Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
BMC Public Health. 2023 Jul 14;23(1):1356. doi: 10.1186/s12889-023-16210-9.
Inequities in COVID-19 vaccine accessibility and reliable COVID-related information disproportionately affected marginalized racial and ethnic communities in the U.S. The Get Out the Vaccine (GOTVax) program, an innovative statewide government-funded COVID-19 vaccine canvassing program in California, aimed to reduce structural barriers to COVID-19 vaccination in high-risk communities with low vaccination rates. GOTVax consisted of a community-academic-government partnership with 34 local trusted community-based organizations' (CBOs) to conduct COVID-19 vaccine outreach, education, and vaccine registration. The purpose of this qualitative evaluation study was to explore the barriers and facilitators of using local CBOs to deploy a geographically, racially, and ethnically diverse state-wide COVID-19 vaccine outreach program.
Semi-structured online interviews were conducted with participating GOTVax CBO leaders from November 2021 to January 2022. Transcripts were analyzed using reflexive thematic analysis.
Thirty-one of 34 CBOs participated (91% response rate). Identified themes encompassed both facilitators and barriers to program participation. Key facilitators included leveraging trust through recognized entities; promoting empathetic, tailored outreach; and flexibility of milestone-based CBO funding contracts for rapid program implementation. Barriers included navigating community sociopolitical, geographic, and cultural factors; managing canvassers' safety; desiring metrics for self-evaluation of outreach success; mitigating canvassing technology challenges; and concerns of program infrastructure initially limiting outreach. CBOs problem-solved barriers with academic and government partners.
Between May and December 2021, the GOTVax program reached over 2 million California residents and registered over 60,000 residents for COVID-19 vaccination. Public health campaigns may improve benefits from leveraging the expertise of community-trusted CBOs and universities by providing flexible infrastructure and funding, allowing CBOs to seamlessly tailor outreach most applicable to local minoritized communities.
在美国，新冠疫苗可及性和可靠的新冠相关信息方面的不平等现象不成比例地影响了处于边缘地位的少数族裔社区。加州的“Get Out the Vaccine”（GOTVax）项目是一项创新的全州政府资助的新冠疫苗宣传计划，旨在减少高风险、低疫苗接种率社区中与新冠疫苗接种相关的结构性障碍。GOTVax 由一个社区-学术-政府合作关系组成，有 34 个当地受信任的社区组织（CBO）参与，以开展新冠疫苗宣传、教育和疫苗接种登记工作。本定性评估研究的目的是探讨利用当地 CBO 部署一个具有地理、种族和族裔多样性的全州范围新冠疫苗宣传计划的障碍和促进因素。
2021 年 11 月至 2022 年 1 月，对参与 GOTVax CBO 领导人进行了半结构式在线访谈。使用反思性主题分析对转录本进行分析。
34 个 CBO 中有 31 个（91%的回复率）参与。确定的主题既包括参与计划的促进因素，也包括障碍。主要的促进因素包括通过公认的实体建立信任；促进富有同情心、量身定制的外展；以及基于里程碑的 CBO 资助合同的灵活性，以便快速实施计划。障碍包括应对社区社会政治、地理和文化因素；管理外展人员的安全；希望对外展成功进行自我评估的指标；减轻外展技术挑战；以及计划基础设施最初限制外展的担忧。CBO 与学术和政府合作伙伴共同解决障碍。
在 2021 年 5 月至 12 月期间，GOTVax 项目覆盖了超过 200 万加利福尼亚居民，并为超过 6 万名居民登记了新冠疫苗接种。公共卫生运动可以通过提供灵活的基础设施和资金，利用社区信任的 CBO 和大学的专业知识，从而提高从利用 CBO 最适应当地少数族裔社区的专业知识中获益的效果。
