi-faceted intervention to support primary care providers and community organizations as trusted messengers to promote COVID-19 vaccination among vulnerable patients in and near Worcester, MA. Our intervention will include: (1) an online library of videos addressing common vaccine concerns to be disseminated by PCPs and local community organizations; (2) evidence-based text messaging from PCPs to their patients conveying recommendations for and information about COVID-19 vaccination; and (3) concise educational materials for PCPs to support their conversations with patients about the COVID-19 vaccine. We will implement and evaluate the intervention via a large pragmatic clinical trial at two Federally Qualified Health Centers, and the UMass Memorial Health Center. These three clinical systems collectively serve large populations of racial and/or ethnic minority groups (Black, Latino, non-primary English speakers) and socioeconomically disadvantaged patients. Our specific aims are: (1) To refine and adapt tools to support effective PCP recommendations for COVID-19 vaccination and information dissemination by PCPs and community organizations to vulnerable patients; (2) To implement and assess the impact of the intervention on COVID-19 vaccine uptake among initially unvaccinated patients and (3) To evaluate the intervention according to the RE- AIM framework, incorporating the perspectives of patients, primary care providers, and clinic leaders. We will characterize the local community environment before, during and beyond the intervention period and will identify ways the environment supports or inhibits intervention effectiveness. This research will generate crucial evidence of how to effectively promote COVID-19 vaccination among vulnerable populations. Our findings can be applied to promote uptake of other vaccines (including possible COVID-19 vaccine “boosters”) among populations at risk of vaccine hesitancy and health disparities.