JMIR Publications

ABSTRACT

Background:

Disparities exist in COVID-19 incidence, hospitalization, and mortality rates among African Americans that suggest the need for targeted interventions.

Objective:

To address this need, we describe the development of a culturally-appropriate, theory-based library of messages targeting concerns around COVID-19 vaccines that could be used in behavioral and communication interventions.

Methods:

Messages were developed using the Health Belief Model and Theory of Reasoned Action and Health Belief Model. Kreuter’s five strategies were used to achieve cultural appropriateness. After forming a community-academic partnership, message development occurred in four phases: 1) adaptation of a message library using the literature; 2) review by clinical and research experts for content validation; 3) Input and review by Community Advisory Panel (CAP); and 4) message pretesting with African Americans via semi-structured interviews.

Results:

Themes from semi-structured interviews were: 1) community reactions to the messages; 2) community questions and information needs; 3) suggestions for additional content; and 4) suggestions to improve comprehension, relevance, and trustworthiness. Feedback from the CAP, community members, and scientific experts was iteratively used to update message content to maximize culturally-appropriateness. The final message library had 18 message subsets for adults and 17 message subsets for parents and caregivers for children. These subsets were placed into three categories: 1) vaccine development; 2) vaccine safety; and 3) vaccine effectiveness.

Conclusions:

We employed a 4-phase, systematic process using multiple community engagement approaches to create messages for African Americans to support interventions to improve COVID-19 vaccination rates among adults and children. Future research should evaluate the impact of these messages on COVID-19 vaccination rates.