Leveraging Community-Academic Partnerships and Social Networks to Disseminate Vaccine-Related Information and Increase Vaccine Uptake Among Black Individuals with Rheumatic Diseases

PROJECT SUMMARY Individuals with chronic rheumatic diseases including arthritis comprise approximately 25% of the U.S. population. Racial/ethnic and socioeconomic disparities in adverse, often avoidable outcomes occur in nearly all rheumatic diseases particularly among Black and lower socioeconomic status individuals. Despite the importance of vaccinations in patients with rheumatic diseases, and the high rates of serious infections, vaccine uptake is consistently poor. In the U.S., COVID-19 vaccine uptake is lower and vaccine hesitancy higher among Black patients compared with White patients, and this holds true in rheumatic diseases. With the profound disparities uncovered by the COVID-19 pandemic aggravated by proven disparities in rheumatic disease outcomes, and heightened vulnerability to infections, there is an urgent need to address low vaccine uptake and hesitancy among Black individuals with these conditions. In addition, it is critical to also increase vaccine uptake among the social networks of individuals with rheumatic diseases who are immunosuppressed and may have less robust vaccination responses. Our team has forged longstanding community-academic partnerships in the Boston and Chicago areas to understand the needs of Black individuals with lupus, a systemic rheumatic disease, and the role racism plays in health and healthcare access. Framed by the Public Health Critical Race Praxis that recognizes the pervasiveness of racism in our society, we will leverage our community-academic partnerships to implement the CDC's Popular Opinion Leader (POL) model whereby trusted community leaders are trained to disseminate information regarding COVID-19 vaccination through their social networks in predominately Black communities to increase vaccine uptake and reduce hesitancy. In response to the NOSI NOT-MD-21-008: Research to Address Vaccine Hesitancy, Uptake and Implementation among Populations that Experience Disparities, we propose the following aims: Aim 1. To leverage community- academic partnerships across two U.S. cities to develop training and evaluation materials for POLs. Aim 2a. To establish the efficacy of a community-based intervention with and without a racial justice framework to increase COVID-19 vaccine uptake and reduce hesitancy among social networks of Black individuals with rheumatic conditions. We will conduct a cluster randomized controlled trial to test whether POLs trained with racial justice framing embedded in information on vaccine safety and efficacy will result in greater COVID-19 vaccine uptake among their social network members compared to safety and efficacy training alone. Aim 2b. To determine the structure and composition of the outreach social networks of POLs. We will enhance the existing POL model by adding a validated mixed methods approach to compare the social networks reached by POLs in each arm. We hypothesize that incorporating a racial justice lens will empower POLs to disseminate information more broadly and more persuasively and increase vaccine uptake by reducing fear and mistrust.