JARRETT AINSWORTH Johnson
$686,134
University of California, San Francisco
California
National Institute on Minority Health and Health Disparities (NIMHD)
Respiratory Syncytial Virus (RSV) causes a substantial burden of hospitalizations and deaths among older adults, comparable to that of influenza. The new and effective RSV vaccines have the potential to dramatically reduce RSV morbidity and mortality, yet their full public health impact will not be realized if the racial and ethnic disparities in RSV vaccine uptake mirror those observed in other respiratory virus-vaccines, from COVID-19 to influenza. We have the opportunity to adapt community-based interventions from the COVID-19 pandemic to proactively address disparities in RSV vaccine uptake. However, evidence-based data, conducted in partnership with impacted communities, are essential. This project will focus on increasing RSV vaccine uptake among Latinos, a community disproportionatly affected by respiratory vaccines and RSV. We will leverage our well-established community-academic partnership, Unidos en Salud, to adapt two components of our ‘Motivate, Vaccinate, Activate’ intervention— CHW counseling and text message nudges. This multi-component intervention was originally designed to increase COVID-19 vaccine uptake among Latinos and to activate people to recommend vaccination to people in one’s social network. Our overall study objective is to adapt this intervention to inform effective and customizable community-based strategies to increase RSV vaccine uptake. In addition to a rigorous randomized trial design, we will collect detailed implementation outcomes to aide in generalizability and adaption to other vaccines and settings. Our primary hypothesis is that language-and culturally-concordant CHW motivation and activation counseling sessions, coupled with text message nudges, will increase RSV vaccine confidence by adressing trust, knowledge, and access-related barriers. The proposed study has three aims. In Aim 1 we will use the ADAPT-IT framework to adapt two intervention components: CHW counseling and text-message nudges to increase RSV vaccine uptake among Latino older adults (>60 years) (Aim 1a) and enable younger adults (18-50 years old) to discuss RSV vaccination with older adults in their social and family networks (Aim 1b). Then in Aim 2 we will conduct a two-arm type-1 effectiveness implementation trial to determine the effectiveness and implementation of a CHW counseling and text-message intervention on RSV vaccine uptake in Latino adults >60 years. In Aim 3, using a parallel trial design and social network analytic techniques, we will test the effectiveness of CHW counseling and text-message nudges on activating Latino adults to discuss RSV vaccination with the older adults within their social networks. The proposed work will provide timely, rigorous, and adaptable data to directly inform community-based approaches to increase RSV vaccination. In addition to providing timely data to reduce RSV vaccine disparities, these data will also advance our scientific understanding of the effectiveness of text-messages from community-based organizations and community-based interventions aimed at activating cross-generational social networks to boost vaccine uptake.