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[Editor’s Note: Since July 2021 Alianza Nacional de Campesinas (Alianza), Migrant Clinicians Network (MCN), Rural Coalition (RC) and 20 organizational partners and members have mobilized 221 community health outreach workers across 20 states and Puerto Rico to encourage vaccination within Black, Indigenous, and people of color (BIPOC) rural communities through a learning collaborative. Funded by an $8.1 million grant from the Health Resources & Services Administration (HRSA), the effort aims to raise vaccination rates among immigrant and migrant farmworkers, and rural communities of color through reinforcing COVID-19 information, addressing vaccine hesitancy and accessibility, and assisting in countering misinformation and disinformation.]
Within rural regions, fear of COVID-19 vaccines has been a major barrier to protecting vulnerable communities during the pandemic. If we want to help these communities get protection from the virus, these fears must be addressed and answered, not dismissed or ignored. Among some Indigenous communities of North America, American Indian Mothers Inc. (AIMI) has been working to help convince community members to get vaccinated, respond to their common fears, and increase vaccine accessibility. “People are stating that people are dying from getting the vaccine,” said Kara Boyd, presenter for AIMI at one of MCN’s recent learning collaboratives, while sharing misinformation she is hearing within communities she serves. “I haven’t had anyone that’s been able to list one person who has died from receiving the vaccine, but they’ve been able to name 20 plus that have died as a result of COVID and not having the vaccine,” Boyd noted.
AIMI, a North Carolina-based non-profit, primarily serves Native American populations residing in the state, supporting their health and wellbeing. As part of AIMI’s efforts during COVID-19, the organization has helped to build the HRSA funded Intertribal Talking Circle Healing of COVID-19 (ITTCH), a project that expands their reach into South Carolina, Virginia, and Maine, where AIMI works to protect the Native American communities, they serve using the considerable knowledge and best practices they have developed. The creation of ITTCH, which also reaches Georgia and New Hampshire, has encouraged the Native American communities that are reached to actively promote vaccination, helping to protect these communities who have been disproportionately harmed by the COVID-19 pandemic. According to the Indian Health Service, Native Americans are 3.5 times more likely to contract COVID-19 and are over 4 times more likely to be hospitalized as a result of COVID-19 than non-Hispanic white populations [3].
Issues of trust within some Native American populations of North America may be making these communities more vulnerable to misinformation. “Distrust of the government due to past aggressions for Native Americans is very challenging, as well as distrust of the medical industry,” Boyd said. Native American populations in North America have often experienced medical mistreatment and abuse at the hands of authorities and this is still a pressing issue that has resulted in health inequalities between Native American populations and other populations within the country. While vaccinations have been proven to be extremely effective and safe, fear of medical intervention is based on real, historical, and material harm that has been done to these communities. These fears cannot be dismissed by those seeking to improve public health. Intercommunity efforts to encourage vaccination, like those encouraged by AIMI, may be better at relaxing community’s fears, building trust, and rebuilding relationships, than efforts by less trusted authorities.
In addition to growing the range of populations AIMI serves through the initiation of the ITTCH, the organization has also worked to increase its communication efforts by creating a hotline for pressing questions. Besides the hotline, Boyd also stressed the importance of face-to-face communication within her community as a valuable communication method for many of the Native American community members they serve. Through candid conversations about health and COVID-19, organization staff encourage vaccination. They also take steps to make vaccination more accessible, which includes offering free transportation to vaccination appointments.
While expanding their reach through the ITTCH, challenges beyond that of misinformation have become apparent. While attempting to reach Native Americans within the states they serve, they have encountered problems with census data, where community members may not be properly represented. Additionally, Boyd noted that while communities living on reservations are easier to reach while countering misinformation due to their specific geographical locations, many Native American community members live elsewhere, and AIMI does not want to abandon those individuals. By working with state-recognized Native American urban centers, AIMI can reach Native Americans who live in cities. Boyd explained that many Native Americans are members of the armed forces and that the urban outreach helps to reach Native Americans at Fort Bragg, one of the largest military installations in the country.
Each week MCN facilitates a bilingual Learning Collaborative that offers partners access to clinical staff, other experts, an extensive library of fully editable COVID-19 resources, evidence-based COVID-19 updates, and extensive communications and marketing technical assistance to support partner’s use and adaptation of resources to fit their community’s needs. Each organization shares learning collaborative content and activities with their frontline community health workers, who tirelessly promote COVID-19 vaccination in the counties, towns, and neighborhoods where they live. This blog series highlights best and promising practices used by grant partners across the country, which are shared at the learning collaboratives, creating a diverse learning environment.
This is supported by the Health Services and Resources Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $8,105,547 with 0% percentage financed with non-governmental sources. The content are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, or the U.S. Government. For more information, please visit HRSA.gov.
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