Project Purpose (150 words max.)

The COVID-19 pandemic has caused significant disruption to the nation’s public health and healthcare infrastructure. Community health centers serve as the safety net to the highest risk patients.The National Association of Community Health Centers (NACHC) proposes to
engage local health centers as trusted brokers to build vaccine confidence in high-risk populations by empowering individuals and communities with accurate accessible
information about COVID-19 and vaccines. This Approach to COVID-19 Vaccine Trust includes:

• Listening sessions with high-risk patient populations and their care teams
• Development of a culturally responsible animated web-based application to build
vaccine trust
• A communication strategy with context-specific messaging tailored to the
communities served by health centers including Latinx, African American, and
American Indian.
• Engagement and use of Vaccine Ambassadors or peer to peer navigators and
community health workers to reach patients/communities impacted by
homelessness, substance abuse and people who engage in sex work.
• Innovative strategies to reach high risk vaccine populations in Puerto Rico, Virgin
Islands, and the border including “Strike Teams”

The results will include

▪ Evidence-based messaging to build vaccine trust in high risk populations.
▪ COVID-19 web app available to the public to address vaccine confidence/hesitancy
▪ Disseminate communication tools health centers for accurate, accessible, information
that meets the needs of their communities to address COVID-19
▪ Electronic shared care plan that connects individuals to social services and medical
care and IIS and results.
▪ Summary of promising practices for reaching high risk populations such as
homelessness, substance use/abuse and those engaged in sex work.

Program Strategy	Program Outcomes
Leadership and Workforce Development**	Improved leadership capacity to identify and prioritize public health needs
Data and Information Systems	Improved capacity of data and information systems to conduct public health monitoring and surveillance
Communication and IT**	Improved communication and IT capacity to inform the public efficiently and effectively Strengthened capability to use communication and IT to affect health decisions and actions
Partnerships**	Improved capacity to establish and maintain partnerships to, within, and across sectors to create a shared vision of health Strengthened capability to respond to public health priorities collaboratively and strategically
Programs and Services**	Increased capability to implement evidence-based/informed public health programs, policies, and services to address public health needs

Project Details

Reference CIO Project Plan for Examples

Program Strategy

Activities

Process Measures

Outputs

Budget Period Outcomes

Outcome Measures

List the proposed activities related to of the program strategies

Propose at least 1 process measure for each program strategy.

Include a unit of measurement (proportion or percentage) and the direction of change (increase, decrease)

List the expected outputs.

Outputs are the direct, tangible results of activities (e.g., resources, tools, products to be developed)

List the expected budget period outcomes

Propose at least 1 outcome measure for each program strategy.

Include a unit of measurement (proportion or percentage) and the direction of change (increase, decrease)

Data and Information Systems

Activities to improve collection, management, interpretation and dissemination of data to guide decision-making

A1. Design an electronic care coordination and management Fast Healthcare Interoperability
Resources (FHIR) application for the management of vaccination preferences and decision-making,
COVID infection, and social determinants of health (SDOH) and social needs on existing standardsbased content in this area including (FHIR App):
- PRAPARE
- The Gravity FHIR IG
- e-Care Plan project for Multiple Chronic Conditions
- DaVinci FHIR Accelerator
- FHIR Clinical Reasoning

A2. Define the data elements suggestions include:
- Vaccine Hesitancy
- COVID prevention
- COVID treatment
- Housing insecurity/ lack of stable housing
- Food insecurity
- Lack of access to health care
- Dental need
- Medication access
- Referral
- Post-COVID syndrome
- Substance abuse
- Mental health treatment need

A3. Design and test the eCare Plan using a Human-Centered Design framework and based on core
data from clinical guidelines, research, best practices and expert opinion

A4. Conduct an environmental scan, virtual observation, workflow evaluation and expert panel
feedback on e Care Plan data elements and standard based content and input from Vaccine
Ambassadors and Community Health Workers.

A5. Test in a live clinical testing with Vaccine Ambassadors and Community Health Workers, in lab
testing and pilot phases and result in continuous development from MVP (minimum viable product)
through production of mobile, EHR-integrated and web-based interfaces

PM1 Number of existing standards
PM2 Number of data elements
PM3 Number of personas and goal statement
PM4 Number of stakeholders informing workflow and data elements
PM5 Results of initial testing in a live clinical setting

Results of environmental scan
List of data elements and a data dictionary based on the 4 cornerstones of a care plan and
Corresponding FHIR standards
List of electronic care coordination standards
Clinical workflows

BPO1 Completed environmental scan

BP02 Completed components of an electronic care plan aligned with FHIR standards
BP03 Clinical workflows harmonizing people, technology and care processes

OM1 an electronic care coordination and management (FHIR) application for the management of
vaccination preferences and decision-making, COVID infection, and social determinants of health
(SDOH) and social needs for homeless, substance use/abuse, and individuals who engage in sex work

Communication and Information Technology**

Activities to improve use of communication and information technology to affect health decisions and actions

A1: Develop scripts for broad range of communication messaging (1-2 minutes each) around
COVID-19 disease susceptibility and severity, vaccine safety and efficacy, and broad range of
vaccine concerns tailored to demographic subpopulations.

