Tier 3 Grantees

To highlight the work, findings, and experiences of our two Centers of Excellence, NASTAD worked with Blue Mountain Heart to Heart and IDEA Exchange Miami to host a joint webinar on February 29^th, 2024. This webinar illuminated the findings of the unique field studies conducted by both programs that focused on Identifying/addressing vaccine hesitancy and best practices for adult vaccination provision at SSP’s.  This webinar was also supplemented with a facilitated listening session with the two tier 3 programs. This additional joint listening session allowed other grantees, CDC partners and community members to learn more about the best practices, challenges and successes for enhanced adult vaccination services in syringe services programs and actionable ways to create more robust adult vaccination services in both urban and rural harm reduction that can be flexible despite local-level environmental factors.

Both Blue Mountain Heart to Heart's and IDEA Miami’s projects aimed to create more robust best practices for rural harm reduction that can be flexible, scalable, and replicable despite local-level environmental factors. Blue Mountain Heart to Heart began their project by conducting a baseline survey of approximately 300 SSP participants across all three BMHTH sites to discern attitudes towards vaccinations of all kinds, COVID-19 specifically, and participants' willingness to work with medical professionals.  Once reasons for reluctance and some potential rationales for getting vaccinated were identified, BMHTH and IDEA brought counter messages to participants across their catchment. Staff then launched expanded mobile SSP services to access particularly hard-to-reach areas. Some participants were offered counter messages and provided an opportunity to receive a vaccine. Other participants were offered an incentive to receive the counter messages before being provided an opportunity to receive the vaccine. BMHTH then analyzed how the specific differing histories of syringe services and harm reduction program legalization in these three states affected vaccination uptake.  Analysis of the data occurred at months three and six of the intervention. During this time BMHTH reported monthly to NASTAD on the numbers of individuals encountered and those who received COVID vaccine, as well as other services received.  After the intervention finished, the Program Manager, Analyst, and Senior Researcher wrote a final "Findings report" which was submitted to NASTAD and will be shared among tier 2 grantees to support their vaccination efforts. The report included a recap of the intervention, methods used, explanation of the A/B incentive split, recommendations for SSPs, lessons learned, tabulated data and best practices for replication.

Findings

“Hesitancy among the target population included misinformation, negative attitudes toward public health workers and practice, suspicion about governmental intentions, and ideas about independence and bodily autonomy that pushed some people away from engaging in COVID-19 vaccination clinics. Despite these misgivings, most individuals approached were motivated by the small incentive to receive vaccine. Secondarily, the counter message of avoiding serious consequences of disease was more effective in generating agreement to receive vaccine than the counter message about preventing the spread of disease. Combining incentives with a trusted workforce helped vaccinate many people who lived in communal settings, and BMHTH staff recommend this approach for future outbreaks of infectious disease when a vaccine is available. - excerpt from Blue Mountain Heart to Heart final findings 

Facilitators and barrier to implementation of the COVID-19 vaccines at the SSP were identified in all the CFIR domains. In particular, the SSPs established partnerships with the vaccines’ distributor, its existing funding sources that could be leveraged for vaccine-related expenses, the tension for change, and the relative advantage of accessing the vaccine from a trusted source as opposed to other locations in the community stood out as key facilitators. Meanwhile, the lack of compensation and the need for improved communication and increased engagement of innovation deliverers stood out as specific and actionable barriers for refinement.” - excerpt from IDEA Miami final findings 

Using the vaccine hesitancy information gathered through the project, BMHTH and IDEA Miami launched expanded mobile SSP services to access particularly hard-to-reach areas. Mobile SSP services include drug checking, wound care, HCV counseling/linkage to care, adult vaccination, and safe supply distribution. With service provision and counseling being informed by their project findings, Tier 3 grantees set to provide vaccine services in a way that centered the needs and concerns of their participants and met them where they were at. In doing so, both programs mentored and shared best practices with the tier 1 and 2 programs for mobilizing their vaccination efforts.