Using Public Health Detailing to Increase Access and Confidence in COVID-19 Vaccines and Reinvest in Disproportionately Impacted NYC Communities

Abstract

Context: COVID-19 vaccination rates in New York City (NYC) began to plateau in the spring of 2021, with unacceptable inequities in vaccination rates based on race. Program: To address racial inequities in vaccination rates and COVID-19 health outcomes, the New York City Department of Health and Mental Hygiene adapted a preexisting provider outreach and education program for public health emergency use with the goals of community reinvestment and increasing patient confidence and access to the COVID-19 vaccines. The Vaccine Public Health Detailing (VPHD) program was delivered as part of a larger community outreach initiative and brought timely updates, materials, and access to technical assistance to primary care providers and staff in NYC neighborhoods experiencing COVID-19 health inequities. Outreach representatives also collected feedback from providers on resource needs to inform the agency's response. Implementation: Sixteen outreach representatives were rapidly trained on COVID-19–related content and strategic communication techniques and launched a 3-wave campaign across targeted neighborhoods throughout NYC. The campaign ran from May 2021 to March 2022 and was conducted in coordination with other community engagement initiatives aimed at the general public to promote greater collective impact. Evaluation: In total, 2873 detailing sessions were conducted with 2027 unique providers at 1281 sites. Outreach representatives successfully completed visits at more than 85% of practices that were in scope and operating. Approximately 20% (285) of the sites requested a referral for technical assistance to become a COVID-19 vaccination site or enroll in the Citywide Immunization Registry. Qualitative information shared by providers offered a more in-depth understanding of vaccine-related sentiments and challenges faced by providers on the ground. Discussion: VPHD is an effective method for supporting community providers, gathering feedback on resource needs and practice challenges, and increasing health systems efficacy during a public health emergency while also prioritizing racial equity and community reinvestment.