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.