Center for Health Promotion and Prevention Research

Project Overview

CBS-CVD’s primary goal was to increase COVID-19 vaccine confidence and uptake among Black and Hispanic individuals ages 18-39 years residing in Harris and Cameron counties. We conducted needs assessments to inform the development and tailoring of intervention components, materials, and implementation strategies to then deliver the program. Ultimately, the team aimed to build a long-term, sustainable model for addressing COVID-19-related disparities in the future.

The UTHealth Center for Health Promotion and Prevention Research (CHPPR) received funding from the CDC’s Vaccine Confidence Network (VCN) to develop and test behavioral science strategies to increase COVID-19 vaccine confidence and uptake. From May 2021 to September 2022, CHPPR was engaged in a campaign across two study regions in Texas, the Greater Houston Area (Harris County) and South Texas (Cameron County), to explore relevant behavioral and environmental factors and vaccination psychosocial determinants contributing to the disparate rates of COVID-19 vaccine uptake.

The objectives of this project were 1) to identify high-risk communities and explore barriers and facilitators to vaccination and 2) to develop and/or adapt multilevel strategies to increase vaccine confidence and uptake. During that time, the CHPPR worked collaboratively with communities to better understand specific barriers and concerns these communities face and to develop strategies to address them. Our teams have established the trust necessary to combat misinformation effectively and provide essential resources to people who have been severely underserved during this pandemic.

The UTHealth Houston and Brownsville campuses conducted community needs assessments across the two study regions to contribute insights toward the development of an intervention to improve vaccine confidence and uptake in underserved communities. For the needs and assets assessments, we collaborated with community partners and multi-disciplinary institutions to conduct a telephone-based survey, in-depth interviews with the priority population, including parents and non-parents, local community and business listening sessions, and message testing experiments related to COVID-19 vaccination uptake. The CDC-funded project continued to adjust and develop the intervention through continued information-gathering via interviews, community listening sessions, and a telephone-based survey delivered by the United Way of Greater Houston.

To design the program, the team, in collaboration with community partners, used Intervention Mapping, a community-engaged systematic approach using theory, evidence, and new data, to design and/or adapt the program materials. We developed intervention components, training materials, and protocols to deliver, such as community health worker (CHW)-led door-to-door outreach and education, including group education sessions and a social marketing campaign, using data from the RADxUP Take Care, Texas Project.

Our program utilized an innovative, community-level version of a dynamic, flexible type of intervention known as a Just-in-Time Adaptive Intervention (JITAI), where the intervention was tailored according to the new information obtained from the interviews, listening sessions, and surveys we conducted. Our program also included an innovative application of social network analysis (SNA). SNA typically looks at relationships between individuals; in our program, we use SNA at the organizational level to better understand how various organizations, including clinics, health departments, community-based organizations, churches, etc., are connected (collaborating, competing, etc.). This approach allowed CHPPR to tackle real-world challenges to COVID-19 testing implementation at the system level. The community JITAI approach allows the team to efficiently use dynamic data sources to make real-time changes to materials and outreach strategies. This approach has enabled the team to rapidly adapt and implement interventions in response to changes in 1) the pandemic itself (e.g., transmissibility, virulence, changing infection rates, etc.) and 2) contextual factors (e.g., public attitudes, knowledge, access to testing/ vaccination resources, etc.) that impact public health at the individual- and community-levels. Through strategies such as community listening sessions and needs and assets assessments, the project team discovered important barriers and facilitators to prevention behaviors and used this information to rapidly develop and adjust campaign messaging.