Select Page

UltraTank10383
please help out with Needs Assessment & Gap Analysis for this…

please help out with Needs Assessment & Gap Analysis for this project below:  You are not conduction a formal needs assessment/gap analysis.  In this section give a rationale as to why your project topic was selected.  What gap or need did you identify that led you to believe that more education on the topic was necessary?

 

Topic chosen:  Barriers Rural African Americans Residents Face With Regards to Vaccination, and Ways to Improve Vaccine Education Among African Americans Residents in Rural Communities.

 

 

Introduction/background

Rural African American communities face unique challenges in accessing healthcare services, including vaccine education and uptake (Fordyce et al., 2007; Joudrey, 2023). Vaccine hesitancy, lack of access to transportation, and limited health literacy are some of the barriers faced by this population in receiving the vaccines. The significance of this problem lies in the potential consequences of low vaccine uptake rates in this population, which can lead to increased rates of infections of the virus, hospitalizations, and loss of lives. Inadequate access to healthcare services, including vaccines, can exacerbate health disparities and perpetuate social inequities.

As of September 2021, African Americans accounted for 12.4% of the US population, yet only 9.1% had received the full COVID-19 vaccine regimen (Strassle et al., 2023). This disparity is even more pronounced in rural areas, where access to healthcare services is limited. According to research, African Americans who are reluctant to receive vaccines may do so because of things like misinformation, lack of access to healthcare services, and skepticism of the healthcare system (Restrepo & Krouse, 2022). Furthermore, limited health literacy and inadequate vaccine education can also hinder vaccine uptake.

Studies have revealed that African American residents of rural Appalachia frequently express vaccine reluctance (Brumbaugh et al., 2023; Freimuth et al. 2017). Only 58% of respondents who identified as African American in a West Virginia survey said they would be open to receiving the COVID-19 vaccine, compared to 77% of respondents who identified as white (Dudley, et al., 2021; Purnell et al., 2022). This emphasizes the requirement for focused measures to enhance vaccine access and education in this demographic.

According to findings, African American students attending historically black institutions are worried about vaccine reluctance. In a poll at a rural HBCU, 42% of participants expressed reluctance to obtain the COVID-19 immunization (Ferdinand et al., 2020). The most often stated reasons for vaccine reluctance were worries about vaccine safety and effectiveness. According to a study carried out in Arkansas, people with poor access to healthcare services were more likely to be skeptical of vaccinations (Razzaghi et al., 2020). As a result, it seems possible that expanding access to healthcare services could increase the population’s rate of vaccination.

Historically, rural residents in the US have been skeptical of public health interventions because of mistrust in the government institutions and healthcare providers (American Academy of Pediatrics Committee on Infectious Diseases; Thomas et al., 2014). This mistrust can lead to vaccine hesitancy and low vaccine uptake rates (McElfish et al., 2022). Addressing this mistrust requires a long-term approach that involves building trust between healthcare providers and rural communities.

Research has shown that vaccine uptake for the human papillomavirus (HPV) vaccine is low among sexually active young adults (Brandt et al., 2021; Carolan et al., 2018). A study conducted at a rural sexually transmitted infections clinic found that only 24% of sexually active young adults had received the HPV vaccine (Ford et al., 2009; Jamison et al., 2019). This emphasizes the requirement for focused programs to raise vaccine awareness and usage among this demographic.

Distrust in government institutions and healthcare providers can contribute to vaccine hesitancy according to studies (Budhwani et al., 2022; Galbraith-Gyan et al., 2017; Jamison et al., 2019). Concerns about vaccine safety and the government’s role in healthcare were found to be recurring themes in a study that looked at Black American and white people’ narratives of institutional trust (Jamison et al., 2019; Kahn et al., 2018). Addressing these concerns and building trust with healthcare providers can improve vaccine uptake rates in this population.

In rural African American communities, how does targeted vaccine education and access interventions (compared to no intervention) affect COVID-19 vaccine uptake and intention among residents?
 

