REDES: a peer network and mobile health (mHealth) enhanced CHW model to maximize COVID-19 vaccination among low income Latinos

Project Summary The COVID-19 pandemic disproportionately impacts Latinos in the US. Failing to provide equitable access to vaccines will exacerbate the profound disparities in COVID-19 and other health conditions among Latinos communities. Our team has established a community coalition and identified effective interventions to reduce disparities among low-income limited English proficiency (LEP) Latino communities using qualitative, survey, and implementation science methodologies. We will test the efficacy of a combination intervention REDES (“Networks”) - a social network and mobile health (mHealth) enhanced community health worker (CHW) intervention - to address COVID-19 vaccine hesitancy and uptake among a cohort of Latinos and their networks in Maryland. We will recruit 300 index participants who have taken the COVID-19 vaccine. Half of the index participants will be randomized to the experimental group (n=150). CHWs will train them to be peer mentors to conduct peer outreach in-person and by text messages and to promote vaccine acceptance and uptake with their networks. Index participants in the control group (n=150) will receive an equal attention intervention. In addition, we will recruit unvaccinated primary and secondary network members of indexes for study participation and COVID-19 vaccination. We will enroll an estimated total of 1,590 primary and secondary network members. All participants will be followed prospectively at 3, 6, 12, and 18 months after baseline intake. The specific aims are: 1) Evaluate the efficacy of a combination intervention REDES to promote COVID-19 vaccine uptake among Latinos; 2) Examine ongoing barriers and facilitators of vaccine uptake among Latinos and their networks to tailor our intervention and address new challenges, and 3) Evaluate the implementation determinants and outcomes of REDES to inform future broad-scale implementation. Our multi-disciplinary research team brings together Latino health, social network, mHealth interventions, vaccine hesitancy expertise; a long-term history of community engagement with partner organizations in Maryland; and existing bilingual/bicultural CHW capacity and a rich local infrastructure for COVID-19 response. If this combination intervention demonstrates the efficacy, we will develop an implementation strategy toolkit, both in English and Spanish, for community partners and health departments interested in replicating the approach. This proposal primarily focuses on COVID-19 vaccination, but knowledge gained will be relevant to future vaccine equity initiatives, such as COVID-19 boosters (if needed) and seasonal influenza vaccination.