Unit I: Select A Public Health Topic Of Interest And Using ✓ Solved

Unit I: Select a public health topic of interest and, using

Unit I: Select a public health topic of interest and, using peer-reviewed scholarly sources, write a one- to two-page research proposal answering: What is your research topic (provide details and background)? Why did you select this topic? What is your research question? Unit II: Conduct a literature review on the same topic using at least three peer-reviewed scholarly articles (at least one from the CSU Online Library). Write a two-page formal literature review addressing: Identify your topic; list the key words used for your literature search; list the sources/databases used; summarize the main points of the articles and compare and contrast them.

Paper For Above Instructions

Title: Vaccine Hesitancy and COVID-19 Booster Uptake in Underserved Adult Populations

Research question: What factors drive COVID-19 booster hesitancy among underserved adult populations in the United States, and which evidence-based interventions are most effective at increasing booster uptake?

Background and Significance

Vaccine hesitancy—delay in acceptance or refusal of vaccines despite availability—remains a persistent public health challenge (MacDonald, 2015). During the COVID-19 pandemic, initial vaccination campaigns substantially reduced severe disease and mortality, but booster uptake has lagged, particularly among underserved communities affected by socioeconomic barriers, limited access, and historical mistrust of health systems (Sallam, 2021; Khubchandani et al., 2021). Low booster coverage in these populations risks continued morbidity, healthcare burden, and the emergence of vaccine-evading variants. Understanding drivers of booster hesitancy and identifying targeted interventions are essential to protect vulnerable groups and reduce health disparities (WHO, 2021).

Why I Selected This Topic

The topic marries current public health urgency with equity concerns. Disparities in COVID-19 outcomes and vaccination uptake illustrate broader systemic inequities in access, trust, and information (KFF, 2022). Addressing booster hesitancy offers an opportunity to design pragmatic, community-centered strategies that can be generalized to other adult immunization programs. Additionally, plentiful recent literature allows a focused literature review and the development of an intervention-ready research proposal.

Research Proposal Overview

This proposal aims to conduct a mixed-methods study in selected urban and rural underserved communities to (1) quantify levels of booster hesitancy and identify sociodemographic correlates through a cross-sectional survey and (2) explore beliefs, trust, and access barriers via focus groups. The ultimate objective is to pilot tailored communication and access interventions—peer navigators and mobile vaccination clinics—and evaluate their effect on booster uptake at 3 and 6 months.

Literature Review Methods

To inform the study design, I conducted a focused literature review using at least three peer-reviewed articles, including one retrieved via the CSU Online Library. Key words used were: "vaccine hesitancy," "COVID-19 boosters," "booster uptake," "vaccination disparities," "underserved populations," "community interventions," and "vaccine confidence." Databases searched included PubMed/MEDLINE, Scopus, Web of Science, and the CSU Online Library database. I also reviewed grey literature from the CDC, WHO, and Kaiser Family Foundation (KFF).

Summary of Key Articles and Comparative Analysis

MacDonald (2015) provides a conceptual foundation by defining vaccine hesitancy and identifying determinants—confidence, complacency, and convenience—which remain highly applicable to booster decisions. Sallam (2021) offers a systematic review of COVID-19 vaccine acceptance worldwide, highlighting variability across contexts and important roles for trust and misinformation. Khubchandani et al. (2021) present U.S.-focused empirical data demonstrating sociodemographic predictors of initial COVID-19 vaccine hesitancy, including education, political orientation, and racial/ethnic differences. These studies converge on the importance of trust-building and access but differ in emphasis: MacDonald focuses on determinants and measurement constructs, Sallam summarizes global acceptance patterns, and Khubchandani et al. provide actionable U.S. correlates for targeted outreach.

Complementary literature from public health agencies and policy analyses (CDC, 2023; KFF, 2022) report practical barriers to booster uptake—logistics, outreach gaps, and inconsistent messaging. Intervention studies and reviews (Brewer et al., 2017; Milkman et al., 2021) suggest that behavioral nudges, trusted messengers, and reducing logistical friction can increase adult vaccine uptake. The comparison reveals that while determinants are well characterized, fewer studies specifically evaluate booster-focused interventions in underserved adult populations, indicating a gap this proposal seeks to fill.

Planned Study Design and Expected Contributions

The proposed mixed-methods study will (a) quantify booster hesitancy prevalence and predictors through stratified surveys, and (b) explore nuanced barriers and facilitators by conducting community focus groups. Based on findings, two interventions will be piloted: a peer navigator program leveraging community health workers to address trust and logistical barriers, and mobile vaccination clinics paired with culturally tailored communication. Outcomes will include change in booster uptake rates, acceptability metrics, and qualitative assessments of trust and messaging effectiveness. This work aims to inform scalable strategies for increasing booster coverage and reducing disparities in vaccine-preventable disease burden.

Conclusion

Booster hesitancy among underserved adults remains a pressing public health issue that intertwines access, trust, and information. The literature supports a multifactorial approach—measuring determinants and testing targeted, community-based interventions. This research proposal and the accompanying literature review will contribute pragmatic evidence to guide public health practice, improve booster uptake, and reduce inequities in COVID-19 outcomes.

Keywords

vaccine hesitancy; COVID-19 booster; booster uptake; underserved populations; vaccine confidence; community interventions; health equity

References

  1. Brewer, N. T., Chapman, G. B., Rothman, A. J., Leask, J., & Kempe, A. (2017). Increasing vaccination: Putting psychological science into action. Psychological Science in the Public Interest, 18(3), 149–207. https://doi.org/10.1177/1529100618760521
  2. Centers for Disease Control and Prevention. (2023). COVID-19 booster shots. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html
  3. Kaiser Family Foundation. (2022). COVID-19 vaccine monitor: Vaccination and booster uptake disparities. Retrieved from https://www.kff.org
  4. Khubchandani, J., Sharma, S., Price, J. H., Wiblishauser, M. J., Sharma, M., & Webb, F. J. (2021). COVID-19 vaccination hesitancy in the United States: A rapid national assessment. Journal of Community Health, 46(2), 270–277. https://doi.org/10.1007/s10900-020-00943-9
  5. Larson, H. J., Jarrett, C., Schulz, W. S., Chaudhuri, M., Zhou, Y., Dube, E., … & Wilson, R. (2015). Measuring vaccine hesitancy: The development of a survey tool. Vaccine, 33(34), 4165–4175. https://doi.org/10.1016/j.vaccine.2015.04.037
  6. MacDonald, N. E. (2015). Vaccine hesitancy: Definition, scope and determinants. Vaccine, 33(34), 4161–4164. (Retrieved from CSU Online Library)
  7. Milkman, K. L., Patel, M. S., Gandhi, L., Graci, H. N., Gromet, D. M., Ho, H., … & Duckworth, A. L. (2021). A mega-study of text-based nudges encouraging vaccination. Proceedings of the National Academy of Sciences, 118(20), e2101165118. https://doi.org/10.1073/pnas.2101165118
  8. Sallam, M. (2021). COVID-19 vaccine hesitancy worldwide: A systematic review of vaccine acceptance rates. Vaccines (Basel), 9(2), 160. https://doi.org/10.3390/vaccines9020160
  9. World Health Organization. (2021). Report of the SAGE working group on vaccine hesitancy. Retrieved from https://www.who.int/immunization/sage/meetings/2014/october/1_Report_WORKING_GROUP_vaccine_hesitancy_final.pdf
  10. Pew Research Center. (2022). Public views on COVID-19 vaccination and boosters. Retrieved from https://www.pewresearch.org

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