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新冠病毒疫苗在黑人和拉丁裔社区的接受度和可及性。

COVID-19 Vaccine Acceptance and Access Among Black and Latinx Communities.

机构信息

Yale National Clinician Scholars Program, Yale University School of Medicine, New Haven, Connecticut.

Community Alliance for Research and Engagement, New Haven, Connecticut.

出版信息

JAMA Netw Open. 2021 Oct 1;4(10):e2128575. doi: 10.1001/jamanetworkopen.2021.28575.

Abstract

IMPORTANCE

Black and Latinx communities have faced disproportionate harm from the COVID-19 pandemic. Increasing COVID-19 vaccine acceptance and access has the potential to mitigate mortality and morbidity from COVID-19 for all communities, including those most impacted by the pandemic.

OBJECTIVE

To investigate and understand factors associated with facilitating and obstructing COVID-19 vaccine access and acceptance among Black and Latinx communities.

DESIGN, SETTING, AND PARTICIPANTS: This community-partnered qualitative study conducted semistructured, in-depth focus groups with Black and Latinx participants from March 17 to March 29, 2021, using a secure video conferencing platform. Participants were recruited through emails from local community-based organizations, federally qualified health centers, social service agencies, the New Haven, Connecticut, Health Department, and in-person distribution of study information from community health workers. A total of 8 focus groups were conducted, including 4 in Spanish and 4 in English, with 72 participants from a diverse range of community roles, including teachers, custodial service workers, and health care employees, in New Haven, Connecticut. Data were analyzed from March 17 to July 30, 2021.

MAIN OUTCOMES AND MEASURES

Interviews were audio-recorded, transcribed, translated, and analyzed using an inductive content analysis approach. Themes and subthemes were identified on the acceptability and accessibility of the COVID-19 vaccine among participants who identified as Black and/or Latinx.

RESULTS

Among 72 participants, 36 (50%) identified as Black, 28 (39%) as Latinx, and 8 (11%) as Black and Latinx and 56 (78%) identified as women and 16 (22%) identified as men. Participants described 3 major themes that may represent facilitators and barriers to COVID-19 vaccinations: pervasive mistreatment of Black and Latinx communities and associated distrust; informing trust via trusted messengers and messages, choice, social support, and diversity; and addressing structural barriers to vaccination access.

CONCLUSIONS AND RELEVANCE

The findings of this qualitative study may impact what health care systems, public health officials, policy makers, health care practitioners, and community leaders can do to facilitate equitable uptake of the COVID-19 vaccine. Community-informed insights are imperative to facilitating COVID-19 vaccine access and acceptance among communities hardest hit by the pandemic. Preventing the further widening of inequities and addressing structural barriers to vaccination access are vital to protecting all communities, especially Black and Latinx individuals who have experienced disproportionate death and loss from COVID-19.

摘要

重要性

黑人和拉丁裔社区受到 COVID-19 大流行的不成比例的伤害。增加 COVID-19 疫苗的接受度和可及性有可能减轻所有社区的 COVID-19 死亡率和发病率,包括受大流行影响最大的社区。

目的

调查和了解与黑人和拉丁裔社区 COVID-19 疫苗获取和接受相关的促进和阻碍因素。

设计、地点和参与者:这是一项社区合作的定性研究,于 2021 年 3 月 17 日至 3 月 29 日期间使用安全视频会议平台对来自纽黑文的黑人和拉丁裔参与者进行了半结构化的深入焦点小组讨论。参与者是通过当地社区组织、联邦合格的健康中心、社会服务机构、纽黑文康涅狄格州卫生部门的电子邮件以及社区卫生工作者的现场分发研究信息招募的。总共进行了 8 个焦点小组,其中 4 个是西班牙语的,4 个是英语的,参与者来自不同的社区角色,包括教师、清洁服务人员和医疗保健员工,他们都来自康涅狄格州纽黑文。数据于 2021 年 3 月 17 日至 7 月 30 日进行分析。

主要结果和措施

访谈通过使用归纳内容分析方法进行录音、转录、翻译和分析。确定了参与者认为在接受 COVID-19 疫苗方面的可接受性和可及性的主题和子主题,这些参与者自我认同为黑人和/或拉丁裔。

结果

在 72 名参与者中,有 36 名(50%)自认为是黑人,28 名(39%)自认为是拉丁裔,8 名(11%)自认为是黑人和拉丁裔,56 名(78%)自认为是女性,16 名(22%)自认为是男性。参与者描述了 3 个主要主题,这些主题可能代表了 COVID-19 疫苗接种的促进因素和障碍:对黑人和拉丁裔社区的普遍虐待以及由此产生的不信任;通过可信赖的信息传递者和信息、选择、社会支持和多样性来建立信任;以及解决疫苗接种获取方面的结构性障碍。

结论和相关性

这项定性研究的结果可能会影响医疗保健系统、公共卫生官员、政策制定者、医疗保健从业者和社区领导人在促进 COVID-19 疫苗公平接种方面可以采取的措施。社区知情的见解对于促进受大流行影响最严重的社区获得 COVID-19 疫苗至关重要。防止不平等的进一步扩大和解决疫苗接种获取方面的结构性障碍对于保护所有社区至关重要,特别是那些因 COVID-19 而经历不成比例的死亡和损失的黑人和拉丁裔个人。

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