A multidimensional Digital Approach to Address Vaccine Hesitancy and Increase COVID-19 Vaccine Uptake among African American Young Adults in the South

项目总结 青壮年(YA)是传播SARS-Co-V2病毒的关键“超级传播者”，SARS-Co-V2是SARS-Co-V2的病原体 新冠肺炎(CoVID)。鉴于他们的无症状感染率很高，加上传播率 被违反身体距离和遮脸规定的行为助长，YA 代表应重点关注的优先人群，以确保高水平的COVID疫苗接种。 虽然COVID疫苗可以保护非洲裔美国年轻人(AA-YA)免受COVID相关疾病的影响 只有在干预措施确保AA-YA的安全性和死亡率的情况下，该人群才会接受疫苗接种 这是一项有益的工作，同时也解决了传播不信任的历史背景和系统力量。数字健康 无论地理位置如何，干预措施(DHI)都可以接触到大量AA-YA，并为他们提供支持 使用YAS重视和信任的熟悉模式，对他们的健康做出明智的决定。我们的 协作团队开发了DHI强硬的谈话理论，以帮助YA做出艾滋病毒披露决定 特别是通过考虑其选择的社会、伦理和行为影响以及 随之而来的后果。回应NOT-MD-21-008：解决疫苗迟疑、吸收、 并在经历健康差距的人群中实施，我们建议应用一个社区- 基于参与性研究(CBPR)的方法，以评估NIMHD中确定的多层次因素 研究框架和调整和测试强硬的谈话，以解决COVID疫苗的迟疑(VH)，强硬 Talks-COVID(TT-C)。在目标1中，我们将进行多方法形成性研究，以诱导行为， 影响AA-YA(18-29岁)COVID VH的认知和环境决定因素 南部各州。我们将有效的调查方法与新的CBPR方法相结合，包括选择您的- 自己的冒险旅程和数字故事讲述，以更好地理解AA-YA的疫苗决策。在……里面 在AIM 2中，我们将利用与专家顾问、社区合作伙伴和AA-YA最终用户的协作 适配ITT以开发和完善TT-C。以用户为中心的参与式设计和快速成型焦点小组 将在南部各州与AA-YA(n=12-16)一起进行。一旦敲定，我们将进行技术试验 用AA-YA(N=24)评估TT-C的可行性和可接受性。在目标3中，我们将进行混合类型1 有效性实施3-ARM RCT，n=540 AA-YA来自南部三个州。参与者将是 随机接受标准护理(对照)，远程提供TT-C，亲自提供TT-C。 主要的效果结果是COVID疫苗的接种率和系列化完成。二次效力 结果是VH、信心、知识、态度和信念。我们将对以下人员进行定性采访 参加者(n=12-16)和现场工作人员(n=6-8)，以评估执行障碍和促进者。我们利用我们的 现有基础设施与南部AA-YA社区有意义地接触，努力拆除 不公平的研究关系和医学上的不信任增加了COVID疫苗的接种量。

PROJECT SUMMARY Young Adults (YA) are a key “super-spreader” population transmitting SARS-Co-V2, the causative agent of COVID-19 (COVID). Given their high rate of asymptomatic infection compounded by transmission rates that are being fueled by behaviors that run contrary to physical distancing and face covering regulations, YA represent a priority population upon which to focus efforts to ensure high levels of COVID vaccine uptake. While COVID vaccines can protect African American young adults (AA-YA) against COVID related morbidity and mortality, this population will only accept vaccination if interventions assure AA-YA of its safety and benefit, while also addressing historical contexts and systemic forces that propagate mistrust. Digital Health Interventions (DHIs) can reach large numbers of AA-YA regardless of geographic location and empower them to make informed decisions about their health using a familiar modality that YAs value and trust. Our collaborative team developed the theory informed DHI Tough Talks to assist YA with HIV disclosure decision making, specifically by considering the social, ethical and behavioral implications of their choices and the consequences that follow. In response to NOT-MD-21-008: Research to Address Vaccine Hesitancy, Uptake, and Implementation among Populations that Experience Health Disparities, we propose to apply a community- based participatory research (CBPR) approach to assess multi-level factors identified within the NIMHD Research Framework and adapt and test Tough Talks to address COVID vaccine hesitancy (VH), Tough Talks-COVID (TT-C). In aim 1, we will conduct multi-method formative research to elicit the behavioral, cognitive, and environmental determinants influencing COVID VH among AA-YA (ages 18-29) in three southern states. We combine validated survey measures, with novel CBPR methods including choose-your- own adventure journeys and digital storytelling to better understand vaccine decision-making in AA-YA. In collaboration with expert advisors, community partners, and AA-YA end-users, in aim 2, we will leverage ADAPT-ITT to develop and refine TT-C. User-centered participatory design and rapid prototyping focus groups will be conducted with AA-YA (n=12-16) in southern states. Once finalized, we will conduct a technical pilot with AA-YA (N=24) to assess TT-C’s feasibility and acceptability. In aim 3, we will conduct a hybrid type 1 effectiveness implementation 3-arm RCT with n=540 AA-YA from three southern states. Participants will be randomized to receive standard of care (control), TT-C delivered remotely, and TT-C delivered in-person. Primary effectiveness outcomes are COVID vaccine uptake and series completion. Secondary effectiveness outcomes are VH, confidence, and knowledge, attitudes and beliefs. We will conduct qualitative interviews with participants (n=12-16) and site staff (n=6-8) to assess implementation barriers and facilitators. We leverage our existing infrastructure to meaningfully engage with southern AA-YA communities, working to dismantle inequitable research relationships and medical mistrust to increase COVID vaccine uptake.