Forthcoming book chapter publication: HELP USA’s Covid-19 Transitional Housing Peer Support Vaccine Program

A book chapter co-authored by HELP Research and Single Adult Services department staff, was accepted for publication in the Spring 2024 edited volume, Pandemic Planning and Homelessness: Lessons from Covid-19 (Canadian Observatory on Homelessness) (link).  It details the performance and outcomes of a Covid-19 peer vaccine support program that was co- designed by both departments and implemented by single adult and family shelter frontline case managers and social workers.

HELP was one of the first homeless service providers to offer vaccinations at our sites, starting in January 2021. We recognized that accessibility was of vital importance to our clients and initially, we found our client’s vaccination rates were on par with the general population. However, this changed as the year progressed as public service announcements and incentives peaked in their effectiveness. Clients expressed that they wanted a forum to discuss their concerns and be heard. Therefore, we designed a peer vaccination program, which was loosely defined, non-dogmatic, and meant to serve simply as a forum for discussion – not trying to convince anyone to get a vaccination against COVID-19. We found this organic approach worked with vaccination rates at peer-led sites at 72% as compared to 58% at sites that did not have peer-led groups. Our peer-led site vaccination rates were statically on par with NYC’s general population, with one site exceeding it at 86%. Continue reading for more details!

HELP Research tracked Covid-19 vaccination rates of shelter clients from April 2021 to September 2022 (study 1, study 2).  Sharing our baseline vaccination rate data and analysis with local officials in July 2021 impacted DHS’s decision to provide vaccines to the city’s shelters the following month. By February 2022, full vaccination rates in 19 HELP sites (61%) trailed the city’s general population rates (77%).  We designed and implemented a peer vaccine support program from March 2022 to May 2022 across three sites to increase client vaccine rates to NYC population levels. Our September 2022 survey showed that full vaccination rates in peer shelters (72%) outpaced non-peer support shelters (58%).  One single adult male peer site (SEC; 86%) exceeded the NYC population level (80%).  Success in SEC was due to a convergence of four factors: shared experiences between peers and clients (living in the same facility under similar conditions),  peer role modeling ( possessing similar traits as clients), social support (“integrating” clients into a “service community”), and successfully focusing  on attendance to service appointments. Together, these factors engendered “trust” among clients and “rapport” between both parties, which motivated clients to discuss their hesitancy, consider information provided by peer workers, and, in some cases, proactively seek assistance from peer workers to attend vaccine appointments (Barker & Maguire, 2017).  The study recommended a model of implementing peer support vaccine programs for annualized influenza and Covid-19 vaccine drives in shelters.

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