"They Don't Really Consider Us Essential, But We Are": a Qualitative Investigation of Vaccine Acceptance and Perceived Workplace Safety Among Black Transit Workers During the COVID-19 Pandemic.

Black Americans face a higher risk of coronavirus disease 2019 (COVID-19) morbidity and mortality due to adverse social determinants of health, including their overrepresentation in the frontline workforce. Despite these inequities, increasing vaccine acceptance among this subpopulation has been challenging. We conducted semi-structured qualitative focus groups with Black public transit workers living in the USA to explore behavioral intentions regarding COVID-19 vaccine uptake, occupational health challenges, and the perceived impact of racism on workplace health and safety during the pandemic. A thematic analysis approach was used to analyze the final transcripts. We completed three focus groups (n=10 participants) in October and November of 2021. Enabling factors for vaccination included opportunities for vaccination in the workplace, flexible hours of operation, and walk-in vaccine clinics. Disabling factors included excessive wait times. Some participants also cited lack of cleanliness, inconsistent enforcement of COVID-19 safety protocols, and unclear workplace policies regarding sick and hazard pay as major safety barriers. Perceptions regarding the role of racism in their experiences with COVID-19 as transit workers were mixed. Though occupational health and safety concerns were high, there are opportunities for transit agencies and government officials to improve both vaccine uptake and working conditions for Black transit workers.

The effect of source credibility on promising belief messages: A message pretesting study to address COVID-19 vaccine hesitancy among Black Americans

Public health messaging campaigns can be useful tools for addressing vaccine hesitancy. Behavior change theory-driven formative research, which guides campaign planners in message topic selection, is necessary for campaigns' success. However, such research cannot advise on how to communicate campaign messages. Information processing theories propose avenues through which messages can be made more persuasive.Focusing on Black Americans, this dissertation aims to test an approach to improve future public health messaging campaigns targeting COVID-19 vaccine hesitancy. Specifically, it investigates whether source credibility (an information processing theory variable) can enhance the persuasiveness of differentially promising campaign message topics. These message topics refer to beliefs associated with intention to receive a COVID-19 vaccine.Study 1 was a two-part belief elicitation. In the first part (Study 1A) participants (N=117) reported their most salient beliefs related to the COVD-19 vaccine in an open-ended survey. The second part involved topic modeling on 5945 tweets discussing the vaccine. Beliefs identified from these studies were transformed into cross-sectional survey items for Study 2. Results from this study highlighted the utility in combining traditional survey data with publicly available social media data to learn about the health concerns of a target population.Study 2 (N=500) identified beliefs varying in promise, following the Hornik & Woolf approach, to be transformed into message topics. Study 3 was a message experiment where participants (N=245) were exposed to messages, addressing either a "more" or "less" promising topic, designed to increase vaccination intention. The messages were also either communicated by a health professional, or layperson source. Results of Study 3 indicated no main effects of neither message promise, nor source credibility on vaccination intention. Messages targeting the "less" promising topic shifted the linked belief, but the belief was not associated with intention. Messages on the "more" promising topic did not shift the linked belief, but the belief was strongly associated with intention. Evidence from these studies underline the benefit of choosing the most promising message topics when planning a public health messaging campaign. These results also suggest that additional research is needed to identify credible sources for vaccine non-intenders, and other differentiating characteristics of this unvaccinated population to develop effective public messaging campaigns in the future. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

An Investigation of Low COVID-19 Vaccination Intentions among Black Americans: The Role of Behavioral Beliefs and Trust in COVID-19 Information Sources.

Developing a COVID-19 vaccine is a critical strategy for combatting the pandemic. However, for vaccination efforts to succeed, there must be widespread willingness to vaccinate. Prior research has found that Black Americans, who are disproportionately impacted by COVID-19, report lower intentions to get a vaccine than do other populations. We investigate two potential contributors to this disparity: COVID-19 vaccine-related behavioral beliefs and trust in four COVID-19 information sources (mainstream media, social media, President Trump, and public health officials and agencies). Using a nationally-representative survey (n= 889), we demonstrate that differences in vaccination beliefs explain the lower vaccination intentions reported by Black participants, compared to non-Black participants. However, while trust in information sources is associated with vaccination beliefs, differences in trust do not account for the observed differences in vaccination beliefs by race. Furthermore, we find that race moderates the relationships between trust in two sources (Trump and public health officials and agencies) and vaccination beliefs. The effects of trusting these sources on COVID-19 vaccine-related beliefs are smaller among Black participants; thus trust in these sources is less consequential to their pro-vaccination beliefs. Our results suggest that trust in information sources alone does not explain the observed relationship between race and vaccination beliefs.

Association of COVID-19 Misinformation with Face Mask Wearing and Social Distancing in a Nationally Representative US Sample.

Wide-spread misinformation about the COVID-19 pandemic has presented challenges for communicating public health recommendations. Should campaigns to promote protective behaviors focus on debunking misinformation or targeting behavior-specific beliefs? To address this question, we examine whether belief in COVID-19 misinformation is directly associated with two behaviors (face mask wearing and social distancing), and whether behavior-specific beliefs can account for this association and better predict behavior, consistent with behavior-change theory. We conducted a nationally representative two-wave survey of U.S. adults from 5/26/20-6/12/20 (n = 1074) and 7/15/20-7/21//20 (n = 889; follow-up response 83%). Scales were developed and validated for COVID-19 related misinformation beliefs, social distancing and face mask wearing, and beliefs about the consequences of both behaviors. Cross-lagged panel linear regression models assessed relationships among the variables. While belief in misinformation was negatively associated with both face mask wearing (B = -.27, SE =.06) and social-distancing behaviors (B = -.46, SE =.08) measured at the same time, misinformation did not predict concurrent or lagged behavior when the behavior-specific beliefs were incorporated in the models. Beliefs about behavioral outcomes accounted for face mask wearing and social distancing, both cross-sectionally (B =.43, SE =.05; B =.63, SE =.09) and lagged over time (B =.20, SE = 04; B =.30, SE =.08). In conclusion, belief in COVID-19-related misinformation is less relevant to protective behaviors, but beliefs about the consequences of these behaviors are important predictors. With regard to misinformation, we recommend health campaigns aimed at promoting protective behaviors emphasize the benefits of these behaviors, rather than debunking unrelated false claims.