April 7-9, 2022 • Hyatt Regency • Lexington, KY
Communication Strategies to Promote Comprehensive Well-being
Communication Strategies to Promote Comprehensive Well-being
Abstract: Applying the Hornik & Woolf Approach to Identify Top Messaging Themes to Improve Healthcare Workers’ COVID-19 Vaccine Confidence
Significance: Although several highly effective COVID-19 vaccines have already been approved for use, vaccination hesitancy remains higher in the U.S. than many other countries, particularly in underserved communities (e.g., rural populations, African American and Latinx communities) already disproportionally suffering from higher cases, hospitalization, and death rates from COVID-19 infections. Healthcare providers are trusted sources of medical information in local communities and can potentially be leveraged to champion COVID-19 vaccines. Despite these potentials, communication-based interventions are urgently needed to address vaccination hesitancy among health providers themselves before they can be called on to promote COVID-19 vaccines in front of undecided community members. To help identify high-priority themes and beliefs to target in messaging to healthcare providers, we applied the Hornik & Woolf (HW) method to a cross-sectional dataset collected through partnership with the Wisconsin Primary Health Association (WPHCA), the member association for the 17 Federally Qualified Health Centers (FQHCs) serving the most vulnerable populations in Wisconsin. We extended the HW method to not only identify beliefs that warrant promotion (confidence-boosting beliefs), but also beliefs that need to be mitigated through messaging (hesitancy-fanning beliefs). Method: In spring 2021, 696 participants from 10 FQHCs completed the survey (347 providers with direct patient contact, 63 service/outreach staff, 286 non-clinical support staff). Each participant indicated their agreement with 37 belief items (M = [.71, 4.25], SD = [.45, 1.36], and also reported intentions for self-uptake (No = 151, Yes = 522) and recommendation to patients/others (No = 167, Yes = 472). All belief measures were on a 5-point Likert type scale. We applied the HW method to estimate the potential percent to gain (PPG) for each belief item, which measures the additional proportion of people who would intend to take/recommend the vaccines should their confidence-boosting beliefs be maximized, or hesitancy-fanning beliefs be minimized. We estimated the 95% CI for each PPG through bootstrapping and ranked belief items by PPG respectively for rural versus urban clinics, and for providers versus staff. Results: Specific rankings of beliefs by behavior, residency, and provider type were summarized. Across the board, themes related to improving perceived ability to explain the science, pros and cons of vaccination, and the authorization process were highly ranked for both uptake and recommendation. In contrast, messaging should focus on reducing doubts about manipulation of available information by those with political and economic motives. We also uncovered considerable heterogeneity—for example, care for community was ranked higher by rural healthcare workers. Conclusion: We demonstrated the usefulness of extending the HW approach to identify high-priority themes and beliefs to promote or to mitigate in communication-based interventions targeting healthcare workers. This group has the potential to serve as local champions for COVID-19 vaccines, but targeted messaging is needed to address their own vaccine hesitancy. Through community-based collaborative research in partnership with WPHCA, we showed the feasibility of applying the HW approach to facilitate the development of messages targeting healthcare workers, who are critical to the success of improving COVID-19 vaccination in underserved communities.