Addressing COVID-19 Vaccine Distrust Among Black Patients: The LEAPS Framework & Afrocentric Approaches in Medical Education

Context: Physicians can significantly influence a patient's decision to vaccinate against SaRS-CoV-2 virus. Black people in Canada are at high risk of covid infections, hospitalizations, ICU admissions and deaths, yet are more hesitant to receive the vaccine. But despite being among those most affected by the COVID-19 pandemic, only 56.4% of Black Canadians report being willing to receive a COVID-19 vaccine compared to 76.9% of the overall population. Vaccine hesitancy in Black communities is not merely due to misinformation; it is also linked to medical distrust and systemic racism. However, medical education often lacks training on specific strategies for communicating with vaccine hesitant patients from Black communities.

Study Design: Community-based participation and medical education program development.

Objectives: Based on previous successes in employing Afrocentric approaches in primary care clinics to increase influenza vaccine uptake among vaccine-hesitant Black patients, ongoing collaboration with community practitioners and health centres serving Black communities in the Toronto area aimed to create a better understanding of Afrocentric health promotion approaches, through the development of: (1) a 'LEAPS' of care communication framework, (2) and an educational online module involving a vaccine-hesitant Black patient that describes in a role-playing simulation how to apply Afrocentric approaches and LEAPS communication strategies in clinical practice.

Intervention: A clinical case and a webpage including three-part video series, less than 10 minute each, was developed to improve providers’ comfort in discussing vaccine distrust and anti-Black racism in healthcare with Black patients.

Results: In collaboration with the Ontario Medical Association, the Black Physicians Association of Ontario, the TAIBU community health centre and the University of Toronto Department of Family and Community Medicine, we created and disseminated an online educational module to help improve clinicians, residents and medical students' counselling skills regarding vaccine distrust and anti-Black racism in healthcare. This module is transferable to an UGME, PGME, CME, and CPD model of training. This project has shown that it is feasible to use Black community-engagement to maximize medical education and train physicians and collaborative care providers. Future directions involve designing a study for intervention evaluation and implementation.