PROJECT SUMMARY/ABSTRACT
Declared a top ten threat to global health by the World Health Organization in 2019, vaccine hesitancy
continues to be a major problem, as highlighted by the ongoing COVID-19 pandemic. COVID-19 and influenza
are both respiratory viral illnesses that result in a substantial number of vaccine-preventable illnesses,
hospitalizations, and deaths due to suboptimal vaccine uptake in the United States (US). There are major
disparities in COVID-19 and influenza vaccine uptake according to race/ethnicity and socioeconomic status.
These disparities contribute to the disproportionately high burden of COVID-19 and influenza illness among
these vulnerable populations, with higher rates of COVID-19 and influenza related hospitalizations and deaths
among individuals of racial/ethnic minorities, non-US born populations, and low socioeconomic status.
Effective strategies are urgently needed to increase COVID-19 and influenza vaccine uptake among vulnerable
populations. The overall goal of this proposal is to test the impact of a highly promising approach, motivational
interviewing, on COVID-19 and influenza vaccine hesitancy among vulnerable adults. Building on experience
training providers in MI and ongoing work supporting PCPs in addressing COVID-19 vaccine hesitancy, we will
develop, implement, and evaluate an innovative motivational interviewing training program specific to COVID-
19 and influenza vaccination for PCPs who care for adult patients in and near Worcester, MA. The training
program will include: (1) a video module introducing providers to key principles of MI and presumptive
recommendations for vaccination; (2) opportunities to practice MI skills and receive feedback using an
innovative Video-based Communication Assessment (VCA) platform; and (3) provider reference sheets with
suggested responses to common concerns. We will implement and evaluate the intervention at three clinical
systems via a large pragmatic clinical trial. The clinical systems include UMass Memorial Health Care
(UMMHC) and two Federally Qualified Health Centers (FQHCs) which collectively serve large populations of
racial/ethnic minority groups, non-US born individuals, and socioeconomically disadvantaged patients. Our
specific aims are: (1) To develop a motivational interviewing training program for PCPs to address COVID-19
and influenza vaccine hesitancy among adult patients; (2) To implement and assess the impact of the MI
training on COVID-19 and influenza vaccine uptake through a large, pragmatic cluster randomized trial; and (3)
To evaluate the intervention according to the RE-AIM framework, incorporating the perspectives of patients
and primary care providers. This research will generate urgently needed evidence for training PCPs to
communicate effectively with vaccine hesitant adult patients. By developing an efficient and scalable platform
for training PCPs in MI, this research will also catalyze the use of MI to promote a range of health-related
behavior changes.
