During the 2021 COVID-19 vaccine rollout, the Centers for Disease Control and Prevention (CDC) conducted 14 Rapid Community Assessments (RCAs) in eight jurisdictions requesting vaccine confidence consultations to ascertain barriers and facilitators for COVID-19 vaccine confidence and demand that potentially contributed to low vaccination coverage and disparities among racial and ethnic populations and in rural areas. CDC provided recommendations to address barriers to vaccination and improve vaccine confidence.

Methods

A case study evaluation ascertained the perceived value of RCAs, suggestions for improving and scaling efforts for future RCAs, and to what extent jurisdictions implemented RCA recommendations. Five virtual focus groups (including one in Spanish) were convened with 16 health department and community based organization staff involved with RCAs in three jurisdictions. A general inductive analysis method was employed for data analysis with a priori codes and summarized findings from verbatim transcripts.

Results

CDC’s RCA services were perceived as valuable for building partnerships and capacity to conduct RCAs across the jurisdiction, filling critical data gaps, and increasing vaccination rates in communities of color. Suggested improvements included a pre-RCA jurisdiction readiness assessment, advanced communication to all involved to ensure proper planning and coordination, and post-RCA follow-up with technical assistance (TA) to facilitate implementation of recommendations.

Conclusions

Jurisdiction staff reported that RCAs yielded useful information about community barriers and facilitators that could improve vaccine confidence and uptake among racial and ethnic populations. They suggested that ample planning, coordinated communication, and TA to health departments to implement recommendations are critical for successful outcomes.

Background

In 2021, Centers for Disease Control and Prevention (CDC) and MidPeninsula Boys and Girls Club (MPBGC) partnered to conduct a rapid community assessment (RCA) to understand and address factors impacting COVID-19 vaccination among adolescents and their families in San Mateo County, CA. This RCA was unique in its participatory approach designed to empower teens to gather evidence to advocate for responsive public health strategies. Further, it provides an example of how to engage marginalized people as co-investigators in public health research.

Methods

Sixteen MPBGC teens were trained to gather and analyze data through the following methods:

• Online survey for adolescents
• Interviews and listening sessions with adolescents and adults
• Online interaction analyses in teen-heavy environments
• Observation and intercept interviews at community sites

Existing data collection tools were adapted by teens and tools for digital listening were co-created with teens. Data was analyzed, synthesized, and reported out by teens with coaching from the CDC team.

Results

Findings and recommendations were presented by MPBGC teens to the CDC COVID-19 Vaccine Task Force, San Mateo County officials, and community partners. Teens reported barriers and facilitators to COVID-19 vaccination that they uncovered as well as their recommendations to:

• Increase teen vaccine confidence
• Address vaccine-hesitant parents/guardians
• Combat vaccine misinformation
• Deliver health messaging that resonates with teens
• Empower teens in making informed health choices

Conclusions

Engaging teens in participatory research has many benefits, including uncovering insights about adolescent health behavior, identifying effective strategies for health promotion, and building capacity to gather evidence and advocate for responsive public health programs.

A concern about polio and other childhood vaccination coverage in 2022 lead the Connecticut Department of Public Health (CTDPH) to partner with CDC and two local health departments (LHD) to adapt the RCA framework to identify facilitators and barriers to childhood immunization. The LHDs were chosen because of their strong local leadership and Immunization Information System (CT WiZ) data that showed larger portions of children still not up-to-date.

By engaging key federal, state, local and community stakeholders, including non-profit organizations, libraries, school-based programs, school nurses, businesses, and churches in each step, CTDPH was able to achieve a successful RCA. Steps taken included:

1. Convening stakeholder planning meetings;
2. Adapting the CDC RCA toolkit and creating new guidance and resource materials;
3. Preparing training for LHD data collection and analysis teams;
4. Assisting the LHDs with data collection, daily debriefs, data analysis, and final report;
5. Joining stakeholder feedback presentations;
6. Conducting evaluations.

As a result, CTDPH gained valuable insights into factors influencing routine childhood immunization. More importantly, insights were gained on leveraging and strengthening relationships established during the pandemic. The RCA also helped to identify and connect new community influencers who could engage in implementing RCA action plan activities.

Through these multi-sector collaborations, it became apparent that the RCA framework is a vital tool that public health organizations can use to build trust while engaging with their communities. CTDPH plans to use lessons learned to inform further framework modifications and work with additional LHDs for implementation throughout the state.

Background: Amid a crisis, health officials needed to address low vaccination coverage among populations who were disproportionately negatively impacted by COVID-19 illness. The Rapid Community Assessment (RCA) approach was developed to quickly gather community insights regarding COVID-19 vaccine confidence and uptake, which are then used to develop programs and strategies that are responsive to community needs. Unlike traditional community assessment, the RCA focuses on understanding how to address specific challenges from the community perspective that can be implemented in as little as 3 weeks. The process of conducting an RCA also engages communities, builds trust in public health systems, and establishes new relationships.

Methods: The RCA has 5 steps and includes quantitative and qualitative data collection methods. A step-by-step guide with adaptable tools is available to assist governmental and non-governmental organizations interested in increasing vaccine uptake. The approach draws on the community-based participatory approach outlined in the World Health Organization’s Tailoring Immunization Programmes guide and uses the Behavioral and Social Determinants for Vaccination framework to structure data collection tools and analysis approaches.

Results: Results of conducting an RCA include:

• Understanding what communities, or parts of communities, think about vaccines
• Assessing barriers and facilitators to vaccine uptake
• Identifying community leaders, trusted messengers, and other important channels of communication with communities
• Identifying potential solutions to increase vaccine confidence and uptake

Conclusions: Initially implemented to address COVID-19 vaccine hesitancy, the RCA approach is currently being implemented to address routine and outbreak vaccinations and can be applied to other public health issues.