Understanding the concept of trust and other factors related to COVID-19 vaccine intentions among Black/African American older adults prior to vaccine development

Harris, Orlando; Perry, Tam E.; Johnson, Julene K.; Lichtenberg, Peter A.; Washington, Tangy; Kitt, Bonita; Shaw, Michael; Keiser, Sahru; Tran, Thi Hà Châu; Vest, Leah; Maloof, Marsha; Portacolone, Elena

doi:10.1016/j.ssmqr.2023.100230

Cited by 4 publications

(7 citation statements)

References 27 publications

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“…[35][36][37] However, the rumors that have spread in Black communities that COVID-19 vaccines were primarily aimed at eliminating older and racialized people may play an important role, including sterilizations. 38,39 Another aspect that drew attention was the fact that in the unadjusted linear regression analyses, the age group least likely to be vaccinated was those aged 55 years old and more. However, in the adjusted linear regression analyses, the group less likely to be vaccinated was those aged 45 to 54.…”

Section: Resultsmentioning

confidence: 99%

“…This may seem controversial, given that vaccination was even more encouraged among the elderly and that they appeared to be more at risk for COVID‐19 35‐37 . However, the rumors that have spread in Black communities that COVID‐19 vaccines were primarily aimed at eliminating older and racialized people may play an important role, including sterilizations 38,39 . Another aspect that drew attention was the fact that in the unadjusted linear regression analyses, the age group least likely to be vaccinated was those aged 55 years old and more.…”

Section: Discussionmentioning

confidence: 99%

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COVID‐19 vaccine uptake, conspiracy theories, and health literacy among Black individuals in Canada: Racial discrimination, confidence in health, and COVID‐19 stress as mediators

Cénat,

Farahi,

Dalexis

et al. 2024

Journal of Medical Virology

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Factors influencing vaccine uptake in Black individuals remain insufficiently documented. Understanding the role of COVID‐19 related stress, conspiracy theories, health literacy, racial discrimination experiences, and confidence in health authorities can inform programs to increase vaccination coverage. We sought to analyze these factors and vaccine uptake among Black individuals in Canada. A representative sample of 2002 Black individuals from Ontario, Quebec, Alberta, Nova Scotia, New Brunswick, British Columbia, and Manitoba, aged 14 years or older completed questionnaires assessing vaccine uptake, health literacy, conspiracy theories, racial discrimination experiences, COVID‐19‐related stress, and confidence in health authorities. Mediation analyses were conducted to assess (1) the effect of health literacy on COVID‐19 vaccination uptake through confidence and need, COVID‐19 related traumatic stress, and racial discrimination, and (2) the effect of conspiracy beliefs on COVID‐19 vaccination uptake through the same factors. Overall, 69.57% (95% confidence interval, 67.55%–71.59%) of the participants were vaccinated and 83.48% of them received two or more doses. Those aged 55 years and older were less likely to be vaccinated, as well as those residing in British Columbia and Manitoba. Mediation models showed that the association between health literacy and COVID‐19 vaccine uptake was mediated by confidence in health authorities (B = 0.02, p < 0.001), COVID‐19‐related stress (B = −0.02, p < 0.001), and racial discrimination (B = −0.01, p = 0.032), but both direct and total effects were nonsignificant. Lastly, conspiracy beliefs were found to have a partial mediation effect through the same mediators (B = 0.02, p < 0.001, B = −0.02, p < 0.001, B = −0.01, p = 0.011, respectively). These findings highlight the need for targeted interventions to address vaccine hesitancy and inform approaches to improve access to vaccinations among Black communities.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

COVID‐19 vaccine uptake, conspiracy theories, and health literacy among Black individuals in Canada: Racial discrimination, confidence in health, and COVID‐19 stress as mediators

Cénat,

Farahi,

Dalexis

et al. 2024

Journal of Medical Virology

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“…However, the success of vaccine-based protection measures hinges on high population uptake and coverage. Monitoring of the COVID-19 vaccination roll-out in high income countries revealed stark gaps and discrepancies in COVID-19 vaccine uptake particularly affecting intersectionally marginalised populations, including migrants (1)(2)(3)(4)(5)(6)(7)(8). In the UK and Europe, several studies have suggested migrants are also an under-immunised group for routine vaccinations, with few systems in place to engage and catch-up older age groups (9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Co-designing a theory-informed, multi-component intervention to increase vaccine uptake with Congolese migrants: a qualitative, community-based participatory research study

