Rosalind Ramsey-Goldman, MD, is the Gallagher Research Professor of Rheumatology and professor of Medicine in the Division of Rheumatology at Northwestern Medicine. The National Institute of Arthritis and Musculoskeletal and Skin Diseases, part of the National Institutes of Health (NIH), has awarded Dr. Ramsay-Goldman a grant to address health disparities and improve outcomes for people with rheumatic disease.
Title: “Leveraging Community-Academic Partnerships and Social Networks to Disseminate Vaccine-Related Information and Increase Vaccine Uptake Among Black Individuals With Rheumatic Diseases”
People with chronic rheumatic diseases, including arthritis, make up about 25% of the U.S. population. Racial/ethnic and socioeconomic disparities in adverse, often avoidable, outcomes occur in nearly all rheumatic diseases, particularly among Black people and people with lower socioeconomic status. Despite the importance of vaccinations in patients with rheumatic diseases and the high rates of serious infections, vaccine uptake is consistently poor.
In the U.S., COVID-19 vaccine uptake is lower and vaccine hesitancy is higher among Black patients compared with white patients, and this holds true in rheumatic diseases. With the profound disparities uncovered by the COVID-19 pandemic aggravated by proven disparities in rheumatic disease outcomes and heightened vulnerability to infections, there is an urgent need to address low vaccine uptake and hesitancy among Black people with these conditions. In addition, it is also critical to increase vaccine uptake among the social networks of people with rheumatic diseases who are immunosuppressed and may have less robust vaccination responses.
Our team has forged longstanding community-academic partnerships in the Boston and Chicago areas to understand the needs of Black people with lupus — a systemic rheumatic disease — and the role that racism plays in health and healthcare access. Framed by the Public Health Critical Race Praxis that recognizes the pervasiveness of racism in our society, we will leverage our community-academic partnerships to implement the Popular Opinion Leader (POL) model from Centers for Disease Control and Prevention (CDC). In this model, trusted community leaders are trained to disseminate information about COVID-19 vaccination through their social networks in predominately Black communities to increase vaccine uptake and reduce hesitancy.
The aims of the project are:
Aim 1: To leverage community-academic partnerships across two U.S. cities to develop training and evaluation materials for POLs.
Aim 2a: To establish the efficacy of a community-based intervention both with and without a racial justice framework to increase COVID-19 vaccine uptake and reduce hesitancy among social networks of Black people with rheumatic conditions. We will conduct a cluster randomized controlled trial to test whether POLs trained with racial justice framing embedded in information on vaccine safety and efficacy will result in greater COVID-19 vaccine uptake among their social network members compared to safety and efficacy training alone.
Aim 2b: To determine the structure and composition of the outreach social networks of POLs. We will enhance the existing POL model by adding a validated mixed methods approach to compare the social networks reached by POLs in each arm. We hypothesize that incorporating a racial justice lens will empower POLs to disseminate information more broadly and persuasively and increase vaccine uptake by reducing fear and mistrust.
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Rosalind Ramsey-Goldman, MD, is the Gallagher Research Professor of Rheumatology and professor of Medicine in the Division of Rheumatology at Northwestern Medicine.
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