ARISe Center for Rural Vaccination at University of Massachusetts Chan Medical School

We propose to establish the ARISe Center for Rural Vaccination at UMass Chan Medical School as a Collaborating Center of the ARISe Network to support the overarching goals of the Network to advance immunization services research through collaboration and contribute to the development of evidence-based practices to promote immunization. The ARISe Center for Rural Vaccination at UMass Chan will seek to promote vaccination across the lifespan in rural geographies. Specifically, we will focus regionally on the six states that comprise New England, which like much of the rest of the country, has significantly lower rates of vaccination in rural areas, compared to urban centers. While these urban-rural inequities are well documented, there is less known about drivers of vaccine hesitancy and implementation of evidence-based interventions in rural areas. Our application seeks to fill these gaps and our proposal is directly responsive to priority areas #1 and #2 of SIP-24-012, as we will both conduct in-depth social science research using innovative methods to explore vaccine hesitancy and how to combat it and pilot test a community-level intervention. To that end, we propose three specific aims to simultaneously accomplish both center and network goals. Aim 1 is to identify characteristics of popular social media fostering vaccine hesitancy and test the effectiveness of vaccine promotion messages in rural populations. First, we will perform a comprehensive content analysis of anti- vaccine messaging on popular social media platforms most used by rural populations (e.g., Instagram, Facebook) to identify key message characteristics (e.g., theme, account type, reasons to be hesitant, etc.). Subsequently, employing psychophysiological measures (i.e., remote eye-tracking) and self-report measures, we will evaluate the responses to vaccine promotion content. In Aim 2 we will adapt and test a model for a community vaccine ambassador program, previously created by our team, in rural communities in New England (n=6 pilot sites). Our goals in adaptation are to ensure appropriateness for the context and to build out a more community-driven approach to implementation. Our ambassador campaigns will focus on multiple dissemination channels, including social media and we will integrate findings from Aim 1 to help ambassadors develop effective communication materials. We will qualitatively evaluate feasibility of this approach through semi-structured interviews with ambassadors. Aim 3 is to actively contribute to ARISe Network activities, including participating in workgroups, creating products to support dissemination of materials, and other needs that arise from the Network. Our team brings expertise in rural vaccination, working with populations across the lifespan, community-based research methods, implementation science, and health communication science to Network activities. Depending on the structure of the network, we would propose to lead workgroups or activities in the areas of rural vaccination and how factors such as social media impact vaccination decision- making.