# A multidimensional Digital Approach to Address Vaccine Hesitancy and Increase COVID-19 Vaccine Uptake among African American Young Adults in the South

> **NIH NIH R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2021 · $746,768

## Abstract

PROJECT SUMMARY
Young Adults (YA) are a key “super-spreader” population transmitting SARS-Co-V2, the causative agent of
COVID-19 (COVID). Given their high rate of asymptomatic infection compounded by transmission rates that
are being fueled by behaviors that run contrary to physical distancing and face covering regulations, YA
represent a priority population upon which to focus efforts to ensure high levels of COVID vaccine uptake.
While COVID vaccines can protect African American young adults (AA-YA) against COVID related morbidity
and mortality, this population will only accept vaccination if interventions assure AA-YA of its safety and
benefit, while also addressing historical contexts and systemic forces that propagate mistrust. Digital Health
Interventions (DHIs) can reach large numbers of AA-YA regardless of geographic location and empower them
to make informed decisions about their health using a familiar modality that YAs value and trust. Our
collaborative team developed the theory informed DHI Tough Talks to assist YA with HIV disclosure decision
making, specifically by considering the social, ethical and behavioral implications of their choices and the
consequences that follow. In response to NOT-MD-21-008: Research to Address Vaccine Hesitancy, Uptake,
and Implementation among Populations that Experience Health Disparities, we propose to apply a community-
based participatory research (CBPR) approach to assess multi-level factors identified within the NIMHD
Research Framework and adapt and test Tough Talks to address COVID vaccine hesitancy (VH), Tough
Talks-COVID (TT-C). In aim 1, we will conduct multi-method formative research to elicit the behavioral,
cognitive, and environmental determinants influencing COVID VH among AA-YA (ages 18-29) in three
southern states. We combine validated survey measures, with novel CBPR methods including choose-your-
own adventure journeys and digital storytelling to better understand vaccine decision-making in AA-YA. In
collaboration with expert advisors, community partners, and AA-YA end-users, in aim 2, we will leverage
ADAPT-ITT to develop and refine TT-C. User-centered participatory design and rapid prototyping focus groups
will be conducted with AA-YA (n=12-16) in southern states. Once finalized, we will conduct a technical pilot
with AA-YA (N=24) to assess TT-C’s feasibility and acceptability. In aim 3, we will conduct a hybrid type 1
effectiveness implementation 3-arm RCT with n=540 AA-YA from three southern states. Participants will be
randomized to receive standard of care (control), TT-C delivered remotely, and TT-C delivered in-person.
Primary effectiveness outcomes are COVID vaccine uptake and series completion. Secondary effectiveness
outcomes are VH, confidence, and knowledge, attitudes and beliefs. We will conduct qualitative interviews with
participants (n=12-16) and site staff (n=6-8) to assess implementation barriers and facilitators. We leverage our
existing infrastructure to meaning...

## Key facts

- **NIH application ID:** 10336591
- **Project number:** 1R01MD016834-01
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Henna Budhwani
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $746,768
- **Award type:** 1
- **Project period:** 2021-04-20 → 2025-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10336591

## Citation

> US National Institutes of Health, RePORTER application 10336591, A multidimensional Digital Approach to Address Vaccine Hesitancy and Increase COVID-19 Vaccine Uptake among African American Young Adults in the South (1R01MD016834-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10336591. Licensed CC0.

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