The Check Up: Dr. Daniel Roth of Trinity Health

Dr. Daniel Roth, executive vice president and chief clinical officer at Trinity Health, based in Livonia, Mich., talks about the ways providers can continue to address vaccine hesitancy.

In March, Trinity launched a $1.6 million education campaign around vaccine hesitancy, with an emphasis on communities of color. Can you talk about how and why Trinity decided to make that big of an investment in the outreach effort?

It’s part of our mission, part of our values about caring for people in our communities, those who don’t have access to care all the time and are impacted by social needs and have disparities, (ensuring) we address those (situations). That’s something we carried into the pandemic, and certainly last year it became clear to all of us that the pandemic was having a disproportionate impact on people of color and people who are under-resourced. We saw that with increasing case rates and increasing mortality in people in Black and Latinx communities.

As we did our vaccine planning, even toward the end of calendar year 2020, we knew this was going to have to be an important part of what we were doing. We were aware of the increased hesitancy, particularly in communities of color, and we knew that was going to be a barrier. So we started, even in December, working toward a plan to be able to do that—bringing together our marketing and communications teams, along with our community health and diversity and inclusion teams, to think of the best ways that we can actually address the hesitancy and really—because it is the way we’ll end the pandemic—to make sure that we don’t carry those disparities through the vaccine process.

What kind of results have you been seeing?

There’s really two parts to that $1.6 million you mentioned. One is creating an education campaign that we call “It Starts Here,” and that is social media, communication materials that we’re using in all of our communities, but also with the focus on 14 communities, which are representative (of areas where) greater than 40% of the population is people of color. Another (part is) to create partnerships with people in our communities, agencies and community groups who can help us carry that message through and really do a couple of things. One is to get that message down. We know that this is a local endeavor and we need to reach and partner with local people. So how do we find people who can be of influence and use those materials for good? How also do we make vaccine accessible?

We want to make sure that people have access to the vaccine. It’s one thing to have a call to action. It’s another thing to be able to say, “Yep, I can get the vaccine,” because at the end of the day, what really matters the most is seeing that vaccine number go up.

We’ve seen the influencers have the impact that we had hoped. We’ve also seen both internally and nationally, increased acceptance of the vaccine and reduced hesitancy in communities of color. We take that as great news, but ultimately we know that what really matters is people getting vaccinated. So while we’ve seen improvements … we know we still have work to do.

How much of the challenge now is hesitancy versus access?

It’s both. I think in December, January, February and March, it was really about education, and now it’s more and more about access. And the good news is we now have supply. We’re seeing, even in the last couple of weeks, an adequate amount of supply … but now we have to make sure the vaccine is easy to get, particularly for people whose schedules are harder, transportation is harder.

The places where we offer the vaccine are on routes for public transportation. We’re getting out into communities, faith-based community agencies, churches. How do we partner with community groups who can get the vaccine right down into the communities, into the neighborhoods where people are?

Some of the more recent data on hesitancy break along different demographic lines—political party, rural versus urban. Are you factoring any of that into your outreach campaign?

We are mindful of that. We knew, even when we did the $1.6 million in the first quarter of this calendar year, that it wouldn’t be the end and that we would have to pivot. So now we’re in the middle of that. By the same token, we’re still committed to making sure communities that experience inequities and populations that experience inequities are ones we’re still committed to. Even as we see improvements in vaccine hesitancy—and hopefully we continue to see improvements in vaccinations—we still know the underlying reasons as to why they’ve experienced the pandemic in a worse way. Addressing those social influencers and social needs remains a commitment of ours. At the same time, to your point, we need to continue to look at the remaining 50%, 40% of the country that hasn’t yet been vaccinated.

Some of the reasons are the same. There is misinformation about the science and the truth of it. We’re always fascinated by the ability in today’s world for social media to continue to propagate misinformation. We’re trying to think of ways we can (use social media) to get the right information in people’s hands, because the worst thing that can happen, independent of party affiliation or race or ethnicity, or rural versus urban, is that people make decisions on bad information.

The other thing that we’re working on, which we think will help in this next phase, is we know that (people tend to) trust their clinicians. They trust their primary-care physician, so how do we then begin as vaccine supply becomes more abundant in all those communities to use our primary-care physicians to help reach out to these patients, address whatever their concerns might be, because those are the people, and those are the conversations we think will help us at the next tranche of improving vaccination.

What kind of leadership lessons have you seen through the outreach effort?

We start with our mission, our core values. They’re who we are and they have really helped us get through the pandemic in the best possible way—making sure of our commitment to safety, communities that are underserved (and) integrity.
We want to make sure people are safe, first and foremost, and that means getting vaccinated, but it also means that we’re building up partnerships.

We know that we won’t solve community health by ourselves … so it’s an opportunity for us to build up those bridges we had before the pandemic and to build new ones, to get into communities across the country, and also to make sure that we leverage our role as a healthcare provider that people trust to do that. We continue to try to do that through the vaccine process, and we’ll continue to do that hopefully over the coming months.


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