Digital, Community-Based Outreach Impacts COVID-19 Vaccination Uptake Among Black, Hispanic Patients

With higher risk for COVID-19 infection and hospitalization reported among Black and Hispanic individuals, researchers implemented interventions such as direct outreach and digital redesign to restrict online self-scheduling for vaccination to local zip codes among underserved populations.

In an interview with Integrated Healthcare Executive, Daniela Diaz, MD, family medicine physician, associate medical director of New York-Presbyterian’s Herman “Denny” Farrell Jr Community Health Center, and assistant professor at Columbia University Vagelos College of Physicians and Surgeons, discussed how restricting online scheduling access significantly impacts which patients get appointments, and how vaccination rates can be increased through community-based outreach.

What existing data led you and your co-investigators to conduct this research?

This research was inspired by the knowledge that the technological divide was leading to disparities in access to vaccinations. We employed several strategies to help improve racial and socioeconomic equity in access to vaccines. We wanted others to be able to benefit from this work by sharing what strategies were most successful in achieving this goal.  

Please describe your study and its findings. Were any of the outcomes surprising?

NewYork-Presbyterian Hospital operated a large COVID-19 vaccination site at the Fort Washington Armory in Washington Heights, NY, between January 14, 2021 and May 14, 2021, where I served as the medical director.

At first, online scheduling was available to all residents of New York, but on January 28,2021, we digitally redesigned the scheduling system to restrict it to residents from local zip codes with higher racial and ethnic minority populations. We also began direct outreach to Spanish-speaking and underserved communities via community-based organizations such as senior centers, faith-based organizations, and local primary care practices.

Our study showed that restricting access to online scheduling to people within target zip codes can significantly impact which patients get appointments and that working with existing community-based organizations to help encourage vaccination is even more effective at increasing vaccination rates. This suggests that it is important to not only think about access, but also pre-existing community relationships and institutions when trying to impact health behaviors and outcomes. 

How can payers use this information in formulary decision making?

We believe these steps could be replicated to help reduce health disparities in future public health campaigns. When trying to influence health behaviors, payers can remember that access is important but insufficient and that the source that brings the information to patients is key.

Do you and your coinvestigators intend to expand upon this research?

At this time we do not plan to expand this research, but NewYork-Presbyterian is always looking for the most effective ways to improve the health of the communities we serve, so we may likely employ these strategies in the future with other initiatives and continue to refine this work toward improved health equity. 

Is there anything else pertaining to your research and findings that you would like to add?

I am glad that this work is being highlighted because the advances in health care are wonderful, but they fall short if populations who are generally underrepresented in health care do not benefit from them as much as other populations do—especially when the underrepresented communities are more negatively impacted by the disease, such as in the case of COVID-19. 

About Dr Diaz
Daniela C Diaz, MD, attended Williams College for her undergraduate education and completed medical school and residency at Columbia University Vagelos College of Physicians and Surgeons and New York Presbyterian’s Family Medicine Residency Program, respectively. She worked for several years in a federally qualified health center in New York State, serving as medical director for one of their sites. She returned to  New York Presbyterian/Columbia University Irving Medical Center in November 2019. 

Dr Diaz is an Assistant Professor at the medical school and is faculty in the Brown Scholars program, which supports medical students with an interest in primary care. On the hospital side she is a clinician, Quality Chair for Family Medicine, a clinical informatics lead and is the Associate Medical Director of N ewYork-Presbyterian's Ambulatory Care Network’s Herman “Denny” Farrell Jr. Community Health Center. Additionally, she is Medical Director of N ewYork-P resbyterian’s Ambulatory Care Network's Central Clinical Triage Center (CCTC), a call center that supports many of NewYork-Presbyterian’s high need patients. She also provided clinical leadership for COVID-19 vaccination efforts across the enterprise and was medical director of the NewYork-Presbyterian Armory Mass Vaccination Site.