Enhancing Vaccine Compliance through Culturally Sensitive Outreach: HPV and Hepatitis B Vaccination in Metro Atlanta

Purpose: This project aimed to increase vaccine adherence among vulnerable populations by assessing health competencies and vaccine awareness among metro Atlanta residents, particularly those receiving harm reduction services from the Georgia Harm Reduction Coalition (GHRC) or employed by the organization. The focus was on two vaccines, human papillomavirus (HPV) and hepatitis B, targeting marginalized communities, primarily African-American individuals, many of whom are housing insecure and use drugs or alcohol. This underscores the need for culturally sensitive outreach and education.
Marginalized racial and ethnic populations in the US experience higher morbidity and mortality rates from HPV, with research showing that vaccine communication between healthcare providers and patients in these communities is often inadequate. Additionally, adherence to and completion rates for the hepatitis B vaccine are particularly low among black or Hispanic populations, those with lower socio-economic status, and individuals with comorbidities.
This initiative, developed by nursing students under a federal grant to increase access to care in underserved populations, applied an evidence-based, values-driven model to facilitate conversations with vaccine-hesitant individuals. Instead of focusing solely on scientific data, the project emphasized respectful, honest, and responsible communication to empower individuals to make informed decisions about their health.
Description: The project used the values driven model to facilitate conversations with vaccine-hesitant individuals, key informant interviews done using motivational interviewing, and a community survey to gather insights into participants' beliefs and experiences. The survey assessed prior knowledge of the vaccines, vaccination history, reasons for hesitancy, and risk behaviors such as condomless sex and needle sharing. This approach built trust between health professionals and community members while deepening understanding of the community’s health knowledge and attitudes toward vaccines.
Evaluation/outcome: Preliminary results showed that 87% of participants had heard of the HPV or hepatitis B vaccines, but only 15.8% had received the hepatitis B vaccine and 10.5% had received the HPV vaccine. Vaccine hesitancy was linked to misinformation, fear of side effects, and limited healthcare access. Additionally, 58% of respondents engaged in behaviors that increased their risk of contracting these viruses, such as condomless sex.
After the survey, nursing students educated community members on the importance of these vaccines for health and prevention. Responses revealed a clear demand for more information and community engagement, highlighting a gap in effective communication. Participants expressed confusion about vaccine necessity and safety, underscoring the need for targeted education.
Following discussions, students asked participants about their interest in receiving the vaccines at GHRC’s health fair. Participants showed 79% interest in the hepatitis B vaccine and 58% in the HPV vaccine. The community health fair, featuring interactive discussions, educational materials, and free onsite vaccinations, increased vaccination rates. The project fostered trust, improved vaccine knowledge, and identified key barriers to vaccination, emphasizing the need for culturally competent education, accessible healthcare, and sustained community engagement to reduce vaccine hesitancy and improve public health outcomes in vulnerable populations.