Capstone Migraine

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Increasing COVID-19 vaccination rates in the Latino community of Tenderloin, San Francisco.

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Course Name and Course Number

Instructor Name and Title

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2 Introduction

The Coronavirus Disease 2019 (COVID-19) pandemic has taken an alarming impact on

San Francisco’s Latino which makes up 15% of San Francisco’s city population (United States

Census Bureau, 2020) and accounts for roughly 41% of the city’s COVID-19 infections

(DataSF, 2021). It is estimated that Latino individuals are four times higher for COVID-19

exposure and infection due to a range of disparities, barriers, and social determinants of health

(Clay et al., 2021). The COVID-19 vaccine is intended to provide immunity against the effects

of a respiratory infection (Graham, 2020). The Latino population in the city of San Francisco

has shown to be at a higher risk for COVID infection. Implementing an educational and

delivery plan about the COVID vaccine for the Tenderloin Latino community will decrease

vaccination hesitancy and promote knowledge about vaccine benefits and help meet Healthy

People 2023 objective IID-DO3: Increase the proportion of adults age 19 years or older who

get recommended vaccines.

Vaccinating communities with the highest prevalence of COVID-19 is an effective

measure to decrease the propagation of this disease (San Francisco Department of Public Health

& COVID Command Center, 2021). Since COVID-19 prevalence across Latino communities

within the city is 1.3x higher than non-Hispanic communities, concentrating vaccination efforts

in these communities will significantly bend the disease curve, while also saving lives (San

Francisco Department of Public Health & COVID Command Center, 2021).

The Latino communities of San Francisco’s Mission District are the most impacted by

COVID when comparing cases and deaths of COVID-19 in the city. The Latino population data

reported 41.4% infection rates with COVID compared to 18% in the Asian community and,

21.5% in the white community (DataSF, 2021).

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According to Salgado de Snyder et al., (2020), the reason Latinos decline vaccination are

(1) insufficient information, (2) lack of trust, and (3) a lack of interest or motivation. Salgado de

Snyder (2020) suggests that adult Latino men will not get the COVID vaccine due to limited

information, cost, and not knowing where to get the vaccine. The limited information provided

during the study was not sufficient, although they understood the need for vaccinations, there

was not a proper educational plan to inform them about the COVID-19 vaccine. Not being

properly informed can create healthcare difficulties. According to Salgado de Snyder (2020),

these barriers include language barriers and a lack of trust in the healthcare system.

Understanding the necessity for vaccination is important. Without the proper

understanding, the patients will have fears about the safety of the vaccine (Fisher et al., 2020).

One of the gaps identified was the need to increase vaccination campaigns to provide

supplemental immunization educational activities to the communities to increase vaccination

rates and provide the necessary services (Fisher et al., 2020; Guzman-Holst et al., 2020;

Olorunsaiye et al., 2020).

Social Determinants of Health

VERY IMPORTANT NOTE REGARDING THE SOCIAL DETERMINANTS OF HEALTH SECTION OF YOUR CAPSTONE DEVELOPMENT PAPER !!

1. Summarize what is meant by the term “ Social determinants of Health(SDOH)”.

2. Discuss how each of the SDOHs ( health , political social, and economic) affect /impact

the health outcomes of the patients in your capstone project community including your

interventions

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Interventions

VERY IMPORTANT NOTE REGARDING YOUR INVERVENTION SECTION !!

YOUR SECTION MUST BE MORE DETAILED AND SPECIFIC FOR YOUR COMMUNITY AND INTERVENTIONS

The focus of this capstone project is to help promote awareness about the benefits of the

COVID- vaccine in the Latino population of the Tenderloin community of San Francisco,

California.by developing a COVID-19 vaccine educational community outreach educational

program that will offer the Covid -19 vaccine as well as other support services such as seminars on

the importance of having a primary care provider . Partnerships will be developed with school, faith-

based, childcare, business communities, and trusted community-based organizations .

Review of Literature

A comprehensive database search was conducted to evaluate how an educational plan

provides a positive impact on the vaccination rates in Latino communities. The following

databases were used in the search: the Cumulative Index to Nursing and Allied Health Literature

(CINAHL), Cochrane, ScienceDirect, and PubMed. The search was limited to literature in

English or Spanish, research articles, and practice guidelines. Other inclusion criteria were

articles involving adults and adolescents (12 and above), journals, and peer review articles. The

search terms “vaccination,” COVID-19 vaccine,” “hesitance” and “acceptance.” The articles

selected examined the benefits of implementing an educational plan, particularly in Latino

communities. The themes identified were as follows: (a) efficiency of an educational plan in the

Latino community, (b) vaccination hesitancy, and (c) infection reduction. The articles were

leveled between I to V with a rating of “B” or “C.” The John Hopkins Nursing Evidence-Based

Practice Appraisal Tools were used to level and rate these articles (Dang and Dearholt, 2018, p.

