Explore the vast range of titles available.

Background Ensuring widespread COVID-19 vaccine uptake is a public health priority in Canada and globally, particularly within communities that exhibit lower uptake rates and are at a higher risk of infection. Public health units (PHUs) have leveraged many resources to promote the uptake of recommended COVID-19 vaccine doses. Understanding barriers and facilitators to vaccine uptake, and which strategies/resources have been used to address them to date, may help identify areas where further support could be provided. We sought to identify the strategies/resources used by PHUs to promote the uptake of the first and third doses of the COVID-19 vaccine among priority groups in their jurisdictions. We examined the alignment of these existing strategies/resources with behavioral science principles, to inform potential complementary strategies/resources. Methods We reviewed the online and in-person strategies/resources used by three PHUs in Ontario, Canada to promote COVID-19 vaccine uptake among priority groups (Black and Eastern European populations, and/or neighbourhoods with low vaccine uptake or socioeconomic status). Strategies/resources were identified from PHU websites, social media, and PHU liaison. We used the Behaviour Change Techniques (BCT) Taxonomy – which describes 93 different ways of supporting behaviour change – to categorise the types of strategies/resources used, and the Theoretical Domains Framework – which synthesises 14 factors that can be barriers or facilitators to decisions and actions – to categorise the barriers and facilitators addressed by strategies/resources. Results PHUs operationalised 21 out of 93 BCTs, ranging from 15 to 20 BCTs per PHU. The most frequently operationalised BCTs were found in strategies/resources that provided information about COVID-19 infection and vaccines, increased access to COVID-19 vaccination, and integrated social supports such as community ambassadors and engagement sessions with healthcare professionals. Identified BCTs aligned most frequently with addressing barriers and facilitators related to Knowledge, Environmental context and resources, and Beliefs about consequences domains. Conclusion PHUs have used several BCTs to address different barriers and facilitators to COVID-19 vaccine uptake for priority groups. Opportunities should be pursued to broaden the scope of BCTs used (e.g., operationalizing the pros and cons BCT) and barriers/facilitators addressed in strategies/resources for ongoing and future COVID-19 vaccine uptake efforts among general and prioritised populations.

The objective of this study was to explore how Ontario Public Health Units (PHUs) partnered with faith-based organizations (FBOs) and other community-based organizations (CBOs) to promote COVID-19 vaccination among ethnoracial groups made structurally vulnerable during the pandemic, and to understand how PHUs perceive the effectiveness of these partnerships with these organizations. Between June to December 2022, we distributed a cross-sectional survey to 34 PHUs in Ontario to explore how PHUs were engaging and partnering with FBOs and CBOs. Responses were received from 28 of 34 (82.5%) public health units. Across Ontario, 23 (82.1%) respondent PHUs worked with FBOs during the COVID-19 vaccine rollout with activities ranging from informing FBOs of vaccine availability, to using places of worship as sites for vaccine administration and co-creating educational materials on immunization that were faith- and culturally sensitive. FBOs can be a valuable community partner as PHUs work to increase the reach and uptake of public health interventions. Ongoing monitoring and evaluation of the impact of FBO engagement on vaccine confidence and uptake among ethnoracial communities is needed to inform future community engaged vaccine programming in Ontario.

Background COVID-19 hit Canada hard and exacerbated health inequities, notably among ethnoracially minoritized populations. By August 2021, some areas in Peel region (Ontario, Canada) continued to have high COVID-19 infection rates and low COVID-19 vaccine coverage. To increase first dose uptake, Peel Public Health implemented smaller community-based vaccination clinics in addition to pre-existing mass vaccination (fixed) clinics. This study describes these community clinics and those who received their first dose at a community clinic to determine whether local public health efforts to implement community clinics reached different population groups and whether these community clinics contributed to an increase in uptake of the first dose of COVID-19 vaccines. Methods We conducted a descriptive, cross-sectional study using data from the Ontario COVID-19 vaccination registry (COVaxON). We included eligible Peel residents 12 years and older who received a COVID-19 vaccine within community and fixed clinics between September 2021 and August 2022. Clinics were classified based on clinic type (community/fixed), and location. COVID-19 vaccine uptake for smaller geographic areas designated by postal codes was calculated at the beginning and end of the study period. Clinic and attendee characteristics were analyzed using descriptive statistics. Results There were 177 community and 11 fixed clinic sites that operated during the study period. Community clinics administered 98,965 doses (27%) of COVID-19 vaccine and fixed clinics administered 264,021 doses (73%). A slightly higher proportion of first doses were administered in community clinics (8.1%) compared to fixed clinics (7.9%) and community clinics saw a higher proportion of first dose recipients from low-coverage areas (23% versus 19% in fixed clinics). Clinics in faith-based organizations, schools and shopping areas administered the most doses among community clinic locations. The absolute increase in first dose vaccine uptake was 11% over the study period. Conclusions Almost 100,000 doses of COVID-19 vaccine were administered in community clinics, which contributed to increased overall vaccine coverage in Peel region. A slightly higher proportion of first doses were administered in community clinics compared to fixed clinics and a higher proportion of doses to residents of low-coverage areas.

