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WASHINGTON, DC—Two new studies comparing ways to boost COVID-19 vaccination rates that were approved for nearly $11 million in new funding today by the Patient-Centered Outcomes Research Institute (PCORI) aim to reduce high rates of vaccine hesitancy among workers in skilled nursing facilities and other long-term care settings for older adults and other vulnerable populations.

Lagging COVID-19 vaccination rates among long-term care workers have become an increasing source of concern as immunization rates have slowed nationwide. Many long-term care workers are among population groups—including earners with lower wages, immigrants, and racial and ethnic groups—that generally have experienced more severe illness and death due to COVID-19. And even as vaccine rates have been generally high among older adults, those who are not or cannot be immunized remain the most likely to become severely sick or die if exposed to the novel coronavirus that causes COVID-19.

"Assessing approaches for increasing COVID-19 vaccine confidence among long-term care workers is an urgent need as demonstrated by a November 2020 survey that found that only 45 percent of these individuals are willing to receive a COVID-19 vaccine immediately when it is available,” explained PCORI’s Executive Director Nakela L. Cook, MD, MPH.

Moreover, Cook added, “the evidence generated from these studies could help not only with the ongoing COVID-19 pandemic, but with other diseases as well. After all, flu, for example, kills tens of thousands of older adults every year, and greater understanding of the benefits of yearly flu vaccination could reduce deaths from that disease as well."

One of the studies conducted by a research team at Dartmouth College will recruit some 1,800 direct care workers nationwide to compare two different active approaches to each other and the usual efforts happening now.

A third of participants will attend virtual, group, dialogue-based webinars co-facilitated by peer leaders selected by the National Association of Health Care Assistants (NAHCA) and expert facilitators as well as content specialists. Another third will visit a website where they can view and discuss curated social media content nominated by other direct care workers that focuses on COVID-19 vaccine concerns and educational information.

To ascertain the effects of the interventions, another third of participants will be encouraged to review COVID-19 vaccine information on the Centers for Disease and Control and Prevention (CDC) website, an enhanced way in which they usually receive information.

The second study led by a research team based at Kaiser Permanente Washington Health Research Institute aims to recruit 6,000 workers total at 30 long-term care facilities in the state of Washington and at another 30 in Georgia. Staff at a third of the facilities in each state will be randomly assigned to receive the full intervention, which entails long-term care workers collaborating with the research team to design educational vaccine information materials tailored to diverse audiences and identify best ways to give that information to other workers; they will also serve as peer advocates.

Staff leaders at another third of facilities will receive these peer-designed materials along with help from the research team on how to use them to share vaccine information with their staffs. The final third of the facilities will receive information in a usual way, namely getting CDC information about the COVID-19 vaccine and help from the study team on how to give that information to their staff members.

In both studies, long-term care workers are helping the research teams to design and conduct the research. Their input, Cook noted, contributes to making the research more likely to focus on and assess issues and outcomes that matter to them, ensuring the results will be relevant and useful.

The two new studies were approved for funding pending administrative and programmatic reviews and the execution of final contracts.

PCORI funded these latest studies through a special allocation of funds to confront the national health crisis posed by COVID-19. To date, PCORI has invested around $70 million in new targeted studies focused on COVID-19. In addition, PCORI swiftly provided researchers with ongoing PCORI-funded studies and other research-related projects with funding to adapt or extend their ongoing studies and projects to respond to COVID-19-related evidence gaps. To date, PCORI has provided about $34 million for enhancements to ongoing projects for this purpose.

Moreover, PCORnet®, the National Patient-Centered Clinical Research Network, a PCORI-funded initiative, is involved in supporting ACTIV-6, a trial assessing the effectiveness of medications repurposed to treat mild or moderate COVID-19 and prevent the need for hospitalization, and HERO Together, a trial exploring the outcomes of COVID-19 vaccinations, as well as the HERO Research Program, which is building a registry of health care workers to study various aspects of the pandemic.

Details of PCORI’s work on COVID-19 can be found in this collection. All projects approved for PCORI funding are on PCORI’s website. With these latest awards, PCORI has invested around $2.8 billion to fund patient-centered comparative clinical effectiveness research (CER) studies and to support other projects designed to enhance CER methods and the infrastructure necessary to conduct CER rigorously and efficiently.

About PCORI

The Patient-Centered Outcomes Research Institute (PCORI) is the nation’s leading funder of patient-centered comparative clinical effectiveness research (CER). By comparing two or more health or healthcare approaches, CER generates evidence that helps people make better-informed decisions and improves healthcare delivery and outcomes. PCORI takes a holistic approach to its work, ensuring that patients and other health decision makers are engaged as partners throughout the research process, supporting dissemination and implementation of results in practice and strengthening clinical research infrastructure to advance patient-centered CER. PCORI is an independent, non-profit organization authorized by Congress.

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