Karna’s comprehensive solution utilized a full range of public health capabilities, including research, health communication, program evaluation, technical assistance (TA), and health analytics. Each area of our work informed the other areas, allowing us to provide evidence-based, data-driven recommendations, messaging, and TA. We continue to support CDC as the pandemic evolves, and the activities described below include both ongoing and completed efforts.
Research, Analytics, & Health Communications Address Broad, National Concerns
To understand and address vaccine hesitancy, Karna took a big-picture approach by developing research plans that would inform national communication efforts. Our research sought to understand the barriers and motivators to vaccination of the population at large and populations exhibiting low vaccine uptake such as Black and Latinx communities, young adults, rural residents, and parents and caregivers of school-aged children.
We conducted 30 focus groups and fielded seven surveys to inform CDC’s COVID-19 vaccine education and communication efforts. Information from focus groups provided a detailed picture of hesitancy, while surveys assessed attitudes around vaccination intent, message acceptance, and message preferences (A/B testing). Our team also performed cross-tab analyses to identify correlations across demographics and psychographic factors. We found that many vaccine concerns centered on safety, effectiveness, side effects, and messenger trustworthiness.
Karna utilized the initial research findings to develop a communication strategy and messaging focused on common concerns. To ensure that our messaging and creative concepts stayed on track, we conducted rapid survey message testing and monthly pulse-check surveys to monitor evolving data trends. With Karna’s data automation capabilities, the surveys enabled us to gather input from a large sample of the population and produce high-level findings within 48 hours. Our surveys tracked audience attitudes and demographic information, which was used to refine audience segmentation and develop effective, tailored messaging. Karna also utilized social listening strategies, including daily monitoring of news and social media platforms, to assess the current state of COVID-19 vaccine confidence and further inform messaging.
In addition to creating ongoing social media and web content, Karna developed messaging and communication tools to assist trusted partners and intermediaries with promoting vaccine confidence. Key materials include:
- A conversation guide to help pediatricians address parents’ vaccine concerns
- The COVID-19 Vaccination Field Guide that offers state and local immunization programs a behavioral science approach for addressing local COVID-19 vaccination concerns in their communities
- Messaging and toolkits about vaccine safety and misinformation for trusted messengers and social media influencers
TA, Communication, and Program Evaluation Assist with State and Local Challenges
CDC also recognized that while the comprehensive vaccine confidence research done was crucial for the development of national vaccine education efforts, some vaccine confidence and uptake challenges were more localized — specific to certain communities and populations. Rather than a “one size fits all” approach, CDC needed to build confidence through tailored strategies and trusted messengers within communities.
Thus, to offer assistance at this level, Karna helped develop the Rapid Community Assessment (RCA) guide and a TA training system. These solutions help funded partners and state, regional, and local immunization programs evaluate, diagnose, and address confidence and uptake concerns specific to their communities.
To assess the effectiveness of the RCA guide, Karna conducted a pilot program with five health departments. The evaluation involved in-depth interviews and observations of RCA training presentations. We used the findings to make improvements to the comprehensive 85-page RCA guide and its accompanying assessment tools.
Karna also supports the Prevention Research Centers’ (PRC) Vaccine Confidence Network (VCN), comprised of 26 accredited schools of public health or medicine across the U.S. With PRC-VCN members, Karna supports the evaluation of PRCs’ individual VCN behavioral interventions for increasing COVID-19 vaccine confidence and uptake as well as monitoring and evaluating the functions and impact of the VCN as a whole. This evaluation is informing future behavioral interventions for increasing vaccination and collaborative strategies for optimizing the use and dissemination of successful vaccine promotion strategies, messaging, and educational materials.
Additional TA is ongoing with CDC-funded partners and communities across the country. Our team conducts needs assessments and sets up TA sessions to discuss vaccine confidence-building strategies. Since each community faces unique challenges, we customize assistance to meet each community’s needs. Activities include:
- Confidence consultation calls with subject matter experts
- Vaccine confidence bootcamps/trainings
- Community-specific messaging and material development and distribution
- Dissemination of the COVID-19 Vaccination Field Guide