Geographic Heterogeneity in Behavioral and Social Drivers of COVID-19 Vaccination

Masters, Nina B.; Zhou, Tianyi; Meng, Lu; Lu, Peng–jun; Kriss, Jennifer L.; Black, Carla L.; Omari, Amel; Boone, Kwanza D.; Weiss, Debora; Carter, Rosalind J.; Brewer, Noel T.; Singleton, James A.

doi:10.1016/j.amepre.2022.06.016

Cited by 19 publications

(6 citation statements)

References 34 publications

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“…Although regional heterogeneity in disease prevalence and outcome are well described, 17 – 19 there are limited data on regional variation in postoperative mortality rates across race or ethnicity in the United States 9 We found substantial geographic variation in postoperative mortality across race and ethnicity, with the widest disparity between Black and White patients observed in the northeastern and western part of the United States. A similar disparity was observed between Hispanic and White patients.…”

Section: Discussionmentioning

confidence: 76%

Current Trends in Mortality Attributable to Racial or Ethnic Disparities in Post-Surgical Population in The United States: A Population-Based Study

Mpody,

Best,

Lee

et al. 2023

Annals of Surgery Open

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Background: No study has contextualized the excess mortality attributable to racial and ethnic disparities in surgical outcomes. Further, not much effort has been made to quantify the effort needed to eliminate these disparities. Objective: We examined the current trends in mortality attributable to racial or ethnic disparities in the US postsurgical population. We then identified the target for mortality reduction that would be necessary to eliminate these disparities by 2030. Methods: We performed a population-based study of 1,512,974 high-risk surgical procedures among adults (18–64 years) performed across US hospitals between 2000 and 2020. Results: Between 2000 and 2020, the risk-adjusted mortality rates declined for all groups. Nonetheless, Black patients were more likely to die following surgery (adjusted relative risk 1.42; 95% CI, 1.39–1.46) driven by higher Black mortality in the northeast (1.60; 95% CI, 1.52–1.68), as well as the West (1.53; 95% CI, 1.43–1.62). Similarly, mortality risk remained consistently higher for Hispanics compared with White patients (1.21; 95% CI, 1.19–1.24), driven by higher mortality in the West (1.26; 95% CI, 1.21–1.31). Overall, 8364 fewer deaths are required for Black patients to experience mortality on the same scale as White patients. Similar figures for Hispanic patients are 4388. To eliminate the disparity between Black and White patients by 2030, we need a 2.7% annualized reduction in the projected mortality among Black patients. For Hispanics, the annualized reduction needed is 0.8%. Conclusions: Our data provides a framework for incorporating population and health systems measures for eliminating disparity in surgical mortality within the next decade.

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Section: Discussionmentioning

confidence: 76%

Current Trends in Mortality Attributable to Racial or Ethnic Disparities in Post-Surgical Population in The United States: A Population-Based Study

Mpody,

Best,

Lee

et al. 2023

Annals of Surgery Open

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“… 77 Third, although the 3C Theoretical Framework incorporates various perspectives required to better understand vaccine hesitancy, multiple factors influence vaccine hesitancy. 78 Numerous models of behavior change such as the Health Belief Model 79 have been applied to determine the reasons behind individual behaviors; perceptions of susceptibility to infection, severity of the virus, types of barriers, and potential benefits are all involved in behavior change. 80 We suggest that utilizing complementary frameworks, theories, and models to understand individual behaviors and the perceptions that influence those behaviors can provide valuable insight on changeable behavior barriers and the potentially effective strategies to overcome them.…”

Section: Discussionmentioning

confidence: 99%

The evolution of vaccine hesitancy through the COVID-19 pandemic: A semi-structured interview study on booster and bivalent doses

