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COVID19 vaccine hesitancy among perinatal women at risk for health disparities

面临健康差异风险的围产期妇女对新冠病毒疫苗接种犹豫不决

基本信息

批准号：
10575972
负责人：
CYNTHIA L. BATTLE
金额：
$ 20.5万
依托单位：
BUTLER HOSPITAL (PROVIDENCE, RI)
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-01-01 至 2024-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10575972
关键词：
Address Admission activity Affective African American American College of Obstetricians and Gynecologists Area Attention Attitude Automobile Driving Behavior Black race COVID-19 COVID-19 pandemic COVID-19 risk COVID-19 vaccination COVID-19 vaccine Centers for Disease Control and Prevention (U.S.)Cessation of life Child Child Health Cognitive Communication Communities Counseling Data Decision Making Development Disadvantaged Discipline of obstetrics Education Enrollment Ethnic Population Family Practice Federally Qualified Health Center Health Health Personnel High Risk Woman Infant Infection Interview Investigation Knowledge Lactation Latina Light Linear Models Location Maternal Mortality Mechanical ventilation Medical Methods Midwife Modeling Mothers Nurses Outcome Patients Perinatal Phase Planning Theory Population Postpartum Period Postpartum Women Pregnancy Pregnant Women Premature Birth Prenatal care Primary Care Procedures Provider Public Health Recommendation Research Risk Role SARS-CoV-2 infection Safety Sampling Secondary Immunization Services Shapes Structure Suggestion Surveys United States Vaccinated Vaccination Vaccines Vulnerable Populations Woman Women&apos s Group Work adverse birth outcomes adverse outcome care providers design disadvantaged women effective intervention ethnic minority experience health care service health disparity health organization high risk improved infant outcome innovation maternal morbidity maternal vaccination mortality novel strategies offspring participant enrollment perinatal period perinatal women pregnant prenatal provider behavior psychological symptom racial minority racial population recruit therapy development unvaccinated uptake vaccination outcome vaccine acceptance vaccine hesitancy vaccine refusal women of color

项目摘要

Abstract Despite safety data supporting use of COVID-19 vaccines among pregnant and lactating women, COVID-19 vaccine coverage among perinatal women in the United States is very low, with uptake even lower among some racial and ethnic groups such as Black/African American and Latina women. Concerningly, pregnancy is associated with more severe outcomes associated with COVID-19 infection: pregnant women with COVID-19 have higher rates of ICU admission, mechanical ventilation, and mortality compared to women with COVID-19 who are not pregnant. Further, infants born to women with COVID-19 are more likely to be born preterm, potentially leading to numerous downstream negative consequences for the child’s health and development. In spite of the high stakes of infection for women and their offspring, little is known about factors contributing to COVID-19 vaccine hesitancy (VH) and refusal among perinatal women, particularly those at highest risk for health disparities. Identifying factors contributing to VH among this vulnerable group of women is crucial to the development of effective interventions to promote vaccine uptake. Further, little is known about factors relating to prenatal care provider behavior and recommendations regarding COVID-19 vaccination during pregnancy and postpartum. Our experienced, interdisciplinary team proposes a 2-year, mixed methods R21 investigation that includes both a patient component and a provider component in order to identify key factors contributing to COVID-19 vaccine uptake and refusal in the perinatal period. In the patient component, we will recruit 120 English and Spanish-speaking financially-disadvantaged pregnant and postpartum women, including half who were vaccinated in pregnancy and half who are unvaccinated. Guided by the Theory of Planned Behavior and the Five C’s model of Vaccine Hesitancy, and with input from a diverse group of community stakeholders, we will assess cognitive and affective factors, psychological symptoms, medical mistrust, and other contributors to vaccine decision-making. We will conduct qualitative interviews with a subset of women (n=30) to augment our understanding of factors driving vaccine reluctance and refusal. In the provider component, we will recruit 60 prenatal care providers who work with financially disadvantaged women (OBs, family medicine, midwives, nurses) to take part in an in-depth survey regarding factors contributing to VH, refusal and uptake during the perinatal period; a subset of 30 providers will take part in qualitative interviews to explore these issues further. Our analytic plan involves generalized linear models to examine predictors of patient vaccination outcomes, and qualitative thematic analysis to identify key themes women and providers endorse regarding COVID-19 vaccine hesitancy. Findings will inform provider education and services innovations, as well as intervention development to target increased vaccination uptake this vulnerable patient group.

摘要