Factors Affecting SARS-CoV-2 Vaccination Intent and Decision Making Among African American, Native American, and Hispanic Participants in a Qualitative Study.

Limited studies are available on how decisions and perceptions on SARS-CoV-2 vaccination have changed since the start of vaccination availability. We performed a qualitative study to identify factors critical to SARS-CoV-2 vaccination decision making and how perspectives evolved among African American/Black, Native American, and Hispanic communities disproportionately affected by COVID-19 and social and economic disadvantage. We conducted 16 virtual meetings, with 232 participants in wave 1 meetings (December 2020) and with 206 returning participants in wave 2 meetings (January and February 2021). Wave 1 vaccine concerns in all communities included information needs, vaccine safety, and speed of vaccine development. Lack of trust in government and the pharmaceutical industry was influential, particularly among African American/Black and Native American participants. Participants showed more willingness to get vaccinated at wave 2 than at wave 1, indicating that many of their information needs had been addressed. Hesitancy remained greater among African American/Black and Native American participants than among Hispanic participants. Participants in all groups indicated that conversations tailored to their community and with those most trustworthy to them would be helpful. To overcome vaccine hesitancy, we propose a model of fully considered SARS-CoV-2 vaccine decision making, whereby public health departments supply information, align with community values and recognize lived experiences, offer support for decision making, and make vaccination easy and convenient.

Place of Strength: Indigenous Artists and Indigenous Knowledge is Prevention Science.

The Place of Strength (PoS) project represents an effort to Indigenize program evaluation with Indigenous communities by melding art with prevention science. We propose that Native artists as evaluators: (a) opens avenues of communication for Indigenous perspectives; (b) provides opportunities to capture spiritual, relational, and emotional impacts of prevention programming; and (c) maintains Indigenous processes, language, and values at the center of knowledge production. The New Mexico Tribal Prevention Project (NMTPP) funded seven Southwestern tribes to develop substance abuse prevention programs. In response to their expressed negative experiences with evaluation of prevention strategies, NMTPP piloted PoS. PoS shifted systematic knowledge paradigms to Tribal thought, values, and perspectives embodied in art. Art exists in Native communities as a way of documenting lifeways and historical experiences through various cultural forms. We share the process of collaborating with Native artists to document the impact of substance abuse prevention initiatives through their art within a community context. We offer concepts derived from this project as a community psychology model for re-conceptualizing evaluation utilizing Indigenous knowledge.

Helping Clients Feel Welcome: Principles of Adapting Treatment Cross-Culturally.

Empirically supported interventions (ESIs) for treating substance problems have seldom been made available to or tested with minority populations. Dissemination of ESIs may help reduce the disproportionate health disparities that exist. However, ESIs may require some adaptation to be effective with minority populations. One ESI, motivational interviewing (MI), appears to be particularly culturally congruent for Native American communities. We worked with Native American community members and treatment providers to adapt MI for Native communities. Reflecting their feedback and suggested amendments, we created and disseminated an intervention manual to improve the accessibility of MI within Native communities. To help guide practitioners working with Native American clients, we used focus-group methodology to explore communication patterns for negotiating change. Native American treatment providers expressed comfort with and enthusiasm for integrating MI into their current practices. Recommendations for adaptations ranged from simple to complex changes. The unique value and challenges of collaboration between academic and community members are presented from each author's perspective. This culturally adapted MI manual will likely improve the accessibility and adoption of MI practices as well as encourage controlled, clinical trials with Native communities.