A team of researchers at Dartmouth’s Geisel School of Medicine, led by Glyn Elwyn, MD, PhD, MSc, and Marie-Anne Durand, PhD, has received a $6.2 million funding award from the Patient-Centered Outcomes Research Institute (PCORI) to test approaches that may increase confidence in the COVID-19 vaccine among those working in long-term care facilities.
PCORI is an independent, non-profit organization authorized by Congress in 2010 with the mission of funding research that will provide patients, their caregivers, and clinicians with the evidence-based information they need to make better informed healthcare decisions.
Public health experts agree that COVID-19 vaccination is the most promising solution to the pandemic. But vaccine hesitancy persists among some groups in the U.S.—with factors such as the speed of vaccine development, limited research data on vaccine safety, and poor-quality information on the web and in the media contributing to people having mistrust and false beliefs about the vaccines.
One group of particular concern is healthcare professionals who work in long-term care facilities. “These direct-care workers are an important group to target because they serve a fragile elderly population and they have a higher risk of passing the virus to others,” explains Elwyn, a professor of The Dartmouth Institute for Health Policy and Clinical Practice (TDI) at Geisel who served as co-principal investigator with Durand, an adjunct associate professor at TDI, on the project.
“And, since a majority are people of color and socioeconomically disadvantaged, they also have unequal risks of infection, illness, and death from COVID-19,” he says. “It is therefore important to increase their confidence in the COVID-19 vaccines so that more will be willing to get vaccinated.”
For the study, the research team is partnering with the National Association of Health Care Assistants to recruit 1,800 unvaccinated certified nurse assistants and residential care assistants working in nursing homes and residential care settings across the country. To help ensure success of the project, the interventions have been co-designed by direct-care workers and their organizations.
The team will compare two promising interactive educational approaches— a live webinar (using a videoconferencing program) and a curated social media website (allowing interaction with selected social media content)—with a more traditional approach (a link to the CDC vaccine website). Study participants will be randomly assigned to one of the three interventions.
The researchers will measure vaccine confidence, whether people get vaccinated, and how sure they are about their choice to vaccinate or not and whether they feel it was a good choice for them. They will also measure their vaccine knowledge, their trust in medical scientists, and their views on what people who are like them think of the vaccine.
This information will be collected through online surveys, sent to participants shortly before and after they view the live webinar, social media website, or CDC website. The study team will also send follow-up surveys two months and six months later.
“We hope this study will provide us with the in-depth information we need to help people become more confident in the COVID-19 vaccines, increasing the likelihood that they will get vaccinated,” says Elwyn. “This may be especially helpful for people who rely on information that is out of date or wrong.”
The Dartmouth Institute for Health Policy and Clinical Practice is a world leader in studying and advancing models for disruptive change in healthcare delivery. The work of Dartmouth Institute faculty and researchers includes developing the concept of shared decision-making between patients and healthcare professionals, creating the model for Accountable Care Organizations (ACOs), and introducing the game-changing concept that more healthcare is not necessarily better care.
