Department of Leadership, Policy and Organizations, Vanderbilt University, 202 Payne Hall, PMB 414, 230 Appleton Place, Nashville, TN, 37203, USA.
Department of Leadership, Policy and Organizations, Vanderbilt University, USA.
Soc Sci Med. 2022 May;301:114880. doi: 10.1016/j.socscimed.2022.114880. Epub 2022 Mar 12.
A field experiment, using a paired audit testing design with testers of different racial and language profiles, was conducted to document and evaluate individual encounters in inquiring about COVID-19 vaccinations in the U.S. states. Testers communicated with state health department and major vaccination site staff about obtaining the COVID-19 vaccine and assessed the extent to which evidence-informed communication tactics for encouraging take-up were employed. The audit testers included individuals representing Latinx identities, given research showing they face greater hardships in navigating vaccine infrastructure and place less trust in public immunization efforts. Data were collected in phone and electronic communications between mid-June and mid-August of 2021. Empirical analyses confirmed that states vary considerably in how clearly officials communicate vaccination requirements and procedures, and in what they ask of individuals before providing the opportunity to receive the COVID-19 vaccine. The Spanish-speaking tester was more likely to encounter negative or racialized language-primarily implicit in nature-such as calls abruptly ended (vs. attempting to secure language support) and requests for additional identification or personal information before continuing with vaccination registration. Examples of overtly negative or racist encounters included condescending comments about Latinx testers' identification (or perceived undocumented status) and the Spanish-speaking tester's communication in Spanish. Analysis of an index of good practices constructed from the audit data revealed that very few strategies for promoting vaccinations were regularly implemented. In regression analyses, an additional point on the good practices index predicted a 0.133 percentage point increase in the percent of the population receiving the first vaccine dose, suggesting the lack of implementation of these good practices may represent a missed opportunity to increase COVID-19 vaccination rates. We identified exemplars in the communications that the federal government could disseminate to rapidly improve state practices and the accessibility of accurate information on COVID-19 vaccination opportunities.
一项现场试验采用了配对审计测试设计，测试人员具有不同的种族和语言背景，旨在记录和评估美国各州询问 COVID-19 疫苗接种情况的个人接触情况，并对鼓励接种的循证沟通策略的实施程度进行评估。审计测试人员包括代表拉丁裔身份的个体，因为研究表明他们在接种基础设施方面面临更大的困难，对公共免疫工作的信任度较低。数据是在 2021 年 6 月中旬至 8 月中旬通过电话和电子通信收集的。实证分析证实，各州在明确沟通疫苗接种要求和程序的方式以及在提供接种 COVID-19 疫苗机会之前要求个人提供哪些信息方面存在很大差异。讲西班牙语的测试人员更有可能遇到负面或带有种族色彩的语言——主要是隐含的语言，例如电话突然中断（而不是试图获得语言支持），并要求提供额外的身份证明或个人信息，然后才能继续进行疫苗接种登记。明显的负面或种族主义遭遇的例子包括对拉丁裔测试人员的身份（或被认为是无证身份）的轻蔑评论，以及讲西班牙语的测试人员用西班牙语进行交流。从审计数据构建的良好实践指数分析表明，很少有促进疫苗接种的策略得到定期实施。在回归分析中，良好实践指数上的额外分数预测了第一剂疫苗接种人口比例增加 0.133 个百分点，这表明这些良好实践的缺乏实施可能代表了增加 COVID-19 疫苗接种率的错失机会。我们在沟通中找到了联邦政府可以传播的范例，可以迅速改善州级实践和 COVID-19 疫苗接种机会的准确信息的可及性。
