To increase vaccination rates among blacks at high risk of COVID-19, using an Afro-centric health promotion approach centered on respecting patient values and perspectives may help, the authors argue in a commentary. published in CMAJ (Journal of the Canadian Medical Association)
“An Afro-centric approach, which recognizes that black health care experiences are affected by historic and current anti-black racism, can be combined with communication frameworks to advise patients hesitant to vaccinate,” writes Dr Onye Nnorom , Family doctor. and Assistant Professor, Department of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto, and President of the Black Physicians’ Association of Ontario, with co-authors.
The authors are a team of Black clinicians, researchers, nurses and community health leaders who have led COVID-19 vaccination efforts in black communities.
Despite the higher risks of infection and serious complications, only 56.6% of black Canadians said they were ready to receive the SARS-CoV-2 vaccine, compared to 76.9% of the general population.
To address vaccine reluctance, which has its roots in medical mistrust and structural racism, the authors discuss how Afrocentric approaches and the LEAPS care counseling framework have been successful in increasing influenza vaccination rates and COVID-19 in black communities.
The LEAPS of care framework encourages providers to listen to and learn more about patient experiences; Empower and involve patients while respecting their own self-determination and perspectives; Ask for and acknowledge patients’ concerns and previous health care contacts where they may have been the victim of racism; Paraphrase and provide vaccine recommendations; Support and foster community partnerships to respectfully overcome barriers to immunization and help patients navigate a complex system.
Black patients experience disrespectful talk with providers due to anti-black racism and prejudice in healthcare. Our position is that at every meeting, patients should feel respected. Please respect the values, opinions and concerns of black patients regarding the vaccine. This is how we can rebuild trust, and that is the key message of this framework. “
Dr Onye Nnorom, Assistant Professor, Department of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto
Black-led community partnerships can be very effective in helping to increase vaccination rates: Vaccination clinics held in a hard-hit Toronto hot spot from April to May 2021 increased vaccination rate by 5.5% at 56.3%.
“Confidence in vaccines will not improve if black communities are made aware that they are at high risk and should continue to distance themselves socially, while they are also excluded from vaccine priority lists or do not have better access to vaccines, ”write the authors. “Providers should offer accurate and up-to-date information to high-risk black patients on how to access vaccines, given the difficulties in keeping up with changing pre-registration criteria at different sites.”
“Rising SARS-CoV-2 Vaccination Rates Among Blacks in Canada” is published on August 9, 2021.