Background Promoting the uptake of vaccination for infectious diseases such as COVID-19 remains a global challenge, necessitating collaborative efforts between public health units (PHUs) and communities. Applied behavioural science can play a crucial role in supporting PHUs’ response by providing insights into human behaviour and informing tailored strategies to enhance vaccination uptake. Community engagement can help broaden the reach of behavioural science research by involving a more diverse range of populations and ensuring that strategies better represent the needs of specific communities. We developed and applied an approach to conducting community-based behavioural science research with ethnically and socioeconomically diverse populations to guide PHUs in tailoring their strategies to promote COVID-19 vaccination. This paper presents the community engagement methodology and the lessons learned in applying the methodology. Methods The community engagement methodology was developed based on integrated knowledge translation (iKT) and community-based participatory research (CBPR) principles. The study involved collaboration with PHUs and local communities in Ontario, Canada to identify priority groups for COVID-19 vaccination, understand factors influencing vaccine uptake and co-design strategies tailored to each community to promote vaccination. Community engagement was conducted across three large urban regions with individuals from Eastern European communities, African, Black, and Caribbean communities and low socioeconomic neighbourhoods. Results We developed and applied a seven-step methodology for conducting community-based behavioural science research: (1) aligning goals with system-level partners; (2) engaging with PHUs to understand priorities; (3) understanding community strengths and dynamics; (4) building relationships with each community; (5) establishing partnerships (community advisory groups); (6) involving community members in the research process; and (7) feeding back and interpreting research findings. Research partnerships were successfully established with members of prioritized communities, enabling recruitment of participants for theory-informed behavioural science interviews, interpretation of findings, and co-design of targeted recommendations for each PHU to improve COVID-19 vaccination uptake. Lessons learned include the importance of cultural sensitivity and awareness of sociopolitical context in tailoring community engagement, being agile to address the diverse and evolving priorities of PHUs, and building trust to achieve effective community engagement. Conclusion Effective community engagement in behavioural science research can lead to more inclusive and representative research. The community engagement approach developed and applied in this study acknowledges the diversity of communities, recognizes the central role of PHUs, and can help in addressing complex public health challenges.

Background Equitable access to vaccination remains a concern, particularly among population groups made structurally vulnerable. These population groups reflect the diversity of communities that are confronted with structural barriers caused by systemic racism and oppression and result in them experiencing suffer disadvantage and discrimination based on citizenship, race, ethnicity, ancestry, religion, spiritual beliefs, and/or gender identity. In Canada, Ontario public health units (PHUs) engage with faith-based organizations (FBOs) to improve vaccine confidence among populations made structurally vulnerable. This study explores the factors that facilitate and hinder engagement in the implementation of vaccine confidence promoting interventions, and challenges associated with working with FBOs. Methods In-depth interviews were conducted with 18 of the 34 Ontario PHUs who expressed an interest. Braun and Clarke’s “experiential” approach was used to explore the realities of PHUs’ contextual experiences and perspectives. Results The results showed that receptivity and openness of PHUs to learn from FBOs, previous experience working with religious communities and FBOs, ongoing relations based on respect of different beliefs and opinions on the vaccines, leveraging the support of trusted faith leaders among communities and communications strategy adapted and sensitive to the needs of the community was facilitators to community involvement in the prevention and control of COVID-19. On the other hand, factors both internal and external to the PHUs have often posed challenges to collaboration with the FBOs. Internal factors include low operational capacity of PHU like insufficient human and financial resources, weak analytical capacity, ambiguity in the roles and responsibilities of the different actors. Some external challenges issues were related to the provincial level and the Ministry of Health, while others were related to FBOs. For example, faith-based and collective beliefs promoting vaccine hesitancy have resulted in resistance from some religious communities when PHUs have reached out to collaborate. Conclusions Engaging with faith-based communities is an ongoing process that requires time, flexibility, and patience, but it is necessary to improve vaccine confidence and equity access among population groups made structurally vulnerable. Lessons learned from this research can guide the implementation of future vaccination programs.