A2: Produce animation to accompany each script, conveying the messaging in an interesting
and engaging manner.

A3: Record narration in English and Spanish for all scripts.
Page 6

A4: Record introductions and closing from broad range of trusted sources for various
subpopulations.

A5: Develop questions for tailoring of messages based upon vaccine intent, disease and
knowledge attitudes, and demographics.

A6. Program web application to tailor source credibility and message content for the
individual user based on baseline questions.

A7. Widely distribute web app to the public through existing mechanisms and partners.

A8. Enlist brain trust of mix of health center and PCA communications staff and multicultural
communications experts in development of new vaccine confidence materials.

A9.Build on the information obtained from the concurrent listening sessions with health
center care teams to customize a 2-3 month campaign in key local communities based on
guidance from local health centers and state PCAs communications teams.

A10. Develop products for information dissemination such as podcasts, op-eds, digital
graphics.

PM1: Number of users of web app overall and among vulnerable subpopulations including
African Americans, Latinx and Native Americans

PM2: Number of partners distributing web app to public with estimated reach of each
partner

PM3: Number of stations for radio media tour

PM4: Number of local partnerships that hold local vaccine community drives and train community and clergy leaders on how to talk with their congregations about the vaccines, dispel myths, and promote vaccine uptake

PM5: Number of paid digital ads in in local communities with lower vaccine rates particularly
among Hispanic, AA and Asians and non-English speaking immigrants

PM6: Number of downloads/users/visits for products developed

COVID-19 web app available to the public
Context-specific messaging tailored to the specific audience(s) the messages are intended
to reach along with guidance(s) for identifying and engaging messengers/trusted
voices/role models within each community and optimal approaches (channels) to utilize
to optimally deliver the messages.
Toolkit that compiles examples of how local health centers adapted CDC evidenced based
COVID vaccine messaging to produce health promotion materials for their non-English
speaking patients

BPO1: Delivery of messaging scrips
BPO2: Delivery of animation
BPO3: Delivery of narration
BPO4: Recording of messages from trusted sources
BPO5: Completion of tailoring questions
BPO6: Delivery of final web app
BPO7: Delivery of messaging and toolkit

OM1: User reporting of app being helpful, trustworthy, interesting, and clear to understand across all users and
among subpopulations (vaccine intention, vulnerable subpopulations (African American, Latinx, Native American)

Partnerships**

Activities to improve establishment and maintenance of results-driven partnerships

A1. Liaison with appropriate federal coordinating agencies (HHS, HRSA, CDC, etc.)

A2. Partner with Global Health C3, Emory University, NACCHO, JHU and AIM to advance
previous work on A3. NACHC will partner with state primary care association communication
staff to provide guidance and on state and local needs on vaccine hesitancy and coordinate
with their state and local health departments.

A3. NACHC will engage 20 or more health centers in diverse geographic areas to Co-Design
the overall vaccine trust communication strategy to insure it meets the needs of health
centers and the patients they serve.

A4. Partner with subject matter expert (SME)organizations for high risk populations including
homeless, people who engage in sex work, and substance use/abuse. Such as Health Care for
the Homeless, Migrant Clinicians Network, Virgin Island Ministry of Health, Puerto Rico
Health Department, Health Centers and Primary Care Association.

PM1. Number of meetings with engaged federal agencies
PM2. Number of meetings to ensure coordinated project design, implementation, and
products with GHC3, Emory, JHU, NACCHO and others.
PM3. Number of calls with 20 health center selected to participate in Co-Design Session on vaccine hesitancy, messaging, and social networks.
PM4. Number of SME organizations.

A multi sector approach to align and coordinate work at the community level to build vaccine trust and access to timely efficient vaccines.

BP O1 Quarterly updates to lead federal partners
BP 02 Minutes of Meetings and Action Steps leading to full project implementation, reinforcing activities that add value to vaccine hesitancy strategy for high risk populations.
BP 03 List of participant health centers in co design sessions.
BP 04 List of Subject Matter Experts for high risk populations.

OM1 Successful completion of joint work across sectors to meet the COVID 19 Vaccine needs
of high risk populations such as homeless, substance abusing, engagement in sex work,
African Americans, LatinX and Native American, Puerto Rico, Virgin Islands, and mobile
populations from the border.