References 

American Academy of Pediatrics Committee on Infectious Diseases. (2009). Recommended childhood and adolescent immunization schedules–United States, 2009. Pediatrics, 123(1), 189-190.
Brandt, H. M., Vanderpool, R. C., Pilar, M., Zubizarreta, M., &; Stradtman, L. R. (2021). A narrative review of HPV vaccination interventions in rural U.S. communities. Preventive Medicine, 145, 106407. https://doi.org/10.1016/j.ypmed.2020.106407
Brumbaugh, J. T., Sokoto, K. C., Wright, C. D., Francis, S. E., Hubbard, J., Alexander, L., & McNeil, D. W. (2023). Vaccination intention and uptake within the Black community in Appalachia. Health Psychology.
Budhwani, H., Sharma, V., Long, D., & Simpson, T. (2022). Developing a clinic-based, vaccine promoting intervention for African American youth in rural Alabama: Protocol for a pilot cluster-randomized controlled Implementation Science Trial. JMIR Research Protocols, 11(4). https://doi.org/10.2196/33982
Carolan, K., Verran, J., Crossley, M., Redfern, J., Whitton, N., & Amos, M. (2018). Impact of educational interventions on adolescent attitudes and knowledge regarding vaccination: A pilot study. PLoS One, 13(1), e0190984.
Dudley, M. Z., Limaye, R. J., Salmon, D. A., Omer, S. B., O’Leary, S. T., Ellingson, M. K., … & Chamberlain, A. T. (2021). Racial/ethnic disparities in maternal vaccine knowledge, attitudes, and intentions. Public Health Reports, 136(6), 699-709.
Ferdinand, K. C., Nedunchezhian, S., & Reddy, T. K. (2020). The COVID-19 and influenza “Twindemic”: barriers to influenza vaccination and potential acceptance of SARS-CoV2 vaccination in African Americans. Journal of the National Medical Association, 112(6), 681-687.
Ford CA, English A, Davenport AF, Stinnett AJ. Increasing adolescent vaccination: barriers and strategies in the context of policy, legal, and financial issues. J Adolesc Health. 2009;44(6):568-57
Fordyce, M. A., Chen, F. M., Doescher, M. P., & Hart, L. G. (2007). 2005 physician supply and distribution in rural areas of the United States. Final Report, 116.
Freimuth, V. S., Jamison, A. M., An, J., Hancock, G. R., & Quinn, S. C. (2017). Determinants of trust in the flu vaccine for African Americans and Whites. Social science & medicine, 193, 70-79.
Galbraith-Gyan, K. V., Lechuga, J., Jenerette, C. M., Palmer, M. H., Moore, A. D., &; Hamilton, J. B. (2017). HPV vaccine acceptance among African-American mothers and their daughters: An inquiry grounded in culture. Ethnicity &; Health, 24(3), 323-340. https://doi.org/10.1080/13557858.2017.1332758
Jamison, A. M., Quinn, S. C., & Freimuth, V. S. (2019). “You don’t trust a government vaccine”: Narratives of institutional trust and influenza vaccination among African American and white adults. Social Science & Medicine, 221, 87-94.
Joudrey, P. J. (2023). Rural mistrust of public health interventions in the United States: A call for taking the long view to improve adoption. J Rural Health, 39, 18-20.
Kahn, K. E., Black, C. L., Ding, H., Williams, W. W., Lu, P. J., Fiebelkorn, A. P., … & Devlin, R. (2018). Influenza and Tdap vaccination coverage among pregnant women—United States, April 2018. Morbidity and Mortality Weekly Report, 67(38), 1055.
McElfish, P. A., Selig, J. P., Scott, A. J., Rowland, B., Willis, D. E., Reece, S., … & Shah, S. K. (2022). Associations Between General Vaccine Hesitancy and Healthcare Access Among Arkansans. Journal of General Internal Medicine, 1-7.doi:10.1007/s11606-022-07859-w.
Purnell, M., Maxwell, T., Hill, S., Patel, R., Trower, J., Wangui, L., & Truong, H. A. (2022). Exploring COVID-19 vaccine hesitancy at a rural historically black college and university. Journal of the American Pharmacists Association, 62(1), 340-344.
Razzaghi, H., Kahn, K. E., Black, C. L., Lindley, M. C., Jatlaoui, T. C., Fiebelkorn, A. P., … & Williams, W. W. (2020). Influenza and Tdap vaccination coverage among pregnant women—United States, April 2020. Morbidity and Mortality Weekly Report, 69(39), 1391.
Restrepo, N., & Krouse, H. J. (2022). COVID-19 disparities and vaccine hesitancy in Black Americans: What ethical lessons can Be learned?. Otolaryngology-Head and Neck Surgery, 166(6), 1147-1160.
Strassle, P. D., Green, A. L., Colbert, C. A., Stewart, A. L., & Nápoles, A. M. (2023). Covid-19 vaccination willingness and uptake among rural black/African american, Latino, and white adults. The Journal of Rural Health. https://doi.org/10.1111/jrh.12751
Thomas, T. L., DiClemente, R., & Snell, S. (2014). Overcoming the triad of rural health disparities: How local culture, lack of economic opportunity, and geographic location instigate health disparities. Health education journal, 73(3), 285-294. https://doi.org/10.1177/0017896912471049