A Tale of Two Cities: COVID-19 Vaccine Hesitancy as a Result of Racial, Socioeconomic, Digital, and Partisan Divides

The unprecedented COVID-19 pandemic has drawn great attention to the issue of vaccine hesitancy, as the acceptance of the innovative RNA vaccine is relatively low. Studies have addressed multiple factors, such as socioeconomic, political, and racial backgrounds. These studies, however, rely on survey data from participants as part of the population. This study utilizes the actual data from the U.S. Census Bureau as well as actual 2020 U.S. presidential election results to generate four major category of factors that divide the population: socioeconomic status, race and ethnicity, access to technology, and political identification. This study then selects a region in a traditionally democratic state (Capital Region in New York) and a region in a traditionally republican state (Houston metropolitan area in Texas). Statistical analyses such as correlation and geographically weighted regression reveal that factors such as political identification, education attainment, and non-White Hispanic ethnicity in both regions all impact vaccine acceptance significantly. Other factors, such as poverty and particular minority races, have different influences in each region. These results also highlight the necessity of addressing additional factors to further shed light on vaccine hesitancy and potential solutions according to identified factors.

Use of Popular Opinion Leader Models to Disseminate Information About Clinical Trials to Black Individuals With Lupus in Two US Cities.

OBJECTIVE: Clinical trials for systemic lupus erythematosus ("lupus") under enroll Black individuals despite higher disease prevalence, morbidity, and mortality among Black compared to White individuals. To begin to address this disparity, we leveraged community-academic partnerships in 2 US cities (Boston and Chicago) to train popular opinion leaders (POLs) to disseminate information about clinical trials in predominantly Black communities. METHODS: The team of community and academic partners collaboratively developed a 5-module curriculum about clinical trials, barriers, facilitators, and structural racism in research. We enrolled POLs in Boston and Chicago to participate virtually in the curriculum and assessed knowledge gained by comparing pre- and post-test scores. We described the POLs' ability to disseminate information about clinical trials through their communities. RESULTS: We enrolled 19 POLs in Boston and 16 in Chicago; overall, 71% reported a lupus diagnosis, 94% were female, and 80% self-identified as Black or African American. The program was adapted to virtual formats due to the COVID-19 pandemic. POLs demonstrated significant improvement comparing pre/post scores for the conduct of clinical trials and history of racism in clinical research. Fifteen POLs (43%) reported their dissemination of information about clinical trials. Information reached 425 community members in Boston (90% virtually) and 1,887 in Chicago (95% virtually). CONCLUSION: By leveraging community-academic partnerships, we developed and implemented a curriculum to promote familiarity with clinical trials, leading to information dissemination by POLs in predominantly Black communities that are underrepresented in lupus clinical trials. The program successfully transitioned to a virtual model during the COVID-19 pandemic.

Use of popular opinion leader models to disseminate information about clinical trials to people of color with lupus in two U.S. cities

1101 Table 1Characteristics of Popular Opinion Leaders in Boston and ChicagoSite Boston Chicago Number of POLs 19 17 Mean (SD) Age 55.6 (11.4) 52.8 (18.2) Sex – N (%) Female 18 (95) 14 (82) Male 1 (5) 3 (18) Self-identified Race/Ethnicity- N (%) Black/African American 13 (68) 16 (94) White 3 (16) 0 Other Race 2 (11) 0 Hispanic 1 (5) 1 (6) Educational attainment (%) High School 6 (32) 1 (6) Technical School/GED 3 (16) 2 (13) Bachelor 4 (21) 6 (38) Master 6 (32) 3 (19) Mean Years of Work Experience (SD) 28.8 (13) 27.4 (10) Marital Status (%) Single 11 (58) 7 (41) Married 4 (21) 6 (35) Divorced 3 (16) 2 (12) Widowed 1 (5) 2 (12) Housing (%) Live with spouse, blood relatives and family 10 (53) 10 (59) Live alone 9 (47) 7 (41) Health Conditions (%) Diagnosed with lupus 12 (63) 13 (77) Diabetes 1 (5) 0 Hypertension 7 (37) 9 (53) Arthritis 12 (63) 12 (71) Obesity 9 (47) 4 (24) Relative with lupus (%) 8 (42) 11 (65) Previous Community-Based Experience (%) Previous training as a health promoter 8 (42) 3 (18) Participated in previous lupus educational training 13 (68) 13 (77) Hosted presentations or community-based events 11 (58) 9 (53) Gave testimony 10 (53) 5 (56) Presented at health fairs 8 (42) 8 (89) Distributed educational materials 10 (53) 8 (89) Contacted stakeholders 6 (32) 3 (33) Participated in patient advocacy 9 (47) 4 (44) Collected information from community members (surveys or other) 6 (32) 3 (33) Patient navigation 5 (26) 3 (33) Social Network (%) Member of a gym/sports club 7 (37) 8 (47) Member of a faith-based organization such as a church or ministry 11 (58) 13 (77) Have places they meet with their social network 10 (53) 8 (47) Abbreviations: POL, Popular Opinion Leader;GED, General Educational Development.ConclusionsThe POL model was effectively adapted to a vi tual program in the context of COVID-19. Modules developed jointly by academic and community partners were implemented and successfully improved knowledge regarding clinical trials. POL retention was high, possibly due to the convenience of virtual trainings and the sense of community developed. Further studies are needed to determine impact on the diversity of SLE trial enrollment.