Strategies to Improve COVID-19 Vaccination in a Pregnant, Marginalized Population: Quality Improvement Project.

Objectives. To improve COVID-19 vaccination rates in pregnant and recently pregnant women from a baseline rate of 30.8% to 60% over 6 months in a marginalized population. Methods. This quality improvement (QI) project was conducted in a federally qualified health center in Western New York between November 2021 and April 2022, using a Lean Six Sigma method. The QI team created a fishbone diagram, process flow map, and driver diagram. Significant barriers were multiple preferred languages, limited health literacy, and a knowledge gap. Increased vaccination rates were the outcome measure. The process measures were attendance at educational events and increased knowledge in community health workers (CHWs) and doulas. Education for CHWs and patients, creating multilingual educational resources, and motivational interviewing sessions for CHWs and patients were the major interventions. We performed data analysis by using weekly run charts and a statistical process control chart. Results. We achieved a sustainable increase in the COVID-19 vaccination rates in women from 30.0% to 48% within 6 months. Conclusions. Patient education in their preferred languages and at health literacy levels and CHWs' engagement played a crucial role in achieving success. (Am J Public Health. 2024;114(S4):S322-S329. https://doi.org/10.2105/AJPH.2024.307665).

Development of video animations to encourage patient-driven deprescribing: A Team Alice Study.

OBJECTIVE: Patient-driven deprescribing initiatives aim to increase patient knowledge and strengthen self-advocacy skills. This article describes the development of three animated videos designed to educate older adults about unsafe prescribing and medication harm, based on the actionable lessons from the death, by polypharmacy, of an older adult in our community. METHODS: Using a community based participatory research approach (CBPR), members of three senior centers (n = 53) and the Deprescribing Partnership of Western New York (n = 30) were recruited and participated in two rounds of focus groups to guide the video development. RESULTS: Stakeholder input led to changes in content, wording, and visual presentation. The final versions of the videos emphasize the following messages (1) "New medications and what you should know about the risks", (2) "What you should do when a doctor tells you never to take a certain medication", (3) "What you should know about medications when you are in the hospital." CONCLUSION: The study highlights the successful process of using CBPR to develop a series of videos designed to provide information on the risks of polypharmacy, and empower older adults to advocate for themselves. PRACTICE IMPLICATIONS: Animated educational videos are a novel strategy to address medication harm in older adults. This research is a critical first step to increasing patient-led discussions that reduce the incidence of medication harm and inappropriate medication use among older adults.