Door-to-Door Strategy Helps Boost COVID-19 Vaccination Rate

It was a personal approach: VaxConnect volunteers went door-to-door in High Point neighborhoods with low COVID-19 vaccination rates—offering information, vaccination scheduling, and free transportation. In one year, the vaccination rate among residents of the targeted neighborhoods increased by 248%.

Program Officer Whitney Davis noted how VaxConnect represents the type of project the Foundation for a Healthy High Point seeks to fund. “This work was a highly collaborative effort, attempting a fresh approach to meet important health needs in Greater High Point,” she said. “The result is that they helped the greater community, including those who decided to get vaccinated and likely influenced their families and friends.”

74% of respondents surveyed said that since being contacted by the VaxConnect team they encouraged others (family, friends, or neighbors) to get vaccinated.

VaxConnect was a pilot initiative in collaboration with YWCA High Point, the Guilford County Department of Public Health, and the Foundation for a Healthy High Point, with support from the City of High Point and additional funding from the Hayden-Harman Foundation. A recent evaluation report from the University of North Carolina at Greensboro praised the project for successfully reaching marginalized populations and offering tangible solutions to overcome identified barriers to vaccination.

Neighborhood barriers to vaccination
In fact, numerous barriers—social determinants of health—deterred the residents of zip codes 27260 and 27262 from getting vaccinated. These low-income neighborhoods have historically lacked community resources and basic needs such as health care, housing, transportation, and nutritious food choices. Many residents have limited access to the internet and computers and may experience language or educational barriers to understanding the medical jargon and conflicting sources of COVID-19 information.

The evaluation suggests that using an in-person approach to assist individuals in making important decisions is more effective, especially when they can address cultural and language barriers and any prevailing misinformation. Another key element of success was meeting the actual needs of these communities—for example, providing transportation where significant percentages of households do not have access to a vehicle.

The “outsider” barrier
One effect of marginalization is that residents are wary of “outsiders” coming into their neighborhoods and homes, asking questions, and offering services. Overcoming the “outsider” barrier is more difficult considering the range of cultures, races, and ethnicities that make up these communities. Residents of the pilot neighborhoods were approximately 30% Black/African American, 28% white, 16% Hispanic/Latinx, 9% Asian, 6.4% multiple races, and 11.3% some other race.

So, it is all the more impressive that the VaxConnect volunteers were able to discuss COVID-19 vaccination with almost half of the residents of the homes they visited. Over the program year, from April 2021 to May 2022, VaxConnect canvassers were sent out every day of the week. While it is not possible to know how many residents chose to get vaccinations due to talking with the VaxConnect teams, it’s clear they were influential in getting people who—months after vaccinations were made available—were finally willing to get vaccinated.

“The vaccine was very new, and I was unsure about the time frame. That was why I wanted to wait and see. I am 85 years old and was afraid of how it would affect my body. After getting educated about the vaccine, I decided to go for it.”
                                                                                  – VaxConnect Program Participant

Measures of success
Within the first year, the pilot program expanded to Greensboro. The Guilford County VaxConnect program was also recognized with an Achievement Award from the National Association of Counties (NACo). This award honors innovative, effective county government programs that strengthen services for residents.

Kenneth Gruber, Ph.D., Senior Research Scientist, and Meredith DiMattina, GISP, GIS Analyst at the Center for Housing and Community Studies at the University of North Carolina at Greensboro, conducted a thorough evaluation of the VaxConnect pilot program. Their report noted “… that the residents who were canvassed were appreciative of the campaign to increase the COVID-19 vaccination rates in their neighborhoods. While the numbers of those who signed up for vaccinations were not large, the potential impact unquestionably was big.”

Only 4,986 residents (15.9% of the targeted neighborhoods) were fully vaccinated when the program began. In the end, 17,366 residents (55.3%) had been fully vaccinated.

What did we learn from the VaxConnect pilot program?

  • It increased the number of residents getting their first, second, and/or booster vaccination.
  • It provided residents an opportunity to discuss getting vaccinated and to receive information that could help them with their decision-making about getting vaccinated.
  • It assisted in getting residents to vaccination sites by informing them where sites were available and their times of operation and, in some cases, arranged transportation to a vaccination site.
  • By providing the valuable fact-based information provided by NC DHHS, the CDC, and the Guilford County Health Department, many participants perceived the canvassing effort positively, delivering useful information against a virus that has been harmful to many people.
  • It reached a largely underserved population with a message of how to reduce a potentially serious health risk through vaccination and self-spacing actions.
  • It let residents of underserved/marginalized neighborhoods know that there are community organizations like the YWCA High Point, the Foundation for Healthy High Point, and the County Health Department who care and want to help in times of need, such as the COVID-19 health crisis.

YWCA High Point will release the full report soon.

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