Boost Your Community: NIMHD’s Role in Increasing COVID-19 Vaccine Uptake and Community Interventions

Posted on April 25, 2022

By Eliseo J. Pérez-Stable, M.D.
Director, National Institute on Minority Health and Health Disparities

Dr. Eliseo J. Pérez-Stable reflects on National Minority Health Month and how NIMHD supports research projects that increase vaccine uptake.

April is National Minority Health Month (NMHM), and this year we are joining the U.S. Department of Health and Human Services Office of Minority Health to highlight the key role individuals and organizations can play in helping to reduce health disparities and improve the health of people who are disadvantaged by social and economic conditions, geographic location, or the environment in which they live.

This year’s theme, “Give Your Community a Boost!,” focuses on the continued importance of COVID-19 vaccination, including COVID-19 boosters, and sharing credible information as important tools to end the COVID-19 pandemic that has disproportionately affected communities already dealing with long-standing social and health inequities. Ongoing vaccination against COVID-19 is the single most important way to blunt the effects of severe disease, the consequences of stress on the health care system, and excess deaths of the most vulnerable people.

The mission and work of NIMHD has never been more visible and crucial than it is now. NIMHD has been on the frontlines raising awareness about the connection of social determinants of health to the disproportionate impact of COVID-19 on communities experiencing health disparities. Through its mission to lead scientific research to improve minority health and reduce health disparities, NIMHD has established scientific programs to respond to many COVID-19 issues, such as evaluating interventions to promote testing through the Rapid Acceleration of Diagnostics Underserved Populations (RADx-UP) initiative, and conducting community-based research and outreach to provide trustworthy, science-based information through the Community Engagement Alliance (CEAL) Against COVID-19 Disparities. In addition, NIMHD has also supported research projects that are working to directly address misinformation, increase vaccine uptake, and evaluate interventions aimed to improve the health of communities experiencing COVID-19 health disparities across the nation.

Impact of COVID-19 Outbreak on Minority Health and Health Disparities

In spring 2020, shortly after the World Health Organization declared the COVID-19 outbreak a global pandemic, NIMHD announced a notice of special interest inviting researchers to apply for funding supplements to evaluate community-level interventions aimed to address the impact of the pandemic on populations that experience health disparities. A few of these supplements included:

• Renovating vacant houses and buildings into temporary community health clinics to provide COVID-19 health care services for people in locations with low health care access.
• Evaluating a digital intervention providing culturally tailored behavioral tools to mitigate the adverse nutritional and physical health effects of the pandemic on Latinas living in Puerto Rico.
• Developing a digital contact tracing and case investigation tool that was customized for use in the Navajo Nation to support care coordination during the pandemic.

However, it has also become evident that the impact of the COVID-19 pandemic and the mitigation strategies implemented in response that led to closing of businesses have had significant psychosocial, behavioral, socioeconomic, and health impacts, which are exacerbated in populations that experience health disparities and in other vulnerable groups.

To respond to this, NIMHD is supporting 6 projects through the “Community Interventions to Address the Consequences of the COVID-19 Pandemic among Health Disparity and Vulnerable Populations” funding opportunity announcement (PAR 20-237). These studies are investigating the effects of locally mandated and community-based interventions among American Indian communities, Latino/Hispanic families and day laborers, and vulnerable populations such as people who are incarcerated or homeless. A few examples of these include evaluating:

• A point of care COVID-19 testing and education program provided by community health workers for justice-involved individuals recently released from incarceration.
• The impact of COVID-19 mitigation strategies on non-COVID-19 health care utilization for American Indians.
• A promotores-led intervention to increase COVID-19 mitigation practices such as physical distancing, handwashing, and use of personal protective equipment for Latino day laborers.

Vaccine Uptake Initiative

Responding to public health experts’ recommendation on the importance of getting a COVID-19 vaccine, NIMHD has taken a leading role in supporting research to determine which interventions are effective in increasing vaccination rates. In June 2021, NIMHD launched a vaccine uptake initiative, which funds research studies to evaluate interventions designed to promote vaccine uptake and facilitate vaccine access for populations that experience health disparities. The first set of research projects supported are evaluating interventions for African American/Black, Latino/Hispanic, and low-income populations. Using community-engaged research approaches, investigators are working with community leaders, local organizations, and trusted messengers to understand the barriers to and facilitators of receiving a COVID-19 vaccine and to address misinformation, distrust, structural barriers, and vaccine hesitancy. A few of these studies include:

• A digital health intervention, Tough Talks COVID, for African American young adults (AA-YA) in the South that uses choose your own adventure journeys and digital storytelling to help with vaccine decision making.
• A smartphone-based embodied conversational agent intervention for African Americans that addresses misinformation using culturally tailored messages developed in collaboration with a Black church alliance in Boston.
• An intervention providing primary care physicians (PCP) at Federally Qualified Health Centers with educational resources, including an online library of videos, evidence-based text messaging, and concise educational materials to support PCP conversations with patients about the COVID-19 vaccine.

The consequences of the pandemic will be felt for a very long time, and it is important that we persist and take direct and deliberate action to alleviate the effects of the pandemic. We must continue to encourage access to credible information from trusted sources and develop sustainable and effective interventions to reduce health disparities. As the Director of the Institute, I can confidently confirm NIMHD’s unwavering commitment and support to improve the health of all communities, especially those that have been disadvantaged for far too long.