Use of a Peer Equity Navigator Intervention to Increase Access to COVID-19 Vaccination Among African, Caribbean and Black Communities in Canada

Josephine Etowa (), Ilene Hyman and Ubabuko Unachukwu
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Josephine Etowa: School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1H 8M5, Canada
Ilene Hyman: Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
Ubabuko Unachukwu: Canadians of African Descent Health Organization (CADHO), Ottawa, ON K2J 0R6, Canada

IJERPH, 2025, vol. 22, issue 8, 1-11

Abstract: African, Caribbean, and Black (ACB) communities face increased COVID-19 morbidity and mortality, coupled with significant barriers to vaccine acceptance and uptake. Addressing these challenges requires innovative, multifaceted strategies. Peer-led interventions, grounded in critical health literacy (CHL) and critical racial literacy (CRL), and integrating collaborative equity learning processes, can enhance community capacity, empowerment, and health outcomes, contributing to long-term health equity. This paper describes and presents the evaluative outcomes of a peer-led intervention aimed at enhancing COVID-19 vaccine confidence and acceptance. The Peer-Equity Navigator (PEN) intervention consisted of a specialized training curriculum grounded in CHL and CRL. Following training, PENs undertook a 5-month practicum in community or health settings, engaging in diverse outreach and educational activities to promote vaccine literacy in ACB communities. The evaluation utilized a modified Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework, using quantitative and qualitative methods to collect data. Sources of data included tracking records with community feedback, and a PEN focus group, to assess program feasibility, outreach, and effectiveness. From 16 September 2022, to 28 January 2023, eight trained PENs conducted 56+ community events, reaching over 1500 community members. Both PENs and community members reported high engagement, endorsing peer-led, community-based approaches and increased vaccine literacy. The PEN approach proves feasible, acceptable, and effective in promoting positive health behaviors among ACB communities. This intervention has clear implications for health promotion practice, policy, and research in equity-deserving communities, including immigrants and refugees, who also face multiple and intersecting barriers to health information and care.

Keywords: peer education; health equity; health promotion; African American/black health; community intervention; critical race theory; outcome evaluation; program planning and evaluation; COVID-19; peer equity (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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