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      Strategies That Promote Equity in COVID-19 Vaccine Uptake for Latinx Communities: a Review

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          Abstract 

          Latinx people in the USA have had a high burden of COVID-19 cases, hospitalizations, and death, yet rates of COVID-19 vaccine uptake among Latinx individuals were lower than other demographic groups. Effective strategies to promote vaccine uptake among Latinx communities are needed. We conducted a rapid review of information available between December 2020 and August 2021. Our search strategy used PUBMED, Google, and print media with a prescribed set of definitions and search terms for two reasons: there were limited peer-reviewed studies during early period of roll-out and real-time perspectives were crucially needed. Analyses included expert opinion, descriptions of project implementation and outcomes. We found that approaches varied. An integral component with all interventions was the use of local Latinx community leaders. They could understand the nuances of vaccine hesitancy, access issues, and structural inequities experienced by Latinx communities. The mechanisms for messaging included the use of social media, radio, and promotora outreach workers to disseminate information about COVID-19 vaccines and counter misinformation. Phone hotlines for scheduling were reported. Promoting access involved pop-up clinics at shopping malls, farmer’s markets, and nearby grocery stores which were popularly used to vaccinate Latinx community members. Other practices included limited registration requirements, avoiding online-only communication, and training staff to provide specialized support to Latinx clients. This rapid review provides a basis for developing strategic implementation to increase COVID-19 vaccine uptake in this ongoing pandemic and planning to promote health equity for future bio-events and health crises.

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          Evidence summaries: the evolution of a rapid review approach

          Background Rapid reviews have emerged as a streamlined approach to synthesizing evidence - typically for informing emergent decisions faced by decision makers in health care settings. Although there is growing use of rapid review 'methods', and proliferation of rapid review products, there is a dearth of published literature on rapid review methodology. This paper outlines our experience with rapidly producing, publishing and disseminating evidence summaries in the context of our Knowledge to Action (KTA) research program. Methods The KTA research program is a two-year project designed to develop and assess the impact of a regional knowledge infrastructure that supports evidence-informed decision making by regional managers and stakeholders. As part of this program, we have developed evidence summaries - our form of rapid review - which have come to be a flagship component of this project. Our eight-step approach for producing evidence summaries has been developed iteratively, based on evidence (where available), experience and knowledge user feedback. The aim of our evidence summary approach is to deliver quality evidence that is both timely and user-friendly. Results From November 2009 to March 2011 we have produced 11 evidence summaries on a diverse range of questions identified by our knowledge users. Topic areas have included questions of clinical effectiveness to questions on health systems and/or health services. Knowledge users have reported evidence summaries to be of high value in informing their decisions and initiatives. We continue to experiment with incorporating more of the established methods of systematic reviews, while maintaining our capacity to deliver a final product in a timely manner. Conclusions The evolution of the KTA rapid review evidence summaries has been a positive one. We have developed an approach that appears to be addressing a need by knowledge users for timely, user-friendly, and trustworthy evidence and have transparently reported these methods here for the wider rapid review and scientific community.
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            A multi-component, community-based strategy to facilitate COVID-19 vaccine uptake among Latinx populations: From theory to practice

