Increasing Coronavirus Disease 2019 (COVID-19) Immunization Awareness in Rural Michigan Communities Through a Multimedia Campaign Author: Alexis Skuras, BSN, RN, Clinical Nurse Specialist DNP Student Faculty Advisor: Jackie Iseler, DNP, RN, ACNS-BC, CNE Introduction § Immunizations are critical to population health, as they prevent millions of hospitalizations and deaths per year § Although research demonstrates the efficacy of immunizations, many Americans remain unvaccinated against various diseases, such as COVID-19 § Rural communities comprise one of the most unvaccinated sectors of Michigan, and subsequently have a higher number of COVID-19 related hospitalizations and deaths Background § COVID-19 vaccination received Emergency Use Authorization in December 2020 and full approval in August 2021 § Data shows reduced risk of infection, transmission, severe illness, hospitalization, and death if vaccinated against COVID-19 § One year after vaccine’s full approval, over 300 million Americans were still unvaccinated, with rates in Michigan below the national average and the lowest rates in rural counties § Rural communities have worse health outcomes, are more susceptible to COVID-19, and have higher COVID-19 mortality rates Review of the Literature • Six themes to improve vaccine acceptance • Vaccine education • Reminders and recall • Recommendations from a healthcare provider • Social influence and norms • Vaccine access • Multimedia and social campaigns Project Site • Michigan State University (MSU) Extension • Grant funding from CDC/Michigan Department of Health and Human Services (MDHSS) Strengths Opportunities • 16:1 economic/social benefits to costs ratio • Need for community health services • Community collaboration • Increased funding and partnerships • Virtual outreach Weaknesses Threats • External financing • Socio-cultural factors • Political climate • Economy Project Description • Digital multimedia campaign led by healthcare providers to promote COVID-19 vaccine awareness • Registered Nurses who either lived or worked in a rural area during the pandemic • Conveyed personal COVID-19 nursing stories and recommended vaccination • Targeted to rural Michigan communities via geofencing and geotargeting • Measured content reach, impressions, and engagement as well as increased COVID-19 vaccine acceptability among the unvaccinated Theoretical Framework and Practice Model Health Belief Model used to Everett Roger’s Innovation Diffusion develop interview questions Theory (IDT) used to guide project • Susceptibility • Knowledge • Seriousness • Persuasion • Benefits and barriers • Decision • Cues to action • Implementation • Self-efficacy • Confirmation Methods Pre-Intervention • Recruited volunteers for digital ads • Obtained approval from health systems for filming on site • Developed interview questions using health belief model as a guide • Contracted videographer, scheduled interviews, created content, developed survey Intervention • Publishing and promotion of content using IDT as guide Post-Intervention • Data collection Results • Media Analytics • 224,188 views and 264 clicks on graphic advertisement • 366,000 radio listeners • 12,792 views, 625 likes, 20 shares, and 3 comments (all positive) on video interviews • Survey Responses • 239 total responses • 116 included in analysis Cost Analysis • Total project cost = $26,767.00 • Video production • Social media promotions • Digital advertisements • CNS time • Estimated savings = $1,955,717.00 • COVID-19 Hospitalizations Sustainability • All interview footage owned by MSU Extension • Content continue to be displayed on MSU Extension’s Vaccine Education webpage • Continue promoting digital content on various platforms • Opportunity to correlate media campaign with vaccination rates Implications • Clinical Nurse Specialists • Identify at-risk populations • Widely disseminate critical healthcare messaging • Promote disease prevention strategies, including but not limited to COVID-19 vaccination • Make a positive impact on community health • Facilitate collaboration among interdisciplinary teams Conclusion • Vaccination rates in Michigan are still below national average • Rural communities continue to have lower vaccination rates than urban counterparts • Clinical Nurse Specialists can improve community health • Identifying at-risk populations • Reviewing the literature • Developing interventions • Analyzing data • Disseminating outcomes Acknowledgements Jackie Iseler, DNP, RN, ACNS-BC, CNE Cheryl Eschbach, Ph.D. Jim Monahan Susan Pell, BSN, RN Valerie Pfander, DNP, APRN, ACCNS-AG, CPAN, FASPAN Matt Lamphere MSU Extension’s MVP team