UCSF

The COVID-19 pandemic has underscored the urgent need for equitable access to public health interventions, healthcare, and accurate health information. This dissertation aims to address health disparities and improve COVID-19 vaccine uptake through culturally tailored interventions and misinformation mitigation strategies.

Paper 1 focuses on identifying barriers and enablers to COVID-19 vaccine uptake among participants in the San Francisco Department of Public Health contact tracing program. Seventeen interviews were conducted, and data analysis employed the Capability, Opportunity, Motivation Behavior model (COM-B) and the Behavior Change Wheel framework. Barriers to vaccine uptake included an unprepared health system, fear of side effects, limited knowledge, and conflicting information. Interventions targeting education, enablement, and environmental restructuring were identified as effective strategies.

Paper 2 evaluates the impact of culturally and linguistically tailored informational videos delivered via social media campaigns on COVID-19 vaccine uptake in Indigenous Maya communities in Guatemala. Pre- and post-intervention surveys were collected from 1,572 participants, and logistic regression models were utilized. Results indicated that exposure to the intervention videos increased the odds of vaccination by 1.78 times compared to those who did not see the videos. Culturally sensitive information delivered through trusted sources on social media was found to positively influence vaccination uptake.

Paper 3 addresses health misinformation among Spanish-speaking communities in the San Francisco Bay Area. Through formative interviews and workshops, a co-created checklist was developed to identify and counter health misinformation. Misinformation surrounding vaccine safety, side effects, and government control were identified as concerns. The checklist empowers Spanish-speaking communities to verify information sources, assess trustworthiness, and engage with reliable content.

This dissertation highlights the importance of tailored interventions and misinformation mitigation strategies in addressing health disparities and increasing COVID-19 vaccine uptake. Culturally sensitive approaches, such as multilingual social media campaigns and community co-creation of tools, can effectively counter barriers and empower marginalized populations. By implementing these findings, public health departments can work towards achieving equitable access to healthcare and reducing health disparities during the COVID-19 pandemic and beyond.