Researchers Develop Ways to Increase Vaccination Rates Among Black People in Canada

Temerty Faculty of Medicine researchers say to increase vaccination rates among Black people who are at high risk of COVID-19, employing an Afrocentric health promotion approach that is centred on respecting patients’ values and perspectives can help.

The approach is discussed in a commentary in CMAJ (Canadian Medical Association Journal) published on Monday, August 9, 2021.

“An Afrocentric approach, which acknowledges that health care experiences of Black people are affected by historical and present-day anti-Black racism, can be combined with communication frameworks to counsel vaccine-hesitant patients,” says Onye Nnorom, a family physician and assistant professor at the Temerty Faculty of Medicine’s Department of Family and Community Medicine (DFCM) and the Dalla Lana School of Public Health (DLSPH). Nnorom is also the President of the Black Physicians’ Association of Ontario.

Nnorom and the co-authors of the commentary are a team of Black female clinicians, researchers, nurses and Black community health leaders who have been involved in addressing COVID-19 vaccination in Black communities.

The team includes Aisha Lofters, associate professor and clinician scientist at DFCM and family physician at Women’s College Hospital, Azza Eissa, a family medicine clinician scholar resident at DFCM and MSc candidate in clinical epidemiology and health research at DLSPH, Cheryl Prescod, executive director of the Black Creek Community Health Centre and Nancy Akor, a registered nurse at Toronto’s TAIBU Community Health Centre.

Despite the higher risks of infection and serious complications, only 56.6 per cent of Black Canadians reported willingness to be vaccinated compared with 76 per cent of people in the general population.

To combat vaccine hesitancy, which has roots in medical distrust and structural racism, the authors discuss how Afrocentric approaches and the LEAPS of care counselling framework have been successful in increasing flu and COVID-19 vaccinations in Black communities.
    
The LEAPS of care framework encourages providers to:

1. Listen and Learn more about the patients’ lived experiences;
2. Empower and Engage patients by respecting their own self-determination and perspectives;
3. Ask and Acknowledge patients’ concerns and previous healthcare encounters where they may have experienced racism;
4. Paraphrase and Provide vaccine recommendations;
5. Support and Spark community-partnerships to respectfully overcome barriers to vaccination and support patients navigating a complex system.

“Black patients experience disrespectful discourse with providers because of anti-Black racism and biases in healthcare. Our position is that in every encounter, patients should feel respected. Please respect Black patients’ values, views, and concerns when it comes to the vaccine. That’s how we can rebuild trust and that is the key message from this framework,” says Nnorom.

Black-led community partnerships can be very effective at helping increase vaccinations, as vaccine clinics held in a hard-hit hotspot part of Toronto from April to May 2021 increased vaccine uptake from 5.5 per cent to 56.3 per cent.

“Confidence in the vaccines will not improve if Black communities are told that they are at high risk and should continue to socially distance, while they are also excluded from vaccine priority lists or are not provided greater access to vaccines,” say the authors.

“Providers should offer accurate, current information to high-risk Black patients about how to access vaccines.”

Photos by Ilhaan Dahir, Katherine Barcsay and Apostolos Dimitromanolakis.