Department of Health Disparities Research, MD Anderson Cancer Center, Houston, TX 77230, USA.
Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA.
Int J Environ Res Public Health. 2023 Feb 14;20(4):3372. doi: 10.3390/ijerph20043372.
COVID-19 has disproportionately affected Black, Indigenous, and People of Color (BIPOC) communities, yet rates of COVID-19 vaccination remain low among these groups. A qualitative study was undertaken to better understand the factors contributing to low vaccine acceptance among these communities. Seventeen focus groups were conducted in English and Spanish from 8/21 to 9/22, with representatives from five critical community sectors: (1) public health departments ( = 1); (2) Federally Qualified Health Centers ( = 2); (3) community-based organizations ( = 1); (4) faith-based organizations ( = 2); and (5) BIPOC residents in six high-risk, underserved communities in metropolitan Houston ( = 11), for a total of 79 participants, comprising 22 community partners and 57 community residents. A social-ecological model and anti-racism framework were adopted to guide data analysis using thematic analysis and constant comparison, which yielded five key themes: (1) legacy of structural racism: distrust and threat; (2) media misinformation: mass and social; (3) listening and adapting to community needs; (4) evolving attitudes towards vaccination; and (5) understanding alternative health belief systems. Although structural racism was a key driver of vaccine uptake, a notable finding indicated community residents' vaccine attitudes can be changed once they are confident of the protective benefits of vaccination. Study recommendations include adopting an explicitly anti-racist lens to: (1) listen to community members' needs and concerns, acknowledge their justified institutional distrust concerning vaccines, and learn community members' healthcare priorities to inform initiatives built on local data; (2) address misinformation via culturally informed, consistent messaging tailored to communal concerns and delivered by trusted local leaders through multimodal community forums; (3) take vaccines to where people live through pop-up clinics, churches, and community centers for distribution via trusted community members, with educational campaigns tailored to the needs of distinct communities; (4) establish vaccine equity task forces to continue developing sustainable policies, structures, programs and practices to address the structural issues driving vaccine and health inequities within BIPOC communities; and (5) continue investing in an effective infrastructure for healthcare education and delivery, essential for competently responding to the ongoing healthcare and other emergency crises that impact BIPOC communities to achieve racial justice and health equity in the US. Findings underscore the crucial need to provide culturally tailored health education and vaccination initiatives, focused on cultural humility, bidirectionality, and mutual respect to support vaccine re-evaluation.
COVID-19 对黑人和有色人种（BIPOC）社区造成了不成比例的影响，但这些群体的 COVID-19 疫苗接种率仍然很低。一项定性研究旨在更好地了解导致这些社区疫苗接受率低的因素。从 8 月 21 日至 9 月 22 日，以五个关键社区部门的代表（1）公共卫生部门（= 1）；（2）合格的联邦健康中心（= 2）；（3）社区组织（= 1）；（4）信仰组织（= 2）；（5）休斯顿大都市六个高风险、服务不足社区的 BIPOC 居民（= 11）进行了 17 次英语和西班牙语焦点小组，共有 79 名参与者，包括 22 名社区合作伙伴和 57 名社区居民。采用社会生态模型和反种族主义框架，通过主题分析和恒定性比较，指导数据分析，得出五个关键主题：（1）结构性种族主义的遗留问题：不信任和威胁；（2）媒体错误信息：大众和社会；（3）倾听和适应社区需求；（4）对疫苗接种的态度不断演变；（5）了解替代健康信仰体系。尽管结构性种族主义是疫苗接种率的一个关键驱动因素，但一个显著的发现表明，一旦社区居民对疫苗的保护益处有信心，他们的疫苗态度就可以改变。研究建议包括采取明确的反种族主义视角：（1）倾听社区成员的需求和关注点，承认他们对疫苗的合理机构不信任，并了解社区成员的医疗保健重点，以便根据当地数据制定计划；（2）通过针对社区关注问题并由受信任的当地领导人通过多模式社区论坛提供的文化上有针对性、一致的信息来解决错误信息问题；（3）通过弹出式诊所、教堂和社区中心，将疫苗送到人们居住的地方，由受信任的社区成员分发疫苗，并针对不同社区的需求开展教育活动；（4）建立疫苗公平工作队，继续制定可持续的政策、结构、计划和做法，以解决推动 BIPOC 社区疫苗和健康不平等的结构性问题；（5）继续投资于有效的医疗保健教育和提供基础设施，这对于应对影响 BIPOC 社区的持续医疗保健和其他紧急危机至关重要，以实现美国的种族正义和健康公平。研究结果强调了提供文化上合适的健康教育和疫苗接种计划的迫切需要，重点是文化谦逊、双向性和相互尊重，以支持重新评估疫苗。
