To increase vaccination rates among Black people who are at high risk of COVID-19, employing an Afrocentric health-promotion approach that is centred on respecting patients’ values and perspectives can help, argue authors in a commentary published in CMAJ (Canadian Medical Association Journal).
“An Afrocentric approach, which acknowledges that health care experiences of Black people are affected by historical and present-day anti-Black racism, can be combined with communication frameworks to counsel vaccine-hesitant patients,” writes Dr. Onye Nnorom, a family physician and assistant professor, Department of Family and Community Medicine and the Dalla Lana School of Public Health, University of Toronto, and President of the Black Physicians’ Association of Ontario, with coauthors.
The authors are a team of Black female 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 reported willingness to receive the SARS-CoV-2 vaccine, compared with 76.9% of the overall population.
To combat vaccine hesitancy, which has roots in medical distrust and structural racism, the authors discuss how Afrocentric approaches and the LEAPS of care counselling framework have been successful in increasing influenza and COVID-19 vaccination rates in Black communities.
The LEAPS of care framework encourages providers to Listen and Learn more about the patients’ lived experiences; Empower and Engage patients by respecting their own self-determination and perspectives; Ask and Acknowledge patients’ concerns and previous health care encounters where they may have experienced racism; Paraphrase and Provide vaccine recommendations; Support and Spark community partnerships to respectfully overcome barriers to vaccination and support patients navigating a complex system.
“Black patients experience disrespectful discourse with providers because of anti-Black racism and biases in health care. Our position is that in every encounter, patients should feel respected. Please respect Black patients’ values, views and concerns when it comes to the vaccine. That’s how we can rebuild trust, and that is the key message from this framework,” says Dr. Nnorom.
Black-led community partnerships can be very effective at helping increase vaccination rates: vaccine clinics held in a hard-hit hotspot part of Toronto from April to May 2021 increased vaccine uptake from 5.5% to 56.3%.
“Confidence in the vaccines will not improve if Black communities are told that they are at high risk and should continue to socially distance, while they are also excluded from vaccine priority lists or are not provided greater access to vaccines,” write the authors. “Providers should offer accurate, current information to high-risk Black patients about how to access vaccines, given the difficulties in keeping up with changing preregistration criteria at different sites.”
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