As COVID-19 vaccines continue to roll out across the country, attention is turning toward making sure everyone has a fair shot at receiving one — especially those in minority and underserved communities, which have been hit especially hard by the pandemic. In order to create outreach programs that are effective, it’s important to understand the challenges that make it difficult for some to get vaccinated. Here are seven strategies that healthcare organizations can use to overcome barriers, improve access, and increase vaccine rates in minority communities.
The challenges of vaccine outreach
There are numerous reasons individuals may not get vaccinated, and recognizing what these challenges are can help in overcoming them.
Although hesitancy rates have dropped as the vaccine rollout progresses, some individuals may still be hesitant to get vaccinated, especially if they have concerns about racism or bias in healthcare settings. In some immigrant communities, undocumented individuals may also worry that getting vaccinated will put them at risk for deportation.
Lack of accessibility
Even for those who want the vaccine, it can be difficult to get to a vaccination center. Whether it’s lack of transportation, narrow hours of distribution, or difficulty navigating appointment registration, these are all roadblocks that can disproportionately affect minority and underserved populations.
Medical terminology can be confusing for anyone, and making sense of vaccine information can be even more difficult for those with limited health literacy or who speak English as a second language.
Strategies for vaccine outreach to minority populations
To combat these challenges, healthcare systems across the country are using the following strategies to increase confidence, raise awareness, and encourage people to get vaccinated.
1. Use data to identify areas of focus
In Louisiana, Ochsner Health is using a data-driven approach to determine where to focus their outreach strategies. “Our system is identifying areas of high deprivation and compare that to where we’re vaccinating patients,” says Dr. Eboni Price-Haywood, medical director for Ochsner’s Xavier Institute for Health Equity.
“Then we started thinking about our outreach strategy to target those neighborhoods where there’s a high deprivation if there are disparities between who’s getting the vaccine. It’s not all about hesitancy, it’s also about access,” she says.
2. Build relationships with community organizations
Many healthcare organizations are working to foster relationships with community-based organizations to help deliver vaccines.
“We had a church in New Orleans where the pastor announced that Ochsner was coming to do the vaccines, and he managed to get 800 people out there to get the shot. A third of those people were walk-ups. So, in terms of equity that is a good example of being in the community and having the flexibility so that people don’t have to pre-register,” says Dr. Price-Haywood.
In Philadelphia, PA, Einstein Healthcare Network is supportive of community-led vaccine outreach efforts. “You need to be able to let the community organization lead the way and you just show up with the vaccine. We need to follow the people in the community and not try to do it all ourselves,” says Juanita Way, associate vice president for healthcare services at Einstein Health.
3. Create infrastructure in the community
Another way healthcare organizations can build trust in minority communities is by showing long-term commitment, not just implementing a temporary program due to the pandemic.
Deirdre Saulet, a researcher with Advisory Board, lauds the work of Parkland Hospital in Dallas, TX, as an effective outreach program: “For a couple of years they’ve been working with ambassadors and specific groups in the community to build trust in the system. It’s been a longstanding project, and as they start vaccinations, they have champions in the community who can amplify the message,” she says.
The Denver Public Health Department has also made an effort to build trust by operating flu clinics in underserved communities over the past year. This work provided a solid infrastructure for distribution of the COVID vaccine and has created relationships between locals and healthcare workers.
4. Listen to people’s concerns
Many individuals have reservations about the safety and efficacy of the vaccines. Allowing them to voice their concerns can help foster discussion about how to overcome them.
“There can be a tendency to dismiss concerns, but a lot of them are very valid,” says Saulet. She says successful organizations are engaging the community in conversation. “They’re opening the door. We have so many stories about how motivational interviewing is the best tool for engaging folks in discussion.”
She also cautions against assuming you know where the hesitancy is coming from. “Don’t assume that you know just because it is a Black community or a Latinx community or a rural community. Truly talk to people and understand what their concerns are so that you’re crafting a message that is going to help build that trust and get them to engage in conversation.”
5. Choose the right messenger
Many healthcare organizations have realized their executives may not necessarily be the best messengers for vaccine information, says Saulet, and they’ve moved to enfranchise well-known and well-respected physicians on staff to help champion vaccine efforts. “Let’s get creative so we’re helping those folks spread correct information,” she says.
Engaging community and church leaders has also been successful. Dr. Wanda Robinson, medical director for community care at Ochsner, shared the story of a pastor who received the vaccine at a community clinic. “He was videoed taking the vaccine and his congregation trusts him, and I think that had a large influence on his congregation,” she says.
6. Share personal stories to build trust
Asking people to share their stories about why they chose to be vaccinated can be more effective than sharing data or efficacy rates. “What’s most influential is everybody’s personal story, not so much the science,” says Dr. Price-Haywood. “They listen to the science but what they care about is why you did it.”
“Once we explain ‘this is what’s going to happen if you get COVID-19, and this is what’s going to happen if you get the vaccine, you have to make a choice between which risk you want to take’, most people are leaning toward the vaccine,” she continues.
7. Create connections and celebrate
Once someone has chosen to receive a vaccine, it’s important to create a positive experience for them.
Juanita Way says most people who’ve been vaccinated by Einstein have been pleasantly surprised by the experience. “Different staff have connections with different people,” she says. “We’ve got criers, we’ve got people who are scared and need their hand held, we’ve got people who haven’t been out of their house in a year, who are lonely and don’t want to leave right away.”
She recognizes that by making each vaccination a small celebration, it creates a positive experience for that individual — and perhaps, turns it into a story they’ll share with others, urging them to get vaccinated, too.
Even as COVID cases continue to drop across the nation, it’s clear that healthcare organizations and community leaders need to work together in order to increase vaccination rates for all Americans. Effective outreach programs listen to community concerns, address barriers to access, and strive to create genuine connections between healthcare providers and the people they serve.
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