Behavioral and Social Science Research to Optimize SARS-CoV-2 Protective Vaccine Uptake in Racial Minority Communities with High Rates of COVID-19

摘要 目前正在加紧努力开发一种预防SARS-CoV-2感染的疫苗，并希望 一种安全有效的疫苗很快就会问世。然而，疫苗的开发并不能 确保它在控制新冠肺炎所需的规模上被使用。在美国， 颜色是新冠肺炎诊断、严重疾病和死亡的不成比例的负担。然而，经验 在流感疫苗接种等领域，预示着非裔美国人接种新冠肺炎疫苗的比例将会较低 受疾病重创的社区。接种流感疫苗的种族差异与个人有关 因素(包括疫苗意识低、医疗不信任、恐惧和对疫苗的怀疑)；结构性障碍 (例如没有可接近的初级卫生保健提供者)；同龄人群体规范不充分 支持接种疫苗；以及造成许多健康不平等的社会、经济和生活压力因素。 类似但也独特的因素可能会削弱少数族裔对新冠肺炎疫苗接种的接受程度 社区。现在必须进行社区参与的研究--在疫苗广泛应用之前的某个时候 可用-了解和解决社区关注的问题，并制定防止种族歧视的战略 新冠肺炎接种接种率的差异。计划中的研究将由密尔沃基的一个团队进行 行为和社会科学家与一家经联邦认证的社区卫生中心合作 为低收入的市中心居民服务。这项研究将使用混合方法来识别少数族裔社区 对新冠肺炎疫苗接种的担忧；确定影响社区成员接种强度的因素 打算接种疫苗；以及试行测试并确定虚拟交付的可行性和可接受性 让社区社会影响者参与的干预措施，以解决疫苗问题并支持疫苗 在他们的社交网络中受益。这项工作将加速进行，分三个不同的阶段进行 相互关联的阶段，所有样本的年龄和性别都不同：(1)与160名非洲人进行的重点小组 美国市中心社区成员引发对新冠肺炎疫苗的信念；感知的风险、好处和 规范；以及阻碍或促进接种疫苗的因素；(2)一项在线量化调查研究，将 从SARS-CoV-2感染率最高的邮政编码招募700名社区成员，并将衡量受访者的 意图接种疫苗并测试包括感知在内的基于理论的预测者的意图对这些意图的影响 新冠肺炎威胁；感知的疫苗接种好处、障碍和自我效能，以及确定首选 疫苗接种设置；以及(3)虚拟提供干预措施的可行性和可接受性试点测试 培训和招募个人认识和信任的社区社会影响力人士来应对新冠肺炎 他们的朋友、家人、邻居、同事和社交媒体关注者对疫苗接种的担忧，以及 这支持了关于疫苗接种的明智决定。这项研究将描述疫苗问题的特点并确定 可以优化易受新冠肺炎影响的少数族裔社区的疫苗接种的战略。

ABSTRACT Intensive efforts are underway to develop a vaccine protective against SARS-CoV-2 infection, and hope is high that a safe and effective vaccine will soon be available. However, development of a vaccine does not ensure its uptake on the scale needed to bring COVID-19 under control. In the United States, communities of color are disproportionately burdened by COVID-19 diagnosis, serious illness, and death. However, experience in areas such as influenza vaccination portends that COVID-19 vaccine uptake will be lower in African American communities hard-hit by the disease. Racial disparities in influenza vaccination have been linked to individual factors (including low vaccine awareness, medical mistrust, fears and vaccine skepticism); structural barriers (such as not having an accessible primary health care provider); peer group norms that do not sufficiently support getting vaccinated; and social, economic, and life stressors that contribute to many health inequities. Similar but also unique factors are likely to undermine acceptance of COVID-19 vaccination in racial minority communities. Community-engaged research must be undertaken now—and at a point before a vaccine is widely available—to understand and address community concerns and to develop strategies to prevent racial disparities in COVID-19 vaccination uptake. The planned research will be undertaken in Milwaukee by a team of behavioral and social scientists in a collaboration with an established federally qualified community health center serving low-income inner-city residents. The research will use mixed methods to identify minority community concerns regarding COVID-19 vaccination; to determine factors that influence strength of community members’ intentions to vaccinate; and to pilot test and establish the feasibility and acceptability of a virtually-delivered intervention that engages community social influencers to address vaccine concerns and endorse vaccine benefits within their social networks. The work will be undertaken in an accelerated manner in three distinct but interrelated phases, all with samples diverse in age and gender: (1) focus groups conducted with 160 African American inner-city community members to elicit COVID-19 vaccine beliefs; perceived risks, benefits, and norms; and factors that would impede or facilitate vaccination; (2) an online quantitative survey study that will enroll 700 community members from zip codes with greatest SARS-CoV-2 rates and will measure respondents’ intentions to vaccinate and test the influence on those intentions of theory-based predictors including perceived COVID-19 threat; perceived vaccination benefits, barriers, and self-efficacy, as well as identifying preferred settings for vaccination; and (3) a feasibility and acceptability pilot test of a virtually-delivered intervention that trains and enlists personally-known and trusted neighborhood social influencers to address the COVID-19 vaccination concerns of their friends, family members, neighbors, coworkers, and social media followers, and that supports informed decisions about vaccination. This research will characterize vaccine concerns and identify strategies that can optimize vaccine uptake in racial minority communities vulnerable to COVID-19.