Programs and Services

Activities to improve the identification of best practices and the implementation of evidence-based/informed programs and services

Vaccine Hesitancy with GHC3:
A1. NACHC will partner with The Human Engagement Learning Platform (HELP) team at Emory
University to address vaccine hesitancy in high-risk populations.

A2. Working in collaboration with HELP, 20 geographic regions will be identified based on evidence based sampling methodologies.

A3. NACHC will recruit 20 health center teams to participate in HELP Co-Design Session per sampling
protocol.

A4. Each participant health centers will recruit 4-8 patients and community thought leaders to
participate in 2 Co-Design Session to provide granular input into specific, important drivers, social
dynamics, context, and relevance to vaccine hesitancy in their communities.

A5. Each participant health center will reconvene Co-Design Session to test the messages and elicit
feedback about their acceptability and perceived effectiveness, and provide further insights how to
improve messaging.
Vaccine Ambassadors to engage homeless, substance using/abusing and people engaged in sex
work.

A6. Partner with internal and external partners to design the project, workflow, measures and
products and leverage NACHCs Health Care for the Homeless Committee, Behavioral Health, HIV and
HEP Committee, and work on Enabling Services.

A7. Partner with key national, state and community stakeholders to support the work of Vaccine
Ambassadors including the National Health Care for the Homeless Council, state and local health
departments, and community organizations.

A 8. Engage up to 25 organizations with national representation with a cross section of urban/rural,
region of the country, race and ethnicity to engage and co design the work.

A 9 Design and Implement a learning community with expert faculty for participating organizations
and vaccine ambassadors to:

• Training key topics such as roles and responsibilities, patient engagement strategies to include
dignity, respect and without judgement, motivational interviewing, trauma informed care,
patient centric care, safety, COVID 19 vaccination, infectious disease and prevention, and
safety
• Explore models for medical respite care and promising practices
• Harvest lessons learned
• Communicate promising practices through case studies and presentations.

A10. Communication strategy to share lessons learned and promising practices.
Puerto Rico, Virgin Islands and Border States with mobile populations.

A11. Partner with the PCA, Health Ministry, Health Departments and local CBOS to coordinate and
align work in Puerto Rico, Virgin Island and US and Mexico Detention Centers.

A12. Conduct listening sessions with care teams and community members and including pregnant
women on the US border, in Puerto Rico and Virgin Islands to increase COVID 19 and Adult
immunization rates.

A13. Conduct COVID 19 strike team training with CHWs and promotores in Puerto Rico, Virgin Islands,
and when needed the border states.

A14. Coordinate vaccinations for COVID 19 and Adult Immunizations for pregnant women released
from detention centers and link them to care where possible.

A15. Design and implement mobile COVID 19 Strike (Immunization teams in Puerto Rico and Virgin
Islands) to reach hard to reach vulnerable populations who are not accessing vaccines.

A16. Summarize results in promising practices for high risk populations.

PM1. Number of partner meetings with HELP team to design sampling methodology, key
informant interviews, Co-Design Sessions, and messaging confirmation.
PM2. Number and location of 20 geographic areas for co-design meeting.
PM3. Number of health center recruited.
PM4. Number of health center care team and patients recruited.
PM5. Number of patients participating in second Co-Design Session.
PM 6. Number of internal and external partners
PM 7. Number of SME partners for homeless,
PM9 Number of learning community sessions and number of participants.
PM10. Number of promising practices highlighting for homeless, substance uses, and
PM11 Number of partners in Puerto Rico and Virgin Islands
PM12 Number of listening sessions in Puerto Rico,Virgin Islands and Border.
PM13 Number of training sessions for community health workers as member of the “strike”
teams.
PM14. Number of pregnant women vaccinated.
PM15.Number of patients vaccinated by strike team.
PM16.Number of promising practices identified for use of strike teams.

Public facing context-specific messaging tailored to the specific audience(s) the messages are
intended to reach along with guidance(s) for identifying and engaging messengers/trusted
voices/role models within each community and optimal approaches (channels) to utilize to
optimally deliver the messages
• Promising Practices for COVID 19 Vaccinations in caring for homeless, substance using
individuals and those engaging sex for work
• Promising Practices for COVID 19 Vaccinations and use of strike teams and care coordination
in Puerto Rico, Virgin Islands, and the Border.

BPO1: Partnership with HELP and Co-Design Sessions Design
BPO2: Recruitment strategy for 20 geographic regions
BPO3: Health Center and patient engagement strategy for co-design sessions.
BP04 Recordings of Co-Design Session with patients, community thought leaders, and care
teams

OMI Co-designed for COVID 19 vaccination trust tailored for high risk populations
OM2 New Models for reaching high risk populations for COVID 19 Vaccination and Adult
Vaccination.

Outputs	What is it?	Owner	Reference documents?	How do we know it is done?	By when?

Outcome Measures

	How will we measure this?

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