Health literacy is a significant barrier for SARS-CoV-2 vaccine acceptance, particularly among low- income and minority communities that have experienced disproportionately high rates of COVID-19 infection and mortality. Previous research has identified the importance of trust for health literacy. This is especially true for minority communities that have experienced systemic discrimination within the US healthcare system and harbor longstanding mistrust of physicians. Vaccine acceptance relies on public trust not only in individual providers, but also in public health officials and the health care system as a whole. Public health experts agree that the US lacks vaccine readiness and that interventions are needed to effectively overcome substantial vaccine hesitancy. Yet tens of millions of U.S. adults are unable to make decisions in their own best interest because they neither can access, nor understand, health information. This project uses a social ecological framework to investigate how low-income Latinx/Hispanics and African Americans in Southern California's Inland Empire engage with health information about COVID-19 and the SARS-CoV-2 vaccine. Understanding how information works as a system, rather than as a problem of physician-patient communication, facilitates identification of high-leverage points for communication interventions to increase vaccine acceptance among vulnerable populations. Research questions: What are the health information-seeking patterns of low-income and minority patients? And what can be learned from these patterns to design effective communication interventions to mitigate misinformation and overcome vaccine hesitancy? Aim 1: Investigate current information needs, knowledge, and concerns regarding COVID-19 and a SARS-CoV-2 vaccine. Focus groups and a Community Advisory Board will inform the design of an online survey to assess low-income African Americans' and Latinx/Hispanics' knowledge, beliefs, expectations, concerns, and fears regarding COVID-19 and a SARS-CoV-2 vaccine. Follow-up phone interviews will be conducted with a subset of survey respondents to probe more deeply into the processes through which individuals seek and obtain health information.
Aim 2 : Develop communication interventions to increase vaccine acceptance. Qualitative and quantitative analyses from Aim 1 will be integrated to categorize information-seeking patterns and identify relationships of trust in low-income minority communities. Communication strategies will then be designed to acknowledge both information barriers and existing social capital that can be harnessed in low-income and minority communities to increase vaccine acceptance.
Although development of a SARS-CoV-2 vaccine holds promise for ending the current pandemic, it cannot benefit low-income and minority communities if they lack access to reliable, scientifically valid health information. This study identifies potential information barriers to COVID-19 vaccination. Our goal is to reduce COVID-19-related health disparities by identifying strategic interventions to improve health literacy for a diverse, low-income, and medically under-resourced population.
