Leveraging Community-Academic Partnerships and Social Networks to Disseminate Vaccine-Related Information and Increase Vaccine Uptake Among Black Individuals with Rheumatic Diseases

项目摘要 患有慢性风湿性疾病（包括关节炎）的人约占美国人口的25%。 人口种族/民族和社会经济差异的不利，往往是可以避免的结果发生在近 所有风湿性疾病，特别是黑人和社会经济地位较低的人。尽管 风湿病患者接种疫苗的重要性，以及严重感染的高发病率， 疫苗接种率一直很低。在美国，COVID-19疫苗接种率较低，疫苗犹豫 在黑人患者中高于白色患者，这在风湿性疾病中也是如此。与 2019冠状病毒病大流行所揭示的深刻差异，因风湿性关节炎的差异而加剧， 疾病的结果，以及对感染的脆弱性增加，迫切需要解决疫苗接种率低的问题。 患有这些疾病的黑人的接受和犹豫。此外，还必须增加 免疫抑制的风湿性疾病个体的社交网络中的疫苗摄取 并且可能具有不太稳健的疫苗接种应答。我们的团队已经建立了长期的社区学术 在波士顿和芝加哥地区的合作伙伴关系，以了解黑人个人与狼疮， 系统性风湿性疾病，以及种族主义在健康和医疗保健方面的作用。公众陷害 健康关键种族实践，认识到种族主义在我们社会的普遍性，我们将利用我们的 社区-学术伙伴关系，以实施疾病预防控制中心的民意领袖（POL）模式， 受信任的社区领袖接受培训，通过以下方式传播有关COVID-19疫苗接种的信息： 他们的社交网络在主要是黑人社区，以增加疫苗的吸收和减少犹豫。在 对NOSI NOT-MD-21-008的回应：解决疫苗犹豫、摄取和实施的研究 在经历差异的人群中，我们提出以下目标：目标1。利用社区- 在美国两个城市的学术合作伙伴关系，为POL开发培训和评估材料。目标2a。到 在有或没有种族公正框架的情况下，确定基于社区的干预措施的效力， COVID-19疫苗接种并减少风湿性黑人个体社交网络中的犹豫 条件我们将进行一项群集随机对照试验，以测试接受种族正义训练的政治人物是否 在疫苗安全性和有效性信息中嵌入框架将导致更多的COVID-19疫苗接种 与单独的安全性和有效性培训相比，目标2b。确定 POL外展社交网络的结构和组成。我们将改进现有的POL模型 通过添加经验证的混合方法来比较每组中POL所达到的社交网络。 我们假设，纳入种族正义透镜将使民意调查员能够更多地传播信息 更广泛和更有说服力，并通过减少恐惧和不信任来增加疫苗接种。

PROJECT SUMMARY Individuals with chronic rheumatic diseases including arthritis comprise approximately 25% of the U.S. population. Racial/ethnic and socioeconomic disparities in adverse, often avoidable outcomes occur in nearly all rheumatic diseases particularly among Black and lower socioeconomic status individuals. Despite the importance of vaccinations in patients with rheumatic diseases, and the high rates of serious infections, vaccine uptake is consistently poor. In the U.S., COVID-19 vaccine uptake is lower and vaccine hesitancy higher among Black patients compared with White patients, and this holds true in rheumatic diseases. With the profound disparities uncovered by the COVID-19 pandemic aggravated by proven disparities in rheumatic disease outcomes, and heightened vulnerability to infections, there is an urgent need to address low vaccine uptake and hesitancy among Black individuals with these conditions. In addition, it is critical to also increase vaccine uptake among the social networks of individuals with rheumatic diseases who are immunosuppressed and may have less robust vaccination responses. Our team has forged longstanding community-academic partnerships in the Boston and Chicago areas to understand the needs of Black individuals with lupus, a systemic rheumatic disease, and the role racism plays in health and healthcare access. Framed by the Public Health Critical Race Praxis that recognizes the pervasiveness of racism in our society, we will leverage our community-academic partnerships to implement the CDC's Popular Opinion Leader (POL) model whereby trusted community leaders are trained to disseminate information regarding COVID-19 vaccination through their social networks in predominately Black communities to increase vaccine uptake and reduce hesitancy. In response to the NOSI NOT-MD-21-008: Research to Address Vaccine Hesitancy, Uptake and Implementation among Populations that Experience Disparities, we propose the following aims: Aim 1. To leverage community- academic partnerships across two U.S. cities to develop training and evaluation materials for POLs. Aim 2a. To establish the efficacy of a community-based intervention with and without a racial justice framework to increase COVID-19 vaccine uptake and reduce hesitancy among social networks of Black individuals with rheumatic conditions. We will conduct a cluster randomized controlled trial to test whether POLs trained with racial justice framing embedded in information on vaccine safety and efficacy will result in greater COVID-19 vaccine uptake among their social network members compared to safety and efficacy training alone. Aim 2b. To determine the structure and composition of the outreach social networks of POLs. We will enhance the existing POL model by adding a validated mixed methods approach to compare the social networks reached by POLs in each arm. We hypothesize that incorporating a racial justice lens will empower POLs to disseminate information more broadly and more persuasively and increase vaccine uptake by reducing fear and mistrust.