Exploring the psychological drivers and impact of public health communications on vaccination beliefs of minority ethnic groups
Lead Research Organisation:
King's College London
Department Name: War Studies
Abstract
Psychological drivers of behaviour can help explain why individuals engage in protective and risky health behaviours and inform strategies to promote behaviour change. Recent evidence indicates some minority ethnic groups have lower intentions to receive a COVID-19 vaccine. This is of considerable concern given higher COVID-19 incidence, morbidity, and mortality among minority ethnic groups. There is limited evidence of the reasons underpinning vaccine hesitancy in minority ethnic groups in the UK, but it is potentially linked to beliefs about vaccine safety/efficacy and issues of mistrust towards formal services, as well as practical barriers such as access. This study will involve three waves of in-depth interviews and focus groups with minority ethnic community members and organisations in London and Birmingham to understand (i) specific barriers and facilitators of vaccine uptake, (ii) changes in COVID-19 and vaccination risk perceptions over time, (iii) challenges for building and sustaining community support for vaccination programmes, and (iv) the impact of public health campaigns on vaccination intention. We will also use a behavioural science framework to evaluate national and local campaigns across the UK. This will facilitate the rapid development of evidence-based, theoretically informed, tailored health messages that are critical for the success of the UK mass vaccination programme. It will also support the sustained community engagement that is crucial for optimising public health outcomes.
Publications
Kamal, A
(2021)
A Rapid Systematic Review of Factors Influencing COVID-19 Vaccination Uptake in Minority Ethnic Groups in the UK
in Vaccines
| Description | This project was funded as part of UKRI's rapid response to COVID-19 to provide real-time data to support the development of tailored public health guidance about the COVID-19 vaccine for ethnic minority communities in the UK. An initial rapid systematic literature review found barriers to vaccine uptake relating to mistrust in formal services, lack of information about vaccine safety, misinformation, inaccessible communications and logistical issues. Facilitators included community engagement and inclusive communications. Three waves of in-depth interviews and focus groups with (i) practitioners in local public health and community organisations, and (ii) residents from diverse communities in London and Birmingham were conducted between September 2021 and June 2022. Practitioner interviews highlighted communication challenges relating to the knowledge, skills and capacity required to develop appropriately tailored messages. They also demonstrated the effectiveness of co-produced, two-way local communications using trusted expert sources and communication channels that are preferred by communities. Resident interviews identified information needs and reasons for mistrust. This data highlighted differences within- and between- minority ethnic group attitudes and experiences. It also indicated that anti-vax messages were being shared via multiple sources with varying impacts, including on community cohesion as well as vaccine behaviours. The longitudinal design revealed that strongly positive and negative vaccine attitudes held over time, but also showed changes in attitudes, risk perceptions and behaviours relating to individual and peer experiences during the pandemic, as well as changes in government and public health responses. The final wave of interviews indicated that the experience of the COVID-19 vaccine has increased delay or refusal of other routinely available vaccines, due to increased information-seeking and the need to regain autonomy over health decision-making. This project was the product of a new research collaboration between King's College London and Birmingham City University. Through this research we built new networks with local public health practitioners that opened up new research questions, as well as allowing the knowledge generated by the project to be swiftly fed into practice. We also developed partnerships with local grassroots organisations that do not traditionally take part in research, which enabled us to include seldom heard voices (e.g. elderly South Asian women that do not speak English). This included working with Latin American community organisations in London to facilitate a better understanding of the diverse needs of 'White Other' minority ethnic communities whose needs are rarely captured in public health data. Through these activities we have developed new knowledge about social psychological drivers of vaccine uptake. This allowed us to develop practical guidance for tailoring communications for diverse communities that is based on the need for public health information to take into consideration specific minority ethnic experiences, while recognising communities of identity and other demographics (e.g. age, income, occupation and language) may be more relevant for both social-psychological and logistical drivers of vaccine-uptake. |
