BY DOROTHY JOHNSON
MARTIN CO HEALTH DEPT
In central Appalachia, the Martin County Health Department faced unique challenges in promoting vaccine acceptance. Our community, characterized by limited access to hospitals and public transportation and a history of cultural exploitation, exhibits a deep-rooted mistrust in healthcare institutions. Additionally, the opioid epidemic has significantly impacted residents’ perspectives.
To gain a deeper understanding of how these issues impact vaccinations, Martin County conducted a Rapid Community Assessment (RCA). We engaged Martin County High School students, particularly from the JAG (Jobs for American Graduates) program, to assist in conducting a survey on vaccine hesitancy. A group of JAG students were selected to lead the survey initiative. This team was instrumental in understanding the concerns and attitudes of their peers towards vaccination. They took an active role in developing the survey questions. Their firsthand experience and understanding of the student body’s mindset ensured that the survey was relevant and addressed the right issues. The final assessment instrument included 23 questions covering demographics, vaccine-specific issues, and an open-response section for additional insights.
To maximize participation, the student leadership team organized a flyer contest. Different student groups created eye-catching flyers encouraging peers to participate in the survey. Each flyer featured a unique QR code for tracking participation. Flyers were posted around the school, making it easy for students to access the survey via their smartphones. To incentivize participation, the student leaders offered a $25 gift card to the creators of the flyer that generated the most traffic. This friendly competition significantly boosted engagement. The survey saw an impressive response, with 178 students (about one-third of the student body) participating. This high response rate was a testament to the effectiveness of peer-led initiatives.
After collecting the survey data, the Student Leadership Team worked with the project leads at the health department to analyze the results. They identified key findings and insights related to vaccine hesitancy. Survey results highlighted several barriers: lack of trust in healthcare, influenced by historical exploitation and the opioid crisis which made individuals skeptical of vaccine safety; and structural issues like limited transportation and affordable housing, leading to difficulty accessing vaccination sites. The team then presented their findings to the entire school, showcasing their hard work and the importance of the project.
Recognizing the identified challenges, our health department took a proactive approach to address them. We collaborated closely with community partners and students to develop targeted strategies. This included transparent communication efforts and community engagement activities to help build trust and emphasize the importance of vaccines for individual and community health. We organized educational events and pop-up vaccine clinics, ensuring accurate information and vaccines were accessible to all.
The involvement of youth in the survey process was a game-changer. Their engagement ensured a high participation rate and provided valuable insights that might have been overlooked by adults. The project underscored the importance of involving young people in public health initiatives, particularly when addressing issues that directly affect them. This helped to foster a sense of community involvement. By empowering students to take the lead, the Vaccine Hesitancy Grant project successfully gathered crucial data and fostered a sense of ownership and responsibility among the youth. This approach can serve as a model for similar initiatives in other communities.
Our efforts have begun to rebuild trust and pave the way for more effective public health initiatives in rural Appalachia.
Dorothy Johnson is the Health Program Development and Outreach Manager at Martin County Health Department, located in Inez, Kentucky.