key: cord-0784855-fd73afg3 authors: Erfani, Parsa; Sofia Sandoval, Raquel; Rich, Katherine M.; Ojo, Ayotomiwa; Walker MDiv, Liz; White-Hammond, Gloria; Lambert, Eugene; Wurce, Alysse title: Ask Me Anything”: Lessons learned in implementing a COVID-19 vaccine information initiative in Massachusetts jails date: 2022-04-08 journal: Vaccine DOI: 10.1016/j.vaccine.2022.04.018 sha: 4f5cfcc8cec38b5df6c56d424f521d4f590d6114 doc_id: 784855 cord_uid: fd73afg3 As a group of medical professionals, faith-community leaders, and jail staff, we launched a COVID-19 vaccine Q&A initiative across Massachusetts county jails to increase COVID-19 vaccine confidence and uptake among detained individuals. Here we describe the lessons learned in developing and implementing this initiative. 178 Latinx individuals, vaccination efforts also offer an opportunity to advance health equity. 4,9 This 179 intervention provides an example of a collaboration between medical professionals, community-faith 180 leaders, and jail staff to increase COVID-19 vaccine confidence in jails. As states, jail leadership, and 181 community leaders strive to increase vaccine uptake among detained individuals, we urge organizers to initiative were to 1) foster an open, non-judgmental dialogue for individuals to share their questions and 65 concerns about the COVID-19 vaccine 2) provide accessible Questions asked during the pilot session were used to design an introductory script 73 and frequently asked questions (FAQ) list for future sessions (Supplemental Material). Of the remaining 74 twelve counties, six counties (seven jails) accepted to host sessions Each one-79 hour session was led by two individuals, at least one of whom was a medical professional. Four session 80 leaders were present for every half-day in each jail, allowing for six one-hour sessions per half-day. The 81 number of attendees per session ranged from about 6-50 individuals. During each half-day in a jail, 82 approximately 50-150 individuals were reached-totaling to about 700 individuals in the two-month 83 period. The introductory script and FAQ In the initial 10 minutes of each session, session leaders shared session goals and reviewed fundamental Some jails provided vaccine 92 sign-up sheets immediately following the session, while others utilized other mechanisms to request a 93 vaccine, i.e., "sick slips" (medical appointment request) or notifying nursing staff. Attendance at AMA 94 sessions was voluntary and incentives for attendance were not provided. At most jails, AMA sessions 95 were announced by correctional officers within the housing unit. For sessions held within housing units, 96 individuals were encouraged to gather in the unit and televisions were muted. For sessions held in areas 97 outside of housing units In organizing and implementing the AMA program, we learned several lessons in effectively designing 103 vaccine information sessions (Table 1). We share our group's reflections to guide the design and Sessions held in jail housing units had greater attendance compared to sessions held in a separate 107 common area in the facility. This was likely because when sessions were held in housing units, 108 individuals slowly joined the AMA session as they heard their housemates discuss their experiences with Vaccinated individuals often shared their motivations for vaccination and 110 experiences with side effects, allowing for peer-to-peer information sharing. For AMA sessions held 111 outside of housing units, while peer-to-peer education was still present We found that explicitly sharing session objectives-namely to 118 empower individuals to make informed, voluntary vaccination decisions-helped engage attendees. It 119 was also helpful for session leaders to answer several questions from the FAQ list before opening the 120 floor to attendee questions. This helped ground the scope of questions to those related to COVID-19 121 vaccines and access in the jail. FAQ mirrored questions in the general community (i.e., concerns 122 regarding efficacy, length of immunity, and long-term side effects) and related specifically to the 123 detention experience (i.e., concerns about state-sanctioned medical experimentation on detained 124 populations and the effect of vaccination on court hearings). Moreover, the most engaging sessions 125 Explicitly 132 discussing how systemic racism and structural violence against detained populations has fueled distrust 133 in medical and carceral systems also helped build rapport. Examples of language used for initiating such 134 a discussion are in the Supplemental Material. Given the disproportionate incarceration of Black and 135 Latinx individuals in MA, recruitment of Black and Latinx leaders as well as Spanish-speaking session 136 leaders helped center the experience of those attending sessions and deepened conversations We also realized that it was vital to leverage existing trust in the community. To do this, we proactively 141 recruited community-faith leaders (such as co-authors and well-known pastors Black medical professionals with existing ties to the population (such as co-author and addiction 143 medicine specialist, E.L.). One individual told G.W. that he was happy to see her because his aunt goes to 144 her church 150 knowledge of vaccine eligibility and the frequency in which individuals were reminded of their eligibility 151 varied across jails. The method of requesting a vaccine also varied (i.e., sign-up sheet, submitting a sick 152 slip, direct communication with nurse) and several individuals mentioned lack of instruction on how to 153 request vaccination. For example, in several sessions, individuals asked COVID-19 and mass 186 incarceration: a call for urgent action Incarceration And Its Disseminations: COVID-19 Pandemic Lessons From 189 Chicago's Cook County Jail COVID-19 cases and deaths in federal and 191 state prisons The contribution of prisons and jails to us racial 193 disparities during COVID-19 Incarcerated people and corrections staff should be prioritized in COVID-19 vaccination plans Just over half of incarcerated people are vaccinated, despite being locked in COVID-19 Prison Policy Initiative Recommendations for Prioritization and 202 Distribution of COVID-19 Vaccine in Prisons and Jails Covid-19 Vaccine Acceptance in California State Prisons Vaccination plus Decarceration -Stopping Covid-208 19 in Jails and Prisons Increase attendance Q&A sessions should be held in housing units rather than common areas in the jail to allow for a gradual increase in participation and attendance Session leaders should disclose their jail affiliation (or lack thereof) at the start of the session, briefly provide information about the vaccine before taking questions from attendees, and minimize distractions in the room. Organizers should proactively recruit session leaders with existing ties to the detained population as well as Black, Latinx, and Spanish-speaking session leaders. Session leaders should initiate an explicit discussion around systemic racism, medical abuse, and individuals' agency in the vaccination decision process. Session leaders should work with jail staff before Q&A sessions to clarify the mechanism and timeline of requesting and receiving the vaccine at the jail and ensure that a simple mechanism to request vaccination is available at each session. 215 216 217 Declaration of interests 218 219 ☐ The authors declare that they have no known competing financial interests or personal relationships 220 that could have appeared to influence the work reported in this paper. 221 222 ☒ The authors declare the following financial interests/personal relationships which may be considered 223 as potential competing interests: 224Alysse Wurcel reports a relationship with Massachusetts Sheriff Association that includes: consulting or advisory.