            Background COVID-19 vaccine coverage in the Latinx community depends on delivery systems that overcome barriers such as institutional distrust, misinformation, and access to care. We hypothesized that a community-centered vaccination strategy that included mobilization, vaccination, and “activation” components could successfully reach an underserved Latinx population, utilizing its social networks to boost vaccination coverage. Methods Our community-academic-public health partnership, “Unidos en Salud,” utilized a theory-informed approach to design our “Motivate, Vaccinate, and Activate” COVID-19 vaccination strategy. Our strategy’s design was guided by the PRECEDE Model and sought to address and overcome predisposing, enabling, and reinforcing barriers to COVID-19 vaccination faced by Latinx individuals in San Francisco. We evaluated our prototype outdoor, “neighborhood” vaccination program located in a central commercial and transport hub in the Mission District in San Francisco, using the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework during a 16-week period from February 1, 2021 to May 19, 2021. Programmatic data, city-wide COVID-19 surveillance data, and a survey conducted between May 2, 2021 and May 19, 2021 among 997 vaccinated clients ≥16 years old were used in the evaluation. Results There were 20,792 COVID-19 vaccinations administered at the neighborhood site during the 16-week evaluation period. Vaccine recipients had a median age of 43 (IQR 32–56) years, 53.9% were male and 70.5% were Latinx, 14.1% white, 7.7% Asian, 2.4% Black, and 5.3% other. Latinx vaccinated clients were substantially more likely than non-Latinx clients to have an annual household income of less than $50,000 a year (76.1% vs. 33.5%), be a first-generation immigrant (60.2% vs. 30.1%), not have health insurance (47.3% vs. 16.0%), and not have access to primary care provider (62.4% vs. 36.2%). The most frequently reported reasons for choosing vaccination at the site were its neighborhood location (28.6%), easy and convenient scheduling (26.9%) and recommendation by someone they trusted (18.1%); approximately 99% reported having an overall positive experience, regardless of ethnicity. Notably, 58.3% of clients reported that they were able to get vaccinated earlier because of the neighborhood vaccination site, 98.4% of clients completed both vaccine doses, and 90.7% said that they were more likely to recommend COVID-19 vaccination to family and friends after their experience; these findings did not substantially differ according to ethnicity. There were 40.3% of vaccinated clients who said they still knew at least one unvaccinated person (64.6% knew ≥3). Among clients who received both vaccine doses (n = 729), 91.0% said that after their vaccination experience, they had personally reached out to at least one unvaccinated person they knew (61.6% reached out to ≥3) to recommend getting vaccinated; 83.0% of clients reported that one or more friends, and/or family members got vaccinated as a result of their outreach, including 18.9% who reported 6 or more persons got vaccinated as a result of their influence. Conclusions A multi-component, “Motivate, Vaccinate, and Activate” community-based strategy addressing barriers to COVID-19 vaccination for the Latinx population reached the intended population, and vaccinated individuals served as ambassadors to recruit other friends and family members to get vaccinated.
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              Using race- and age-specific COVID-19 case data to investigate the determinants of the excess COVID-19 mortality burden among Hispanic Americans

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                Author and article information

                Contributors
                LaRon.Nelson@yale.edu
                Journal
                J Racial Ethn Health Disparities
                J Racial Ethn Health Disparities
                Journal of Racial and Ethnic Health Disparities
                Springer International Publishing (Cham )
                2197-3792
                2196-8837
                6 May 2022
                : 1-9
                Affiliations
                [1 ]GRID grid.415502.7, St Michael’s Hospital, MAP Centre for Urban Health Solutions, ; Toronto, ON Canada
                [2 ]GRID grid.47100.32, ISNI 0000000419368710, Yale University School of Nursing, ; Orange, CT USA
                [3 ]GRID grid.47100.32, ISNI 0000000419368710, Yale College, ; New Haven, CT USA
                [4 ]GRID grid.47100.32, ISNI 0000000419368710, School of Public Health, , Yale University, ; New Haven, CT USA
                [5 ]GRID grid.264260.4, ISNI 0000 0001 2164 4508, State University of New York at Binghamton, ; Binghamton, NY USA
                [6 ]GRID grid.412988.e, ISNI 0000 0001 0109 131X, Faculty of Humanities, , University of Johannesburg, ; Johannesburg, South Africa
                [7 ]GRID grid.419407.f, ISNI 0000 0004 4665 8158, Science Applications International Corporation (“SAIC”), ; Reston, VA USA
                Author information
                http://orcid.org/0000-0002-2630-602X
                Article
                1320
                10.1007/s40615-022-01320-8
                9075141
                35524004
                eab1c691-5292-437d-ab8f-114e1ea545ea
                © 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.

                History
                : 5 January 2022
                : 19 April 2022
                : 21 April 2022
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100004400, Science Applications International Corporation;
                Categories
                Article

                covid-19,vaccine,hesitancy,access,interventions,latinx,hispanic,community

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