This document proposes solutions to increase COVID-19 vaccine confidence among white evangelical communities. It suggests establishing "community health ambassadors" who are members of these communities and trained to conduct local outreach through social events. These ambassadors would address health concerns, build trust, and recruit new ambassadors. Evaluation methods would include surveying participants and measuring changes in vaccination rates over time. Competing solutions target specific demographic groups or leverage trusted community leaders and financial incentives. Remaining gaps include ensuring access to vaccines in rural areas and building trust through consistent, factual communication and addressing concerns with local medical experts.

1. VACCINE
CONFIDENCE
final pitch to nimhd grant funders
Stephanie Bittner, Jeffrey Van Liew, Katie Parrish,
Thomas Hayden, Catherine Pearson

2. WHAT WE SET OUTTO DO
we are exploringfundingopportunitiesto:
instillvaccineconfidencein the white evangelicalamerican
populationby appealingto theirneed for freedom and trust.
We are defining vaccine confidence as the trust that the population has on vaccines, providers who
administer vaccines, and processes and policies regarding the vaccines.

3. Approximately one in
four persons inthe
United States identify
as evangelical
2016 exit poll found 26% of voters self-
identified as white evangelicalChristians.

4. Among Republicans, White
Evangelical Christians are more
likely than other religious
groups to believe in certain
conspiracy theories, according
to a study by the conservative
American Enterprise Institute.
CHALLENGES WITHIN THESE COMMUNITIES…
Significant
disinformation
Disproportionately
Resistant
About 14% of American adults
say they won't get vaccinated
under any circumstances as of
June, while the number is a
much higher 22% among white
evangelical Americans
(Christians), landing it the
highest among any
demographic studied.
(KFF, 2021)

5. Meet Robyn
Age: 38
Home: suburban Indiana
Marital Status: Married for 18 years
Children: 3 - boys ages 15 and 12, girl age 8
Education: some college, did not graduate
Occupation: Homemaker
Active in local Baptist church
Enjoys attending parties hosted by her friends who sell
various MLM products
Feels like she has lost the ability to control many
aspects of her life during the COVID-19 pandemic and
isn’t sure who to trust anymore
Has not received the COVID-19 vaccine

6. Solution:Preparation
Community Health Ambassadors
(CHAs)
Identify and Train CHAs
Social Event Invites
CHAs invite women in the
community to events through
social media and word of mouth;
pins are required for entry.

7. Solution:Execution
Social Events
- Centered around food and
conversation
- Public health discussion
would be larger than COVID
- Discussion about health
questions / concerns, led by
CHA and supported by local
HCPs in attendance
Participant Follow-Up
Email follow up includes:
- Survey to gauge perception
shift
- More educational information
(including info on where they
can get vaccinated, if desired)
Emails sent quarterly with CHA news.
Community Health Ambassador
Dashboard (CHAD)
Elevating comments / questions from
group, recording when meetings
happen, ideas for other CHAs from
group, etc. (see subsequent slides)

8. Competition/Allies
Vaccinate Alabama TikTok Contest
sponsored by the Alabama
Department of Public Health
https://www.alabamapublichealth.gov/covid19vaccine/tiktok.html
https://www.tiktok.com/@g3n3ricusername/video/6986825442896416005?i
s_copy_url=1&is_from_webapp=v1
https://www.vaccineconfidence.org
https://www.who.int/immunization/sage/meetings/2013/april/3_Vaccine_Hesit
ancy_Landscape_Analysis_reduced8.pdf
https://worldprojects.columbia.edu/increasing-covid-19-vaccine-confidence
“..the vaccine confidence
challenge is a window into the
broader issues of our polarized,
mistrustful society.”
Utilize data science and artificial
intelligence, to develop messaging
that encourages vaccination.

9. Measuring Success
Short-term:
1) Brief survey administered upon checking in to the party
2) Short post-party survey administered via email
3) # of Participants uploaded to CHAD (Community Health Advocate
Database)
4) # of “allies of CHAs” for community health advocacy
Long-term:
1) Analyze data through CHAD to determine project efficacy
2) Retrospective study measuring community vaccination rate
3) Measuring rates of hospitalizations in the calendar year
Qualitative Measures
- Participant comments shared with
community public health
professionals
-CHAs and Allies can assist with
helping participants make
appointments and future health
needs
Quantitative Measures

10. THANK YOU
SOLUTION 2:
Comedy Show

11. Why This Works
This approach:
○ Leverages a “person like yourself”, which is highly trusted by the white Evangelical Christian.
○ Operates through women, who are the primary healthcare decision makers for a family; impacting
them leads to impact among a much larger group.
○ Responds to the audience’s need for control and trust.
○ Empowers women in these communities.
○ Allows us to infiltrate church communities without entering the church itself.
○ Leverages the power of 1:1 conversation.
- The MLM model is highly successful in these communities, and house parties are very familiar to this target.
- There is scalability to this model:
○ Allowing us to address various health concerns of the community in a safe space
○ And offering the opportunity to inspire new ambassadors (CHAs) and allies to these CHAs.
- There is opportunity to work with local health officials to enact real change based on concerns.
- There is opportunity to conduct research through the model on a variety of health topics, and local response
to them.