237).

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The following articles reviewed are fundamental to the establishment of this

improvement project and highlight the potential benefits related to the educational plan

effectiveness and education management for Latinx patients. Salgado de Snyder et al., (2020)

described reasons for not getting vaccinated among adult Latino males. The study’s findings

implied that the limited knowledge about the benefits of vaccines was a great predictor of not

getting vaccinated, despite knowing that vaccines are important.

In Guzman-Holst's (2019) systematic review the most frequent barriers to vaccinations

were group influences, followed by socioeconomic factors, low levels of education, lack of

awareness and religious and cultural beliefs.

Similarly, Salgado de Snyder (2020) showed the lack of knowledge about a disease and

its vaccines are major barriers to vaccination in the Latino population. This determines a gap in

understanding as well as a lack of education for the prevention of COVID-19 disease.

A cross-sectional survey completed by Fisher et al., (2020) demonstrated that the main

factors for vaccine hesitancy included low levels of education attainment, vaccine concerns, and

not enough information about the COVID-19 vaccine as well as lack of trust in the healthcare

system. Living in rural areas also had a strong correlation with not getting vaccinated. A

systematic review completed by Olorunsaiye et al., (2020) also found that starting a vaccination

campaign and additional immunization activities can help increase the vaccination rate in low

and middle-income communities.

According to Fisher et al., (2020) and Olorunsaiye et el., (2020), the best approach for

preventing vaccine hesitancy and achieving herd immunity is to implement an educational

approach that addresses the COVID-19 vaccine in a way that people from all educational levels

can understand. Implementing an educational plan consists of expanding the most up-to-date

information to patients to address any vaccination concerns and expand immunization services.

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Rivera (2013) describes that cultural competence, trust, and acceptance are fundamental

concepts for the development of intervention of change, particularly in the Latino population. In

addition to trust and acceptance. A culturally appropriate educational approach has become

important, especially by distributing information, connecting community members with

appropriate resources, messaging, and providing emotional support to help community members

implement positive health practices. (Caceres et al., 2021; Rivera, 2013; Messias et al., 2021).

Role of the FNP

VERY IMPORTANT NOTE REGARDING YOUR ROLE OF THE FNP SECTION OF YOUR CAPSTONE DEVELOPMENT PAPER!

IN THIS SECTION , DISCUSS HOW YOU WILL UTILIZE EACH OF THE FOLLOWING ROLES

OF THE FNP TO DEVELOP AND IMPLEMENT YOUR CAPSTONE PROJECT:

1. PROVIDER

2. EDUCATOR

3. RESEARCHER

4. ADVOCATE Conclusion

VERY IMPORTANT NOTE REGARDING THE CONCLUSION OF YOUR CAPSTONE

DEVELOPMENT PAPER !

The conclusion of your paper conclusion must end with the following statement or similar statement:

Continued development and refinement of this capstone project will be completed

in Nurs 8949/8950 including the development of the PICOT statement and culminate in a

final capstone project paper and posterboard that will be presented at the on-campus

FNP capstone project presentation session in the Fall 2024.

The Latino population is at higher risk for COVID-19 exposure. This exposure reveals

the need for understanding vaccination efforts. Immunization helps stops the spread of COVID-

19 infections. The focus is to immunize and educate the Latino population about the benefits of

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the COVID vaccine. In doing so, the occurrence of COVID-19 infections will decrease. With the

integration of an educational plan in the Latino community, addressing vaccine hesitancy has the

potential to increase vaccination rates, and herd immunity and promote protection against the

COVID-19 disease. Vaccine hesitancy is a complex issue, and no single strategy will be able to

address it. This project can help inform future approaches when designing campaigns to increase

trust and confidence and ultimately improved vaccination rates for communities with health

disparities. Continued development and refinement of this capstone project will be

completed in Nurs 8949/8950 including the development of the PICOT statement and

culminate in a final capstone project paper and posterboard that will be presented at the

on-campus FNP capstone project presentation session in the Fall 2024.

