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      The Past Is so Present: Understanding COVID-19 Vaccine Hesitancy Among African American Adults Using Qualitative Data


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          African Americans (AAs) are disproportionately affected by structural and social determinants of health, resulting in greater risks of exposure to and deaths from COVID-19. Structural and social determinants of health feed vaccine hesitancy and worsen health disparities.


          The present study aims to explore vaccine attitudes and intentions among program participants, understand the role of an African American faith-based wellness program in COVID-19 awareness and vaccine uptake, and solicit potential solutions for this deep-rooted public health problem.


          Data were collected through 21 in-depth interviews among individuals involved within a community-based wellness program. Sixteen phone and five in-person interviews were conducted with church leaders, lifestyle coaches, and program participants. All interviews were audio-recorded, transcribed verbatim, and inductively and thematically analyzed by three researchers.


          Live Well by Faith (LWBF) acted as a trusted information source for COVID-19 resources for the AA community. Services provided by Live Well by Faith included enrolling community members for vaccines, negotiating vaccine provision to and facilitating the establishment of vaccine clinics at AA churches, and connecting community members to healthcare providers. Despite the role Live Well by Faith played, VH was a significant concern due, in part, to historical mistrust of government and pharmaceutical companies conducting unethical healthcare research among Black populations. Other factors included uncertainty about vaccination (vaccines’ safety, efficacy, and necessity), social media misinformation, and political affiliation. Participants expressed the need for government to commit resources towards addressing historical factors and building trust with minority populations.


          Resource targeting programs such as Live Well by Faith that engage faith and community leaders in co-designed shared and culturally grounded interventions can help restore and strengthen trust in vaccines and governments and reduce vaccine hesitancy.

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          Most cited references44

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          Is Open Access

          Vaccine hesitancy: Definition, scope and determinants.

          The SAGE Working Group on Vaccine Hesitancy concluded that vaccine hesitancy refers to delay in acceptance or refusal of vaccination despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place and vaccines. It is influenced by factors such as complacency, convenience and confidence. The Working Group retained the term 'vaccine' rather than 'vaccination' hesitancy, although the latter more correctly implies the broader range of immunization concerns, as vaccine hesitancy is the more commonly used term. While high levels of hesitancy lead to low vaccine demand, low levels of hesitancy do not necessarily mean high vaccine demand. The Vaccine Hesitancy Determinants Matrix displays the factors influencing the behavioral decision to accept, delay or reject some or all vaccines under three categories: contextual, individual and group, and vaccine/vaccination-specific influences.
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            Saturation in qualitative research: exploring its conceptualization and operationalization

            Saturation has attained widespread acceptance as a methodological principle in qualitative research. It is commonly taken to indicate that, on the basis of the data that have been collected or analysed hitherto, further data collection and/or analysis are unnecessary. However, there appears to be uncertainty as to how saturation should be conceptualized, and inconsistencies in its use. In this paper, we look to clarify the nature, purposes and uses of saturation, and in doing so add to theoretical debate on the role of saturation across different methodologies. We identify four distinct approaches to saturation, which differ in terms of the extent to which an inductive or a deductive logic is adopted, and the relative emphasis on data collection, data analysis, and theorizing. We explore the purposes saturation might serve in relation to these different approaches, and the implications for how and when saturation will be sought. In examining these issues, we highlight the uncertain logic underlying saturation—as essentially a predictive statement about the unobserved based on the observed, a judgement that, we argue, results in equivocation, and may in part explain the confusion surrounding its use. We conclude that saturation should be operationalized in a way that is consistent with the research question(s), and the theoretical position and analytic framework adopted, but also that there should be some limit to its scope, so as not to risk saturation losing its coherence and potency if its conceptualization and uses are stretched too widely.
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              Demonstrating Rigor Using Thematic Analysis: A Hybrid Approach of Inductive and Deductive Coding and Theme Development


                Author and article information

                J Racial Ethn Health Disparities
                J Racial Ethn Health Disparities
                Journal of Racial and Ethnic Health Disparities
                Springer International Publishing (Cham )
                19 February 2022
                : 1-13
                [1 ]GRID grid.134936.a, ISNI 0000 0001 2162 3504, Department of Health Sciences, , University of Missouri, ; Columbia, MO USA
                [2 ]GRID grid.8974.2, ISNI 0000 0001 2156 8226, Department of Occupational Therapy, Faculty of Community & Health Science, , University of the Western Cape, ; Cape Town, South Africa
                [3 ]GRID grid.134936.a, ISNI 0000 0001 2162 3504, Masters of Public Health Program, , University of Missouri, ; Columbia, MO USA
                © W. Montague Cobb-NMA Health Institute 2022

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.


                covid-19,vaccine hesitancy,social determinants of health,health disparities,live well by faith,african american


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