Vaccine Case Study: Understanding and Encouraging the Reluctant

The pandemic has rocked California. And Cedars-Sinai provides care for over a million people annually across 40 locations in the incredibly diverse Los Angeles area.

Today, as vaccine distribution is underway, Cedars-Sinai is faced with a common challenge: how to encourage vaccination among Black and Latino communities.

We asked Dorian Harriston, associate director of brand strategy, to explain how Cedars-Sinai is tackling this challenge. The answer lies in the organization’s longstanding commitment to community partnerships.

photo courtesy of Cedars-Sinai

Jarrard Inc: The issue of vaccine hesitancy among the Black community is well-documented and something many providers are struggling with right now. What does it look like in Los Angeles?

Dorian Harriston: Vaccine hesitancy appears to be as prevalent here as anywhere else – especially in Black and brown communities.

From my experience, the level of education, income or job doesn’t factor into whether an individual is hesitant to get the vaccine. It’s a deeply rooted effect of historical medical mistreatment that has caused distrust. I hear the same things from family and friends as I do on social media and even colleagues in healthcare: People are afraid, and the conspiracy theories and misconstrued testimonies posted online are not helping. This is a serious issue.

How is Cedars-Sinai addressing the hesitancy?

We’ve prepared an overall strategy to strengthen our relationship with these communities. It starts by partnering with organizations that cater to the needs of Black and brown communities. We hope to be a true partner, amplifying their messages and providing support – and not just monetary support – to increase and sustain resources while conducting outreach to show commitment to our community.

What does that strategy look like in practice?

Initially, we’re doing a series of virtual talks and engaging faith, community and healthcare partners to discuss the issue in various formats. We’re enabling our clinicians and researchers to answer FAQs and attempt to ease fears by responding with facts.

We have to be honest about barriers that cause hesitancy to address them and help determine culturally relevant and satisfactory solutions. Transparency, honesty and commitment are paramount to changing longstanding thoughts and behaviors. We need to regain the Black community’s trust, and we must prepare for a long-term commitment.

Talk more about the role of your team members.

It’s essential that we take as much care internally as we do externally. We’re creating internal conversations around vaccine hesitancy and trust, taking the time to tackle this initiative collectively because it affects all aspects of the programs and services we provide as an institution. Employees must be ambassadors that carry factual and positive messages to their circles of influence. It will take a village to make headway.

How is it going?

We’re just getting started. The first step is to find out what Black and brown communities want and need. We’re doing this through our partners and stakeholders. Partnership is the key to expanding outreach and ensuring the message is reaching every audience within these communities. We need to communicate with influencers – whether that’s the internal family circle (caretakers responsible for multi-generational households, children that bring new information and technology, etc.) or external relationships (faith leaders, clinicians, community and civic leaders and friends). Organizations have provided what they believe this demographic needs for far too long without doing the research to back it up. We want to be sure we are addressing needs in a way that helps build trust and establish a consistent path to preventive care.

Healthcare is local. How do you, as a large system with a significant geographic footprint and diverse patient population, present messages that will resonate with each community while remaining consistent across the system?

The pandemic has forced our team to review our current practices for efficiency and align messages across channels. I see us working together more as a team due to COVID-19 than before the pandemic. Although we have a lot more meetings, being able to divide and conquer and form special project teams has allowed us to refine our messaging and reach a larger audience while promoting significant but often overlooked areas – in particular, research, education, and community engagement. These areas create a trifecta with clinical care vital to defining needs, breaking down barriers to vaccine acceptance, and promoting health equity. We also want to ensure that Black faculty and staff are included and visible so that these communities know there are people who look like them working on their behalf.

What advice do you have for other providers? Are there best practices that that apply across the board?

  1. It’s important to align strategy around your organization’s health equity and diversity and inclusion goals. Creating tactics is easy, but it’s essential to have a definitive strategy that speaks to who the organization is and provides a roadmap to inclusively provide for your community’s health.
  2. Ensure that your communication is honest and transparent. There’s no shame in admitting you don’t have a piece of information or don’t know something. Also, remember that one message may not be sufficient. There are varied audiences within each targeted demographic, and having a single message isn’t enough. Having multiple messages and communications vehicles could be the difference between being heard or ignored.
  3. Before beginning any outreach, know that there are no quick fixes. If your organization isn’t willing to invest budget, time and resources, don’t proceed. To battle the distrust and inequity that Black and brown communities have experienced, you must consistently engage and work to understand unique needs, health disparities and cultural norms. Have BIPOC (Black, Indigenous and people of color) on your team or as advisors to vet advertising and messaging and provide communication vehicles such as unique media outlets and preferred ways in which the target demographic seeks and digests information. One wrong message or misstep could injure an already fragile relationship with communities of color.
  4. When crafting a call to action, ensure you have the capacity and resources to engage and execute in a manner that will make it easier on your audience. Right now, individuals are afraid, anxious, angry and burned out. Anything that appears to be unclear or complicated will cause frustration, dismissal and possibly a negative perception of your organization. Ensure that your strategy allows for flexibility and resources that will help everyone within the community – even if you cannot provide those services.
David Shifrin
dshifrin@jarrardinc.com