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References

Alligood, M. R. (2014). Nursing Theorists and Their Work. 8th ed. St. Louis, Mo.: Mosby

Clay S.L., Woodson, M., Mazurek, K., & Antonia, B (2021). Racial disparities and

COVID-19: Exploring the relationship between race/ethnicity, personal factors, health

access/affordability, and conditions associated with increased severity of COVID

19. Race Social Problems, 1-13. https://doi.org/10.1007/s12552-021-09320-9 Carrico, G. (2022). Increasing vaccination rates in the Latinx communities through a public health initiative for increasing education and vaccination. University of San Francisco.*

Dang, D., & Dearholt, S. L. (2018). John Hopkins Nursing evidence-based practice: Model and

guidelines (3rd ed.). Sigma Theta Tau International.

Data SF (2021, March 19). Covid-19 data and report.

https://data.sfgov.org/stories/s/9cs7-wy53

Centers for Disease Control and Prevention (2021, May 14). Provisional death counts for

coronavirus disease 2019.

https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm

Fiedler M., Song, Z.(2020). Estimating potential spending on COVID-19 care. Brookings.

https://www.brookings.edu/research/estimating-potential-spending-on-covid-19-care/

Fisher, K. A., Bloomstone, S., Walder, BA., & Crawford, S. (2020). Attitudes toward a

potential SARS-CoV-2 vaccine: A survey of U.S. adults. Annals of internal

medicine, 173(12), 964–973. https://doi.org/10.7326/M20-3569

Glanz, K., Rimer, B. K., & Viswanath, K. (2015). Health behavior: Theory, research, and

practice (5th ed., pp. 149-150). Wiley.

Graham B. (2020). Rapid COVID-19 vaccine development. Science, 368(6494), 945–946.

https://doi.org/10.1126/science.abb8923

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Guzman-Holst, A., DeAntonio, R., Prado-Cohrs, D., & Juliao, P. (2020). Barriers to

vaccination in Latin America: A systematic literature review. Vaccine, 38(3), 470–

481. https://doi.org/10.1016/j.vaccine.2019.10.088

King, C. R., Gerard, S. O., & Rapp, C. G. (2019). Essential knowledge for CNL and APRN

nurse leaders. Springer Publishing Company.

Linke, S. E., Robinson, C. J., & Pekmezi, D. (2014). Applying psychological theories to promote

healthy lifestyles. American Journal of Lifestyle Medicine, 8(1), 4-14.

https://doi.org/10.1177/1559827613487496

Melnick, G., Maerki, S. (2020, June 3). The Financial impact of COVID-19 on California

hospitals. California Health Care Foundation.

https://www.chcf.org/publication/financial-impact-covid-19-california-hospitals/

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing &

healthcare: A guide to best practice. Lippincott Williams & Wilkins.

Olorunsaiye, C. Z., Yusuf, K. K., Reinhart, K., & Salihu, H. M. (2020). COVID-19 and Child

vaccination: A systematic approach to closing the immunization gap. International

journal of Maternal Child Health and AIDS, 9(3), 381–385.

https://doi.org/10.21106/ijma.401

San Francisco Department of Public Health & COVID Command Center (2021). San

Francisco COVID-19 Vaccination Plan. Retrieve from

https://sf.gov/outreach-toolkit-coronavirus-covid-19

Salgado de Snyder, V. N. S. de, Garcia, D., Pineda, R., Calderon, J., Diaz, D., Morales, A., &

Perez, B. (2020). Exploring why adult Mexican males do not get vaccinated: Implications

for COVID-19 preventive actions. Hispanic Journal of Behavioral Sciences, 42(4), 515–

527. https://doi.org/10.1177/0739986320956913

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San Francisco Department of Public Health & COVID Command Center (2021). San

Francisco COVID-19 Vaccination Plan. Retrieve from https://sf.gov/outreach-toolkit-

coronavirus-covid-19

United States Census Bureau (2020, April 1). San Francisco city California.

https://www.census.gov/quickfacts/fact/table/sanfranciscocitycalifornia,sanfranciscocoun

tycalifornia/POP010210#POP010210 U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion

Healthy People 2030 Increase the proportion of adults age 19 years or older who get

recommended vaccines.

https://health.gov/healthypeople/objectives-and-data/browse-objectives/vaccination/increase-

proportion-adults-age-19-years-or-older-who-get-recommended-vaccines-iid-d03

*sample paper adapted from this source