Tuesday, March 21, 2023
3/21/2023
Project Summary Every winter, seasonal influenza infects over 10,000,000 US children, hospitalizes 50,000, and kills 300-500. Black children are 2-3 times more likely to get sick, be hospitalized, and die than children of other races and ethnicities. These disparities are associated with influenza vaccination disparities, which are in turn associated with historical exploitation, access to care, health illiteracy, and vaccine hesitancy. The long-term objective of the candidate, Joshua T.B. Williams, MD, is to reduce vaccination disparities by partnering with minority stakeholders to co-create interventions that improve vaccination equity in pragmatic trials. This objective will further the mission of the National Institutes of Child Health and Development to ensure all children have an equitable chance to grow and fulfill their potential free from diseases. Dr. Williams is well-suited for this work as a general pediatrician with prior health services research training who has received 4 competitive grants and first-authored 15 papers on vaccines, vaccine hesitancy, and vaccine-preventable diseases since 2019. To achieve this objective, Dr. Williams will pursue formal coursework, mentored experiential training, and directed learning in three specific areas: (1) health disparities and disparities research, (2) community engagement, and (3) implementation science, including the design and conduct of pragmatic trials. To support him, Dr. Williams has identified a primary mentor with national expertise in vaccine hesitancy, intervention design, and pragmatic vaccination trials (Dr. Sean T. O'Leary). He has assembled a team of three co-mentors with expertise in health disparities (Dr. Romana Hasnain-Wynia), community engagement (Dr. Donald Nease), and implementation science (Dr. Amy Huebschmann). Moreover, he has an established partnership with the Center for African American Health (Ms. Deidre Johnson) and support from 6 other distinguished experts. Dr. Williams proposes 3 sequential projects that build upon his training goals and prior work, which uncovered a stakeholder recommendation to improve vaccination confidence through personal stories. Digital stories are personal narratives that synthesize images, video, voice, or text to create compelling accounts of human experience. In pilot pragmatic trials, digital stories have improved hypertension control in Black adults and increased self-report of Human Papillomavirus vaccination in Korean women. The 3 specific aims of this proposal are to (1) explore diverse stakeholders' perceptions of and priorities for a digital storytelling intervention through qualitative interviews, (2) co-create a digital storytelling pediatric influenza vaccination intervention through novel community-engaged methods, and (3) assess the feasibility, acceptability, appropriateness, and pilot effectiveness of the intervention in a pragmatic trial involving 200 Black parent-child dyads in two safety-net clinics in Denver, CO. The outstanding research environment at the University of Colorado and Dr. Williams' expert mentorship team will ensure his success, enhance his training, and advance our understanding of engagement methods and interventions to promote health equity.
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