R01MD019235

Improving COVID-19 vaccine uptake among racial and ethnic minority groups with rheumatic diseases - project summary.

Black and Latinx individuals are at higher risk for certain autoimmune rheumatic diseases (AIRDs) and have experienced worse COVID-19 outcomes compared to their white counterparts.

The American College of Rheumatology recommends beyond the initial COVID-19 vaccination, subsequent COVID-19 vaccine doses to complete the primary vaccination series and a booster dose in people with AIRD.

Yet, historically, overall vaccine uptake among people with AIRDs has been low, and this vaccine reluctance has extended to COVID-19 vaccination.

This proposal will harness community-engaged methods to develop and test the effectiveness of a multi-modal intervention that combines "storytelling" videos and patient navigation to increase uptake of recommended COVID-19 vaccination among Black and Latinx AIRD patients in two distinct US geographic regions.

Aim 1 will develop a multi-modal intervention that includes a) "storytelling" videos we will produce with vaccinated Black or Latinx patients with AIRDs narrating their COVID-19 vaccination experiences, and b) a patient navigation approach to encourage recommended COVID-19 vaccination.

Navigators will be trained using virtual case simulation to discuss up-to-date guidance and provide logistical support for vaccination.

In Aim 2A we will recruit 1,170 racial and ethnic minority patients from 4 rheumatology clinics in the southern and northeastern U.S. to participate in this patient-level, randomized, controlled, parallel group trial.

Participants will be randomized to receive at the routine clinic visit either "storytelling" or an "attention-control" plus usual care.

At the clinic visit, coordinators will invite participants to view "storytelling" videos on tablet computers deployed in a private clinic area.

At 2 days after the clinic visit, the navigators will contact each participant remotely (phone/video calls) to provide customized assistance for vaccination. A second contact will occur ~2 weeks later.

We will examine the differences in rates of COVID-19 vaccine receipt between racial/ethnic minority participants with AIRD exposed to our multi-modal intervention versus an "attention-control" video (focused on the merits of a balanced diet/exercise on health status) plus usual care.

We will measure rates of receipt of subsequent COVID-19 vaccination at 3 months after the clinic visit using extant linkages to state vaccination records (primary endpoint).

We will measure via surveys COVID-19 vaccine confidence, influenza vaccine uptake (self-report) as a proxy for intervention effect on vaccination behavior for other vaccines, self-efficacy, and social health.

We will explore whether insurance status and education moderate COVID-19 vaccine uptake.

In Aim 2B, using surveys and semi-structured interviews, we will assess how intervention components achieved their effects to inform future scale-up of our intervention.

Beyond our innovative approach and experienced team, a key strength of our study is its generalizability since we are including two geographically distinct regions with substantial ethnic/racial diversity in their populations that deliver care to many uninsured, Medicaid, and other historically marginalized groups.

University Of Alabama At Birmingham

NOT APPLICABLE

93.846 - Arthritis, Musculoskeletal and Skin Diseases Research

National Institute for Minority Health and Health Disparities (NIMHD) [HHS - NIH]

Birmingham, Alabama 352940004 United States

Single Zip Code

Research Project Grant (Parent R01 Clinical Trial Required) (PA-20-183)

Amendment Since initial award the End Date has been extended from 02/29/28 to 05/31/28 and the total obligations have increased 1453% from $200,000 to $3,106,910.