12. Appendix
SOLUTION 2:
Comedy Show

13. Deliverable:FinalPresentations (40%)
● Presentations will be a “pitch” to funders, investors, or stakeholders and should include:
1) JV - Concept: What is this and why should we be interested (should be attention grabbing and short)?
2) JV- Problem: What is the problem being solved (what, why, and why amongst other competing priorities. What is
the magnitude of the problem)? Mention COVID is disproportionately impacting poorer communities and
communities of color.
3) CP - Target Market: Define and describe your target user.
4) SB – Solution: What are you proposing and why?
5) TH - Competition: How is this different than what has already been tried?
6) KP - Success: How will you evaluate the impact/success of your service/product?

14. SOLUTION1:
Community HealthAmbassador
What It Is: Establish paid positions for “community health ambassadors” within highly
Evangelical communities. These ambassadors would be trained by Yale (appealing to their
intelligence) and would do local canvassing and lead digital communication to share health
information pertinent to their community. They would also bring in new ambassadors. Their
focus would change based on health needs, but would first focus on getting these
communities COVID-19 vaccinations.
Why It Works:
- Leverages person like yourself
- Women tend to be HC decision makers
- MLM model is highly successful in these communities
- Leverages 1:1 conversations
- Scalable

15. SolutionsShowing Success
CONSTANTCOMMUNICATION+ RELATIONSHIP BUILDING
Doctors on the Navajo Nation, once among the hardest-hit areas of the country, say
constant communication with their tribal members about fighting the "monster" of
COVID-19 has helped this remote region achieve some of the highest vaccination
rates in New Mexico and Arizona.
1:1 Connections
In Maryland, the University of Maryland partnered with local barbershops and salons
to hold vaccination events and to educate stylists on how to address vaccine
concerns by equipping them with accurate medical information and to ensure stylists
are equipped with accurate medical information regarding vaccine concerns.
https://www.npr.org/sections/health-shots/2021/06/11/1005367753/rural-communities-fall-farther-behind-in-covid-19-vaccination-rates
https://www.nga.org/center/publications/state-strategies-to-increase-covid-19-vaccine-uptake-in-rural-communities/

16. OtherSolutions
TrustedCommunity Voices
Trusted community voices such as faith-based leaders, local health directors, and
doctors, are strategically important in combating vaccine hesitancy and
misinformation.
IdentifiedFinancial Incentives
• $100 from state government
• Providing free transportation to vaccine sites
• Free tickets to a sporting event
• $20 coupon for items such as food or drink
https://medicine.umich.edu/sites/default/files/content/downloads/RAND_RRA1446-1.pdf https://www.kff.org/coronavirus-covid-19/poll-
finding/kff-covid-19-vaccine-monitor-may-2021/

17. Financial incentives
What
helps
Currentinterventions
https://www.cdc.gov/mmwr/volumes/70/wr/mm7020e3.htm
https://www.nga.org/center/publications/state-strategies-to-increase-covid-19-
vaccine-uptake-in-rural-communities/
https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-may-2021/
https://medicine.umich.edu/sites/default/files/content/downloads/RAND_RRA1446-1.pdf
https://www.tandfonline.com/doi/pdf/10.1080/10410236.2019.1573295
Who toTrust?
What
hurts
Mandates Mandates
Support from trusted
community figures
Lack of support from trusted
community figures
Social media ads and influencers Social media ads and influencers
Financial Barriers
Lack of access to vaccines
Access to vaccines

18. Where are
there gaps?

19. AREMAINING GAP IS ACCESS
Vaccine Advocates and Ambassadors
*Deploy public health professionals to work with local communities on
identifying stakeholders who can be vaccine advocates
*The team should develop an understanding of the culture and
common beliefs within rural communities in order to provide
appropriate vaccine education through a trusted local source.
*Provide easily accessible vaccine clinics in non-traditional areas
such as churches, recreational facilities, and small businesses.
Access to vaccines in rural areas not only includes physical access within counties but access to trusted
members of the community who will advocate for vaccines and act as vaccination ambassadors.
confidence
complacency
constraints
calculation
collective
responsibility
Combat the 5 Cs of
Vaccine Hesitancy
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0208601#pone-0208601-t002

20. AREMAINING GAP IS TRUST
People who have yet to be vaccinated cited trusting their personal physicians and insurers over prominent
national and public health figures such as President Biden and Dr. Fauci.
Strategies to Increase Trust:
1.Do not wait.
2.Be credible.
3.Be clear.
4.Express empathy and show respect.
5.Acknowledge uncertainty and manage expectations.
https://www.nap.edu/read/26068/chapter/1#2
Build vaccine confidence among rural communities through
consistent, transparent and factual communication strategies and
campaigns. Establish straightforward pathways for individuals in
rural areas to access vaccines within their communities.

21. Leveraging current solutions:
University of Mississippifootball example
● All 240 players and staff on the University of
Mississippi football team are vaccinated against
COVID-19.
● Head coach Lane Kiffin spearheaded the effort by
getting vaccinated along with his assistant coaches to
set the example.
● The team brought in doctors to discuss vaccine safety
and side effects with anyone who still had concerns.
● Kiffin hopes they will be a positive example for the
state.
● Example of trust and education coupled with access
working on the vaccine hesitant.