| Exploitation Route | This research has produced a database of COVID-19 vaccine communications that target Black and Asian audiences in the UK, which can be used by others interested in studying targeted public health communications. It has also produced practical guidance on tailoring communication for diverse communities in response to a pressing need identified by local public health practitioners. There is widespread awareness that tailoring is required, but our research demonstrates that many are unsure about how to do this in practice. Furthermore, this research has provided new methodological insights on conducting rapid response research with seldom heard voices, including guidance on language to use and avoid when recruiting participants based on ethnicity. For example, some participants did not initially recognise they were eligible to take part in this research study as they did not identify with the language used to invite specific communities of interest (e.g. many people with Caribbean heritage identify as Black British). Interview and focus group data has demonstrated the importance of sustaining partnerships and identified new norms that health systems will need to take into consideration both for routine vaccination programmes and preparedness for future novel health threats. |
| Sectors | Communities and Social Services/Policy,Healthcare,Government, Democracy and Justice |
| Description | This research was conducted in partnership with the UK Health Security Agency (formerly Public Health England) to allow findings to be fed into the UK response to COVID-19 in real time. From the outset we convened an advisory board, which included national stakeholders from UK central government (including the Cabinet Office and the Department for Levelling Up, Housing & Communities), Scottish Government, Welsh Government, and local stakeholders from London & Birmingham local authorities and from the voluntary sector. The board met six times across the lifetime of the project to support project design (providing input at key decision-making points to maximise the relevance and usefulness of research findings), project delivery (including supporting participant recruitment and identifying COVID-19 vaccine communication campaigns) and project impact (by helping to disseminate findings and feed them into practice). This allowed the project to rapidly respond to new developments during the COVID-19 vaccination roll out. For example, in September 2021, when children were offered a first dose of the vaccine with parental consent, we conducted focus groups with 13-17-year-olds to provide insights into young people's vaccine attitudes and intentions and the role of schools in providing information about the COVID-19 vaccine to young people. This unplanned responsive research was designed in collaboration with COVID Youth Champions to ensure relevance to community stakeholders. Throughout the project we regularly contributed to and generated critical discussions with local, national and international stakeholders to support the development of more effective tailored communications to facilitate well-informed decision making. |
| First Year Of Impact | 2021 |
| Sector | Communities and Social Services/Policy,Healthcare,Government, Democracy and Justice |
| Impact Types | Societal,Policy & public services |
| Description | Research partnership with the UK Health Security Agency (UKHSA) |
| Organisation | UK Health Security Agency |
| Country | United Kingdom |
| Sector | Public |
| PI Contribution | This research was conducted in partnership with UKHSA (formerly Public Health England). The value of our research to UKHSA relates to the amplification of seldom heard voices from communities who may have been under-served by guidance and communications relating to the COVID-19 vaccine and in helping UKHSA to understand barriers and facilitators to address vaccine hesitancy in these groups. This project also generated theoretical, methodological and practical insights that are valuable to UKHSA beyond the COVID-19 pandemic. The research team regularly met with partners at UKHSA throughout the lifetime of the project. We also presented a research seminar to staff at the UKHSA Behavioural Science and Insights Unit (BSIU) and contributed to a UKHSA/NHS action oriented day with community partners and senior decision makers from across London. We are ensuring that the outputs from this project continue to be incorporated into UKHSA training and practice via ongoing contributions from the Principle Investigator as part of the NIHR-funded Health Protection Research Unit in Emergency Preparedness and Response (http://epr.hpru.nihr.ac.uk/). |
| Collaborator Contribution | UKHSA's participation in this project ensured that key stakeholders for this research in policy, operational response and communications participated in the project and were able to make use of project findings. The added value from the participation of UKHSA came from vital ties they were able to create from theory and evidence to practice and policy, all of which require a close working relationship to develop common concerns, language and a shared set of objectives. The support that UKHSA provided for recruitment activities for interviews and with building our database of of COVID-19 vaccine communications that target Black and Asian audiences in the UK was vital for the success of this project. |
| Impact | All of the research outputs and outcomes associated with this project have resulted from this collaboration. |
| Start Year | 2021 |