Parsons Leigh,

FitzGerald,

Moss

et al. 2024

Human Vaccines & Immunotherapeutics

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We sought in-depth understanding on the evolution of factors influencing COVID-19 booster dose and bivalent vaccine hesitancy in a longitudinal semi-structured interview-based qualitative study. Serial interviews were conducted between July 25th and September 1 st , 2022 (Phase I: univalent booster dose availability), and between November 21 st , 2022 and January 11 th , 2023 (Phase II: bivalent vaccine availability). Adults (≥18 years) in Canada who had received an initial primary series and had not received a COVID-19 booster dose were eligible for Phase I, and subsequently invited to participate in Phase II. Twenty-two of twenty-three (96%) participants completed interviews for both phases (45 interviews). Nearly half of participants identified as a woman ( n = 11), the median age was 37 years (interquartile range: 32–48), and most participants were employed full-time ( n = 12); no participant reported needing to vaccinate (with a primary series) for their workplace. No participant reported having received a COVID-19 booster dose at the time of their interview in Phase II. Three themes relating to the development of hesitancy toward continued vaccination against COVID-19 were identified: 1) effectiveness (frequency concerns; infection despite vaccination); 2) necessity (less threatening, low urgency, alternate protective measures); and 3) information (need for data, contradiction and confusion, lack of trust, decreased motivation). The data from interviews with individuals who had not received a COVID-19 booster dose or bivalent vaccine despite having received a primary series of COVID-19 vaccines highlights actionable targets to address vaccine hesitancy and improve public health literacy.

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“…Another limitation is that our study sample was only from Arkansas, which may limit generalizability to Marshallese and Hispanic communities in other areas of the US. Also notable is that the increase in COVID-19 rates, hospitalizations, and deaths due to the Delta variant during the time this study took place likely played a factor in people’s decision to get vaccinated [ 46 ]. A strength of this study is our novel contribution to the literature about the socio-ecological influences among late-adopting Marshallese and Hispanic communities in the context of community-engaged vaccine events.…”

Section: Discussionmentioning

confidence: 99%

Reaching late adopters: factors influencing COVID-19 vaccination of Marshallese and Hispanic adults

et al. 2023

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Background Marshallese and Hispanic communities in the United States have been disproportionately affected by COVID-19. Identifying strategies to reach late vaccine adopters is critical for ongoing and future vaccination efforts. We utilized a community-engaged approach that leveraged an existing community-based participatory research collaborative of an academic healthcare organization and Marshallese and Hispanic faith-based organizations (FBO) to host vaccination events. Methods Bilingual Marshallese and Hispanic study staff conducted informal interviews with 55 participants during the 15-minute post-vaccination observation period and formal semi-structured interviews with Marshallese (n = 5) and Hispanic (n = 4) adults post-event to assess the implementation of community vaccine events at FBOs, with a focus on factors associated with the decision to attend and be vaccinated. Formal interview transcripts were analyzed using thematic template coding categorized with the socio-ecological model (SEM). Informal interview notes were coded via rapid content analysis and used for data triangulation. Results Participants discussed similar factors influencing attitudes and behaviors toward receiving the COVID-19 vaccine. Themes included: (1) intrapersonal – myths and misconceptions, (2) interpersonal – protecting family and family decision-making, (3) community – trust of community location of events and influence of FBO members and leaders, (4) institutional – trust in a healthcare organization and bilingual staff, and (5) policy. Participants noted the advantages of vaccination delivery at FBOs, contributing to their decision to attend and get vaccinated. Conclusions The following strategies may improve vaccine-related attitudes and behaviors of Marshallese and Hispanic communities not only for the COVID-19 vaccine but also for other preventive vaccinations: 1) interpersonal-level – develop culturally-focused vaccine campaigns targeting the family units, 2) community-level – host vaccination events at convenient and/or trusted locations, such as FBOs, and engage community and/or FBO formal or lay leaders as vaccine ambassadors or champions, and 3) institutional-level – foster trust and a long-term relationship with the healthcare organization and provide bilingual staff at vaccination events. Future research would be beneficial to investigate the effects of replicating these strategies to support vaccine uptake among Marshallese and Hispanic communities.

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Geographic Heterogeneity in Behavioral and Social Drivers of COVID-19 Vaccination

Cited by 19 publications

References 34 publications

Current Trends in Mortality Attributable to Racial or Ethnic Disparities in Post-Surgical Population in The United States: A Population-Based Study

Current Trends in Mortality Attributable to Racial or Ethnic Disparities in Post-Surgical Population in The United States: A Population-Based Study

The evolution of vaccine hesitancy through the COVID-19 pandemic: A semi-structured interview study on booster and bivalent doses

Reaching late adopters: factors influencing COVID-19 vaccination of Marshallese and Hispanic adults

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