Among vaccine-hesitant African American adults enrolled in an inner-city medical program (P), will education (I) compared to no education (C) demonstrate a shift in knowledge and an increase in vaccines uptake (O)?

Abstract

Influenza and COVID-19 are infectious respiratory diseases accountable for globally high morbidity and mortality rates. Seasonal influenza and COVID-19 vaccines are known to prevent outbreaks. However, African American adults are more likely to refuse the vaccines due to vaccine hesitancy, prompting low vaccine uptake. In an inner-city adult clinic with high vaccine hesitancy among African American participants, a PICOT question concerning using implemented strategies to decrease flu and COVID-19 vaccine hesitancy and increase vaccines uptake evolved. A systemic review of literature provided evidence that with this population, knowledge-based and community-based dialogues will decrease vaccine hesitancy and increase its uptake. This project proposes an educational intervention under the framework of an iterative FOCUS PDCA. This strategy will utilize a pre-test survey to assess the perceived beliefs and myths inducing vaccine hesitancy, implement a culturally sensitive education to explore the information deduced, and a post-test survey to measure the outcomes of the intervention—the study plan to use a McNemar’s test to analyze the data.

Keyword: vaccine hesitancy, intervention, education, vaccine uptake

Summary

This project addressed the following PICOT question: Among vaccine-hesitant African American adults enrolled in an inner-city medical program (P), will education (I) compared to no education (C) demonstrate a shift in knowledge and an increase in vaccines uptake (O)? Results of McNemar tests performed with SPSS resulted in significant differences in responses from pre to post-intervention for all items in the survey.  There were significant increases in participants planning on receiving the covid—19 and flu vaccines. Additionally, there were significant increases in agreement that vaccines help the body’s immune system. There was a significant increase in the knowledge of how vaccines work. There were significant increases in the importance of vaccinations. Regarding medical providers, there was an increase in the provider answering questions about vaccines as well as the provider caring about the patient’s health. There was a significant increase regarding the safety of vaccines and a decrease in the number of worries about receiving the vaccine. Additionally, there was a significant increase in the importance of receiving vaccines. Regarding vaccine hesitancy, there was a significant reduction from pre to post-intervention in vaccine hesitancy.

Interpretation

The results of the project indicate that the implementation of an educational video concerning vaccinations demonstrates a shift in knowledge and an increase in vaccine uptake in the African-American population at a clinic in inner-city New Jersey. The results of this project are in agreement with other studies. A systemic review of literature provided evidence that with this population, a knowledge-based and community-based dialogue would decrease vaccine hesitancy and increase its uptake.

Limitations

One limitation of this project was the use of convenience sampling. Studies utilizing convenience sampling present challenges to external validity (Etikan, 2016). Studies that involve such samples may have issues with the generalizability of the study findings to broader populations of interest (Etikan, 2016). This study utilized convenience sampling which lowers external validity, as the results cannot be generalized to the general population. Additionally, this project only focused on African-Americans Thus, the results are not generalizable to other ethnicities.

Conclusions

Strategies that engage trusted messengers are needed to lead sustainable partnership and action in a meaningful way to address vaccine hesitancy and build acceptance and trust in health recommendations. The results of this project do indicate that the implementation of education regarding vaccinations could lead to decreased vaccine hesitancy and increased vaccination uptake.  The next step would be to share the results of this project with the health administrators and educators in order to educate the population regarding the importance of vaccinations.