PCR014: Black Patient Perceptions of COVID-19 Vaccine, Treatment, and Testing

Gisselle De Leon, BS; Raquel Garcia, BA; Donna Zulman, MD, MS; Taylor Hollis; Joy Cox; Cati Brown-Johnson, PhD; Juliana Baratta, MS

Abstract

Context: The Presence for Racial Justice project leverages the Stanford Presence 5 framework to present anti-racism communication practices that promote clinician trust-building for Black patients in primary care. With the racial/ethnic disparities in COVID-19 infection rates, an assessment of Black patients’ perspectives around COVID-19 care is required to promote health equity in current and future health crises. Objective: To compile clinician communication strategies for promotion of patient understanding and agency concerning Black patients’ perceptions of COVID-19 vaccine, treatment and testing. Study design: Qualitative study employing inductive and deductive thematic analysis. Setting: Four primary care clinics primarily serving Black patients in Oakland, CA; Rochester, NY; Leeds, AL; and Memphis, TN. Population Studied: 37 Black patients, recruited through convenience sampling by their primary care clinician for 45-minute semi-structured audio-recorded interviews. Outcome Measures: Emergent themes around Black patient perceptions and motivations for seeking/delaying COVID-19 vaccine, treatment, and testing, and their ideal medical guidance on COVID-19 care. Results: Due to historic mistreatment of Black patients within the healthcare system, medicine, and research, there is a high prevalence of mistrust amongst the Black patient interviewees towards the safety, efficacy, and equitable distribution of the COVID-19 vaccine compared to existing vaccines. Patients feared racial discriminatory treatment and intended to wait for the general population, authority figures, and White patients to receive the vaccine first. Many patients believed personal protective behaviors (e.g., mask wearing, staying home, taking supplements) would be more effective than receiving the COVID-19 vaccine. They expressed a preference for receiving COVID-19 medical care in the comfort of their homes due to high costs and risks of maltreatment, death, and loneliness. Conclusion: Black patients hinged their vaccination decisions on having enough time to observe vaccine rollout and discussion with their clinicians. Relating new medical interventions (ie., COVID-19 vaccine) to accept medical approaches (ie., Flu vaccine) and being aware of historical distrust in medicine can inform clinician efforts to empower and provide excellent care for Black patients moving forward.
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Jack Westfall
jwestfall@aafp.org 11/19/2021

Great poster and abstract. Thanks

Gillian Bartlett
gillian.bartlett@health.missouri.edu 11/22/2021

Great project - I know this will be really helpful to medical students who are trying to tackle this issue as well as primary care providers. I would like to hear more about how you think the Presence 5 framework could be leveraged.

Emily Godfrey
godfreye@uw.edu 11/22/2021

Thank you for exploring an important topic. Is it possible to engage patients such that they drive the research questions and plans for intervention? It seems like patients were participants in this research, but not fully engaged in research?

Ann Macaulay
ann.macaulay@mcgill.ca 11/23/2021

So very important to learn from patients. Could patient partnering with patients help in future research?

Ann Macaulay
ann.macaulay@mcgill.ca 11/23/2021

typo in my comment below Should be : could patient partners (or partnering with patients) help with future research?

Andy Pasternak
avpiv711@sbcglobal.net 11/26/2021

Great topic. I've learned so much during COVID on this topic in doing some work with Black Churches in our area. The need for boosters is now a bigger hurdle than even the first shots

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