Digital Storytelling to Reduce Pediatric Influenza Vaccination Disparities: A Pilot Pragmatic Trial

项目摘要 每年冬天，季节性流感会感染1000多万美国儿童，50,000人住院，300-500人死亡。 黑人儿童患病、住院和死亡的可能性是其他种族和儿童的2-3倍 种族。这些差异与流感疫苗接种差异有关，而流感疫苗接种差异又与 历史上的剥削、获得保健的机会、卫生文盲和疫苗迟疑不决。的长期目标是 候选人，医学博士约书亚·T·B·威廉姆斯将通过与少数族裔合作来减少疫苗接种差距 利益攸关方共同创建干预措施，以改善务实试验中的疫苗接种公平性。这一目标将 此外，国家儿童健康和发展研究所的使命是确保所有儿童都有 公平的机会来成长和发挥他们的潜力，不受疾病的侵扰。威廉姆斯博士非常适合做这项工作 作为一名普通儿科医生，曾接受过卫生服务研究培训，曾获得4项竞争性补助金 自2019年以来，首次发表了15篇关于疫苗、疫苗迟疑和疫苗可预防疾病的论文。 为了实现这一目标，威廉姆斯博士将继续进行正式的课程工作，指导经验培训， 和三个具体领域的定向学习：(1)健康差异和差异研究，(2)社区 参与，以及(3)实施科学，包括设计和进行务实试验。支持 威廉姆斯博士已经确定了一位在疫苗犹豫不决、干预方面具有国家专长的主要导师 设计、实用的疫苗接种试验(肖恩·T·奥利里博士)他已经组建了一个由三名共同导师组成的团队 具有健康差距方面的专业知识(Romana Hasnain-Wynia博士)、社区参与(Donald博士 和实施科学(艾米·赫布施曼博士)。此外，他已经建立了合作伙伴关系 与非裔美国人健康中心(Deidre Johnson女士)合作，并得到其他6位杰出人士的支持 专家。威廉姆斯博士提出了三个连续的项目，这些项目建立在他的培训目标和之前的工作基础上， 揭示了利益相关者通过个人故事提高疫苗接种信心的建议。 数字故事是将图像、视频、声音或文本综合在一起以创造出引人入胜的个人故事 人类经验的记述。在试点务实试验中，数字故事改善了高血压的控制 韩国妇女接种人乳头瘤病毒疫苗的黑人成年人和自我报告增加。3个具体的 本提案的目的是：(1)探讨不同利益相关者对数字化的看法和优先事项 通过定性访谈进行讲故事干预，(2)共同创建数字讲故事儿童流感 通过新的社区参与方法进行疫苗接种干预，以及(3)评估可行性， 一项涉及200人的务实试验中干预措施的可接受性、适当性和试点有效性 科罗拉多州丹佛市两家安全网诊所的黑人亲子二人组。大学杰出的研究环境 科罗拉多大学和威廉姆斯博士的专家指导团队将确保他的成功，加强他的训练， 并增进我们对参与方法和干预措施的理解，以促进健康公平。

Project Summary Every winter, seasonal influenza infects over 10,000,000 US children, hospitalizes 50,000, and kills 300‐500. Black children are 2‐3 times more likely to get sick, be hospitalized, and die than children of other races and ethnicities. These disparities are associated with influenza vaccination disparities, which are in turn associated with historical exploitation, access to care, health illiteracy, and vaccine hesitancy. The long‐term objective of the candidate, Joshua T.B. Williams, MD, is to reduce vaccination disparities by partnering with minority stakeholders to co‐create interventions that improve vaccination equity in pragmatic trials. This objective will further the mission of the National Institutes of Child Health and Development to ensure all children have an equitable chance to grow and fulfill their potential free from diseases. Dr. Williams is well‐suited for this work as a general pediatrician with prior health services research training who has received 4 competitive grants and first‐authored 15 papers on vaccines, vaccine hesitancy, and vaccine‐preventable diseases since 2019. To achieve this objective, Dr. Williams will pursue formal coursework, mentored experiential training, and directed learning in three specific areas: (1) health disparities and disparities research, (2) community engagement, and (3) implementation science, including the design and conduct of pragmatic trials. To support him, Dr. Williams has identified a primary mentor with national expertise in vaccine hesitancy, intervention design, and pragmatic vaccination trials (Dr. Sean T. O'Leary). He has assembled a team of three co‐mentors with expertise in health disparities (Dr. Romana Hasnain‐Wynia), community engagement (Dr. Donald Nease), and implementation science (Dr. Amy Huebschmann). Moreover, he has an established partnership with the Center for African American Health (Ms. Deidre Johnson) and support from 6 other distinguished experts. Dr. Williams proposes 3 sequential projects that build upon his training goals and prior work, which uncovered a stakeholder recommendation to improve vaccination confidence through personal stories. Digital stories are personal narratives that synthesize images, video, voice, or text to create compelling accounts of human experience. In pilot pragmatic trials, digital stories have improved hypertension control in Black adults and increased self‐report of Human Papillomavirus vaccination in Korean women. The 3 specific aims of this proposal are to (1) explore diverse stakeholders' perceptions of and priorities for a digital storytelling intervention through qualitative interviews, (2) co‐create a digital storytelling pediatric influenza vaccination intervention through novel community‐engaged methods, and (3) assess the feasibility, acceptability, appropriateness, and pilot effectiveness of the intervention in a pragmatic trial involving 200 Black parent‐child dyads in two safety‐net clinics in Denver, CO. The outstanding research environment at the University of Colorado and Dr. Williams' expert mentorship team will ensure his success, enhance his training, and advance our understanding of engagement methods and interventions to promote health equity.