Crawshaw

Kitoko

Nkembi

et al. 2023

Preprint

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Introduction Inequitable uptake of routine and COVID-19 vaccinations has been documented among intersectionally marginalised populations, including migrants, and attributed to issues of mistrust, access, and low vaccine confidence. Novel approaches which seek to share power, build trust and co-design tailored interventions with marginalised or underserved communities must be explored, to promote equitable engagement with vaccination and other health interventions. Methods A theory-informed, qualitative, community-based participatory research study, designed and led by a community-academic partnership, which aimed to understand decision-making related to COVID-19 vaccination among Congolese migrants in the UK and co-design a tailored intervention to strengthen their vaccine uptake (2021-2022). Barriers and facilitators to COVID-19 vaccination, information and communication preferences, and intervention suggestions were explored through qualitative in-depth interviews with Congolese migrants, thematically analysed, and mapped to the theoretical domains framework (TDF) and the Capability, Opportunity, Motivation, Behaviour (COM-B) model to identify target behaviours and strategies to include in interventions. Workshops were done in partnership with Congolese migrants to co-design and tailor interventions. Results 32 Congolese adult migrants (foreign-born and living in UK; 24 (75%) women, mean 14.3 [SD 7.5] years in UK, mean age 52.6 [SD 11.0] years) took part in in-depth interviews and 16 (same sample) took part in co-design workshops. We identified 14 barriers and 10 facilitators to COVID-19 vaccination; most barrier data related to four TDF domains (beliefs about consequences; emotion; social influences; environmental context and resources), and the behavioural diagnosis concluded interventions should target improving psychological capability, reflective and automatic motivations, and social opportunities. Strategies included behaviour change techniques based on education, persuasion, modelling, enablement, and environmental restructuring, which resulted in a co-designed intervention comprising community-led workshops, COVID-19 vaccination plays and posters. Findings and interventions were disseminated through a community celebration event. Conclusions Our study demonstrates how behavioural theory can be applied to co-designing tailored interventions with marginalised migrant communities through a participatory research paradigm to address a range of health issues and inequalities. Future research should build on this empowering approach, with the goal of developing more sensitive vaccination services and interventions which respond to migrant communities unique cultural needs and realities.

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“…However, the success of vaccine‐based protection measures hinges on high population uptake and coverage. Monitoring of the COVID‐19 vaccination roll‐out in high‐income countries revealed stark discrepancies in COVID‐19 vaccine uptake particularly affecting intersectionally marginalised populations, including migrants 5,10–16 …”

Section: Introductionmentioning

confidence: 99%

“…Monitoring of the COVID-19 vaccination roll-out in high-income countries revealed stark discrepancies in COVID-19 vaccine uptake particularly affecting intersectionally marginalised populations, including migrants. 5,[10][11][12][13][14][15][16] Health inequalities can be linked to wider social inequalities, including broader environmental, social and economic factors.…”

Section: Introductionmentioning

confidence: 99%

Co‐designing a theory‐informed, multicomponent intervention to increase vaccine uptake with Congolese migrants: A qualitative, community‐based participatory research study (LISOLO MALAMU)

Crawshaw,

Kitoko,

Nkembi

et al. 2023

Health Expectations

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IntroductionDisparities in the uptake of routine and COVID‐19 vaccinations have been observed in migrant populations, and attributed to issues of mistrust, access and low vaccine confidence. Participatory research approaches and behaviour change theory hold the potential for developing tailored vaccination interventions that address these complex barriers in partnership with communities and should be explored further.MethodsThis study used a theory‐informed, community‐based participatory research approach to co‐design a culturally tailored behaviour change intervention aimed at increasing COVID‐19 vaccine uptake among Congolese migrants in London, United Kingdom (2021–2022). It was designed and led by a community‐academic partnership in response to unmet needs in the Congolese community as the COVID‐19 pandemic started. Barriers and facilitators to COVID‐19 vaccination, information and communication preferences, and intervention suggestions were explored through qualitative in‐depth interviews with Congolese migrants, thematically analysed, and mapped to the theoretical domains framework (TDF) and the capability, opportunity, motivation, behaviour model to identify target behaviours and strategies to include in interventions. Interventions were co‐designed and tailored in workshops involving Congolese migrants.ResultsThirty‐two Congolese adult migrants (24 (75%) women, mean 14.3 (SD: 7.5) years in the United Kingdom, mean age 52.6 (SD: 11.0) years) took part in in‐depth interviews and 16 (same sample) took part in co‐design workshops. Fourteen barriers and 10 facilitators to COVID‐19 vaccination were identified; most barrier data related to four TDF domains (beliefs about consequences; emotion; social influences and environmental context and resources), and the behavioural diagnosis concluded interventions should target improving psychological capability, reflective and automatic motivations and social opportunities. Strategies included culturally tailored behaviour change techniques based on education, persuasion, modelling, enablement and environmental restructuring, which resulted in a co‐designed intervention comprising community‐led workshops, plays and posters. Findings and interventions were disseminated through a community celebration event.ConclusionsOur study demonstrates how behavioural theory can be applied to co‐designing tailored interventions with underserved migrant communities through a participatory research paradigm to address a range of health issues and inequalities. Future research should build on this empowering approach, with the goal of developing more sensitive vaccination services and interventions which respond to migrant communities' unique cultural needs and realities.Patient or Public ContributionPatient and public involvement (PPI) were embedded in the participatory study design and approach, with community members co‐producing all stages of the study and co‐authoring this paper. An independent PPI board (St George's Migrant Health Research Group Patient and Public Involvement Advisory Board) comprising five adult migrants with lived experience of accessing healthcare in the United Kingdom were also consulted at significant points over the course of the study.

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Understanding the concept of trust and other factors related to COVID-19 vaccine intentions among Black/African American older adults prior to vaccine development

Cited by 4 publications

References 27 publications

COVID‐19 vaccine uptake, conspiracy theories, and health literacy among Black individuals in Canada: Racial discrimination, confidence in health, and COVID‐19 stress as mediators

COVID‐19 vaccine uptake, conspiracy theories, and health literacy among Black individuals in Canada: Racial discrimination, confidence in health, and COVID‐19 stress as mediators

Co-designing a theory-informed, multi-component intervention to increase vaccine uptake with Congolese migrants: a qualitative, community-based participatory research study

Co‐designing a theory‐informed, multicomponent intervention to increase vaccine uptake with Congolese migrants: A qualitative, community‐based participatory research study (LISOLO MALAMU)

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