The Baltimore City Health Department (BCHD) seeks $4 million dollars over two years to support an Urban intervention to increase vaccinations among Baltimore City?s youth by increasing health literacy among individuals and agencies. Using listening sessions, training and education, peer support, and communication, Baltimore youth, their parents/caregivers, and the health care providers (HCP) that support them will learn about COVID-19 and the vaccine in a manner that supports the Principal Standard of the National CLAS Standards and advances Healthy People Objectives HC/HIT-01, HC/HIT-02, and HC/HIT-03. Our Goal is to achieve 80% City vaccination rates by June 30, 2023. Our Aim is that Baltimore youth and their parents/caregivers become adept at seeking health information and engage in dialogue with their HCP that builds the health literacy of all involved, thus addressing issues affecting health disparities and specifically sustains acceptance of the COVID-19 vaccine.We plan to address and advance personal and organizational health literacy by offering health education and health literacy to youth, their parents/caregivers and their HCP. We will provide a COVID-19 educational program to youth ages 12-16 years initially in public middle and high schools in high SVI areas (Months 3-6) and then all remaining public middle and high school youth (Months 6-9). We will initiate education with 5?11-year-olds and begin outreach to families of 6-month-to-4-year-olds in Month 6. All public-school youth and families in high SVI areas will be engaged by Month 12. All remaining public-school youth and pre-school children will be engaged by Month 18. At the end of each education session youth will be asked: a) if they would like to be a Health Ambassador (HA), and b) if they wish to be vaccinated. Volunteer HA will be trained and supported by project staff to answer ongoing questions and assist with seeking health information on-line. The parents/caregivers o
f those who wish to be vaccinated will be provided materials that help them understand COVID-19 and how to get their child vaccinated. The materials will be developed based on what we already know about vaccine hesitancy and what we learn in listening sessions with community members. Responding to each community?s specific cultural, language, health literacy and communication needs ensures that we are aligned with the Principle Standard of the National CLAS Standards. Community members will be asked if they would like to serve as HA/champions for this initiative; they will be trained and supported by project partners. HCP will receive training and written materials regarding the need to ensure their agency uses CLAS Standards and promotes the relevant HP Objectives. Specifically, they will receive the results of the listening sessions, and they will be trained in plain language and teach-back to ensure they counsel their clients and parents/caregivers in a manner that promotes health literacy and encourages ongoing health care. Publicly funded HCP will be mandated to take the training annually as part of their funding. BCHD will seek support of local professional organizations to make this a standard of practice. QA/QI data will be collected quarterly allowing for course corrections. Impact data will be collected annually and will assess vaccination rates as well as client satisfaction with care, increases in health literacy by clients, parents/caregivers and HCP, and changes in health information-seeking and health care patterns. Finally, we expand our tracking system to include COVID-19 case rates, testing rates, and vaccination rates among residents 18 and younger. We will disaggregate data by race and ethnicity and set targets for eliminating disparities. By the end of Year 2, this project will allow us to achieve 80% vaccination coverage for Baltimore City residents.