JMIR Publications

ABSTRACT

Background:

During the early rollout period of the Coronavirus Disease 2019 (COVID-19) vaccine for children, the United States experienced racial and ethnic disparities in COVID-19 vaccination rates. According to COVID-19 vaccine administration data, during the initial period when vaccines became available for children 5 to 11 years old (November 2 to December 2021), children belonging to racial and ethnic minority groups were underrepresented among those receiving the first dose.

Objective:

We conducted a community-based randomized controlled trial of a digital intervention to increase COVID-19 vaccine uptake among Hispanic children. Our phone-delivered digital intervention was designed in collaboration with community organizations, and was linguistically- and culturally- tailored to meet the informational needs of parents and caregivers of Hispanic children. Our intervention was focused on families with unvaccinated children 5-11 years old, but we also included families with any unvaccinated children 17 years or younger. Intervention content was administered over 4-weeks, and intended to build COVID-19 vaccine knowledge and confidence through various activities.

Methods:

We evaluated the impact of our intervention using a Difference-In-Difference (DID) estimation model, with an Intention to Treat (ITT) approach. Our primary outcome of interest was COVID-19 vaccination status of children in the household pre- and post- intervention. Secondary outcomes included trust on vaccines related to governmental approval and measures of program experience. Participants completed a baseline and 1-month follow up survey, where 254 participants completed the baseline and 216 completed the 1-month follow up

Results:

We found a statistically significant difference of 13.3 percentage points in vaccination status between treatment and control groups among parents/caregivers with Hispanic children 5-11 years old pre-intervention to post-intervention. We find that our intervention had a positive impact of 14.3 percentage points in trust on governmental approval process to ensure safety of vaccines for children.

Conclusions:

We concluded that our intervention based on a mobile-phone delivered digital program had a positive impact on COVID-19 vaccination among Hispanic children through our culturally-tailored and community-based approach. Clinical Trial: We registered this RCT in the American Economic Association (AEA) RCT Registry (https://www.socialscienceregistry.org/trials/11339). MVLA 1.0 was registered in the NIH Clinical Trials (https://clinicaltrials.gov/study/NCT05234372). RCT was also approved by UCLA IRB Board (IRB protocol #21-000857).