Development and Evaluation of a Peer Equity Navigator Intervention for COVID-19 Vaccine Promotion and Uptake in African, Caribbean and Black Communities in Ottawa, Canada

Abstract Background African, Caribbean and Black Communities (ACB) have experienced an increased burden of COVID-19 morbidity and mortality as well as significant barriers to COVID-19 vaccine acceptance and uptake. Addressing the complex issues of vulnerable populations, such ACB communities, requires a multipronged approach and innovation. Peer-led approaches framed within critical health literacy (CHL) and critical racial literacy (CRL) discourses, along with collaborative and participatory equity learning processes, increased community capacity, empowerment, and practice outcomes. They may contribute to long-term improvements in health and health equity. Methods We developed and evaluated a peer-equity navigator intervention to increase vaccine confidence and acceptance in ACB communities using a modified Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) Framework. The evaluation drew upon multiple data sources, including tracking data, surveys with community members, and a focus group with peer equity navigators (PENs). Results We found that an innovative, community-informed and peer-led model designed to increase awareness and agency among ACB communities was feasible, acceptable, and effective for over 1500 ACB community members between Sept 16, 2022 and Jan 28, 2023. Consistent with the partnership approach, 8 trained PENS conducted over 56 community events. Peer equity navigators (PENS) and community members reported high levels of engagement, appreciation for peer-led community-based approaches and increased vaccine literacy. Conclusions The PEN approach is a feasible, acceptable, and effective intervention for reaching and engaging ACB community members in health-promoting actions and behaviors.