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Novel Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and are in the process of generating evidence of effectiveness or may not yet be tested.
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White Paper/Brief
This report is part of a collaboration between Phreesia, a health care technology firm, the Commonwealth Fund, and Harvard University researchers. The authors of the report interviewed primary care providers at practices that use Phreesia technology and have taken part in vaccination campaigns about the barriers and challenges they encountered to participating in these campaigns. The article offers take-aways for policymakers and other providers on how to reduce barriers to vaccination in primary care, which will be critical to promoting COVID-19 vaccine uptake in future years. The practice strategy this article is focused on is promoting vaccine access and uptake.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Systematic Review/Meta-Analysis
This article summarizes considerations for COVID-19 prevention among migrant workers in meat processing plants. They review evidence on vaccinations, air filtration, masking, and other approaches.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Case Study
This process overview summarizes the approach taken by the Alberta Health Services Design Lab to respond to the outbreak of COVID-19 among meat plant employees, who are largely immigrants. They implemented a vaccine clinic at processing plants to support vaccination and provide culturally relevant health information.
Novel Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and are in the process of generating evidence of effectiveness or may not yet be tested.
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Peer Review Study
This survey study of health care workers in two academic hospitals, one adult and one child, presents findings on the differences in COVID-19 vaccine hesitancy by race/ethnicity among health care workers. Striking differences were found across race and ethnic groups regarding reported vaccine hesitancy with Whites, on average, having the lowest level of hesitancy. Hesitancy was defined as not planning on, being unsure, or planning to delay getting a COVID-19 vaccine. Black, Asian, Hispanic or Latino, and mixed-race participants were more hesitant than Whites. Reasons for hesitancy include concern regarding side effects, the newness of the vaccine, and lack of vaccine knowledge.
Best Practices that show evidence of effectiveness in improving public health outcomes when implemented in multiple real-life settings, as indicated by achievement of aims consistent with the objectives of the activities.
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Peer Review Study
This study recommends that governments should continue to fund and prioritize use of Federally Qualified Health Centers (FQHCs) as major vaccine administration sites. This retrospective cohort study examines COVID-19 vaccination administration rates at FQHCs by race and ethnicity and also the racial and ethnic equity in vaccine receipt at FQHCs. The results of the study found that vaccine administration at FQHCs was equitable for American Indian or Alaska Native, Asian, and Hispanic populations, but there were inequities for the Black population. FQHCs have provided critical access to COVID-19 vaccinations for patients from diverse racial and ethnic groups. This resource may help motivate governments to continue funding and prioritizing the use of FQHCs by showing that these health centers have provided access to COVID-19 vaccinations for patients from diverse economic, racial, and ethnic groups.
Best Practices that show evidence of effectiveness in improving public health outcomes when implemented in multiple real-life settings, as indicated by achievement of aims consistent with the objectives of the activities.
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Case Study
This article summarizes the approach one vaccine collaborative in Philadelphia, PA took to address vaccination inequity among Black community members. The intervention utilized community partners to build trust and encourage community members to schedule vaccinations at a clinic through a low-tech platform. These vaccination clinics were also designed to minimize wait times.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Peer Review Study
This case study describes how Inova Health System in Northern Virginia developed and integrated a vaccination administration program, while simultaneously caring for patients hospitalized with COVID-19, and provides recommendations on how other health cares systems can integrate a vaccine program. Inova Health System created a Vaccination Implementation Team led by a triad of leaders in conjunction with established emergency management leaders and Inova’s COVID-19 Coordination Center to plan for the immediate delivery of the COVID-19 vaccine, once available. The guiding imperatives were to protect the safety of the vaccination team and vaccine recipients while offering vaccination for all eligible individuals. The initial work streams carried out by the team included: (1) process design, including space/geography, personnel, and vaccine handling; (2) prioritization and scheduling; and (3) communications. Inova’s Inclusion Council implemented strategies that facilitated culturally appropriate communication, identified ethnic and racial biases and fears, and promoted recommended and safe vaccination practices through an “inside-out” program.
Best Practices that show evidence of effectiveness in improving public health outcomes when implemented in multiple real-life settings, as indicated by achievement of aims consistent with the objectives of the activities.
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Peer Review Study
This multidisciplinary vaccine delivery strategy was implemented by the Puget Sound Veterans Affairs (VA) facility to mitigate inequities in COVID-19 vaccination among veterans. The practice, which followed the Equitable Vaccine Framework, was put in place in the VA Puget Sound Health Care System and entailed targeted outreach to individual patients based on a score consisting of the sum of risk factors for severe COVID-19 disease and high-risk race or ethnicity. The strategy included four main domains: allocation, outreach, delivery, and monitoring. The care system conducted sequential outreach using multiple communication modalities, worked with community partners to publicize and deploy mobile clinics to underserved areas, and monitored vaccination coverage rates by age, race, sex, and rural status at prespecified intervals and adjusted operations to ensure equity. During the vaccine drive, vaccination rates were higher among Black, multiracial, and Hispanic veterans, compared with white veterans.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Peer Review Study
The article presents strategies of how Durham County Department of Public Health operationalized equity into multiple phases of its COVID-19 response through infrastructure changes and how to apply these methods to future public health emergencies to better serve vulnerable populations. This response relied upon robust data collection of demographic data to identify inequities. Infrastructure changes included standing up multiple COVID-19 Task Forces (Homeless, Community, Food Security, African American) and Strike Teams (Long-Term Care Facility, Clusters) targeting vulnerable populations; placing testing sites in targeted locations; collaborating with multisector and community partners for feedback; and providing Health Ambassadors for in-person dissemination of COVID-19 information. The paper reviews results from these interventions and lessons learned.
Novel Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and are in the process of generating evidence of effectiveness or may not yet be tested.
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Key Informant Interview
The director of the Black Hawk County Public Health Department in Iowa shares her thoughts on best practices for community engagement and public health leadership in this Q and A with The Kresge Foundation. The conversation is geared towards her experiences dealing with a highly segregated community and varying needs during COVID-19.