By July, half of American Indian and Alaskan Native residents living in Arizona had gotten a vaccine – much like the national average. And in Maricopa County, home to Phoenix and half of Arizona residents, the vaccination rate for American Indian and Alaskan Natives is 74% – higher than for any other racial or ethnic group.
To support these trends, the Arizona Community Health Workers Association (AzCHOW), which has been part of the community for 20 years, hosts free COVID-19 trainings for community health workers. Ruby Meraz, M.P.H., AzCHOW's training center director and a community health education specialist, said the goal is to “send them off with tricks and tips that they could pull out of their back pocket to talk about the vaccine.”
One of the best strategies, Sabo said, has been helping these essential health workers get vaccinated first, so they can share that message and their experience with others. While many members of tribal communities view vaccines as important, Sabo explained, they still need support to get their shot. This may include health workers printing out information for people living in areas without Wi-Fi, answering questions about new vaccines and variants, transporting family members to appointments, or making a visit to a homebound elder.
Their goal is to make information available and accessible, which sometimes requires extra translation. It also requires that they stay in touch with key people in the community. If they have questions they aren’t sure how to answer, for example, the health worker can reach out to a researcher or doctor, or to AzCHOW.
Many medical experts have also met with the community, where tribal leaders feel comfortable asking questions: What’s in a vaccine? What are the benefits? What happens after you get vaccinated? These leaders, often respected elders, appreciate the ability to have interactions in safe spaces, Sabo explained. Ultimately, the conversations help them make decisions and shape what information they share with their community, which can have an impact.
Another factor that helps is seeing COVID-19 rates among American Indian and Alaskan Native communities get closer to zero. In January in Arizona, more than 600 per 100,000 people in Indigenous communities had the disease, according to data from the Centers for Disease Control and Prevention. Seven months later, weekly case rates fell below 3 per 100,000 people.
“Any way that we can promote how COVID rates are changing really seems to be working for people to get motivated to get the vaccine,” Sabo said. “Folks are very well up to date on the COVID case counts in their communities.”
To continue to help tribal communities respond to COVID-19, community health workers will soon share resources designed to support the mental health and emotional well-being of residents, Meraz said. The goal is to help those who suffered throughout the pandemic, such as if they lost a loved one, were hospitalized, or felt isolated.
Meraz said, “The first step always starts with meeting people where they are.”
Learn about other CEAL research in Arizona to support members of AI/AN communities, including a public health campaign designed to strengthen vaccine confidence and community partnerships that support early research engagement.