Epperson Anna E, Carson Savanna L, Garcia Andrea N, Casillas Alejandra, Castellon-Lopez Yelba, Brown Arleen F, Garrison Nanibaa' A
Department of Psychological Sciences, School of Social Sciences, Humanities and Arts, University of California, Merced, Merced, CA, 95343, USA.
Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA.
Vaccine X. 2022 Dec;12:100212. doi: 10.1016/j.jvacx.2022.100212. Epub 2022 Aug 30.
Significant disparities in COVID-19 morbidity and mortality exist for Native American (NA) people, the majority of whom live in urban areas. COVID-19 vaccination is a key strategy for mitigating these disparities; however, vaccination disparities affect NA communities. The current study investigated COVID-19 vaccine decision-making before widespread vaccine rollout occurred, among urban NA communities. We aimed to understand vaccine decision-making factors to develop recommendations about COVID-19 vaccine outreach.
We conducted three in-depth virtual focus groups with 17 NA adults living in an urban community (Los Angeles County) between December 2020 and January 2021. Participants were recruited through NA community-based organizations and community stakeholders. Reflexive thematic analysis was conducted using Atlas.ti.
Participants in this study identified two overarching themes with implications for health vaccination campaigns. First, participants described a need for tailored information and outreach, including NA vaccine outreach that addresses misconceptions about vaccine development to calm fears of experimentation and support communication of vaccine evidence specific to NA people. Second, participants suggested strategies to improve public health resources in the urban NA community, such as the need for unified, proactive communication across trusted NA entities, navigation support to improve vaccine accessibility, and adequately resourcing health partnerships with and among trusted NA community agencies for improved reach.
In this qualitative study, we found that urban NA participants reported several factors that affected their vaccine decision-making, including a lack of tailored information for their communities. Our findings also underscore the need to work with tribes, tribal leadership, and urban NA serving organizations to coordinate vaccine communication and distribution to urban communities where the majority of NAs now reside. Further, these findings have implications for COVID-19 vaccine outreach among urban NA communities and demonstrate the need for clear and tailored engagement about the COVID-19 vaccine.
美国原住民（NA）人群在新冠病毒病（COVID-19）的发病率和死亡率方面存在显著差异，其中大多数人生活在城市地区。COVID-19疫苗接种是缓解这些差异的关键策略；然而，疫苗接种差异影响着NA社区。本研究调查了在疫苗广泛推广之前，城市NA社区中人们对COVID-19疫苗的决策情况。我们旨在了解疫苗决策因素，以便就COVID-19疫苗推广提出建议。
2020年12月至2021年1月期间，我们与居住在城市社区（洛杉矶县）的17名NA成年人进行了三次深入的虚拟焦点小组访谈。参与者通过基于NA社区的组织和社区利益相关者招募。使用Atlas.ti进行反思性主题分析。
本研究的参与者确定了两个对健康疫苗接种运动有影响的总体主题。首先，参与者表示需要量身定制的信息和推广，包括针对NA人群的疫苗推广，以解决对疫苗研发的误解，平息对人体试验的恐惧，并支持传播针对NA人群的疫苗证据。其次，参与者提出了改善城市NA社区公共卫生资源的策略，例如需要在受信任的NA实体之间进行统一、积极的沟通，提供导航支持以提高疫苗可及性，以及为与受信任的NA社区机构建立和开展健康合作关系提供充足资源，以扩大覆盖范围。
在这项定性研究中，我们发现城市NA参与者报告了几个影响他们疫苗决策的因素，包括缺乏针对其社区的量身定制的信息。我们的研究结果还强调，需要与部落、部落领导层以及服务于城市NA人群的组织合作，以协调向大多数NA人群现在居住的城市社区进行疫苗宣传和分发。此外，这些研究结果对城市NA社区中的COVID-19疫苗推广具有启示意义，并表明需要就COVID-19疫苗进行清晰且量身定制的宣传。
