Educate to Vaccinate Using The 5Ms Approach

From the outset, the Woodgrange Outreach Team recognised that effective vaccine outreach must be rooted in the local community’s needs, values, and concerns. A significant part of the team’s strategy was to educate and inform local residents about the importance of vaccines, addressing common misconceptions and building trust through ongoing community engagement.

Key elements of the community engagement strategy include:

• Weekly Meetings and Collaboration: The team regularly met with Integrated Care Boards (ICBs), hospital trusts, and Voluntary, Community, and Faith Sector (VCFS) organisations. These meetings help coordinate efforts, ensuring that outreach activities are aligned with the specific needs of each community. They also provide a platform for educational initiatives and the sharing of information about the benefits of vaccination.
• Targeted Data Collection: Data is gathered through surveys, focus groups, and community forums. This allows the team to better understand the specific barriers to vaccination in each borough and tailor educational messages accordingly. This targeted approach ensures that outreach efforts are both effective and efficient.
• Advisory Committees: The team works closely with local leaders, including faith leaders, community advocates, and representatives from asylum-seeker communities, to ensure the outreach was culturally sensitive. These committees also play a critical role in educating the community, as they are trusted voices who could share accurate information and correct misconceptions about vaccines.

Outcome:

These collaborative efforts help build a foundation of trust and understanding between the outreach team and the communities they serve. Culturally competent education has led to increased engagement and ultimately, greater vaccine uptake.

The 5Ms approach was developed by Woodgrange Covax to address vaccine hesitancy in culturally diverse and underserved communities. It originated from the need for a structured, culturally sensitive strategy to build trust and encourage vaccine uptake, particularly among groups facing barriers due to societal, religious, or cultural concerns.

1. Messaging: Crafting culturally appropriate and accessible vaccine messages to resonate with specific communities. These messages counter misinformation and promote confidence.
2. Mentorship: Partnering with trusted community leaders and influencers to advocate for vaccination, leveraging their credibility to reach hesitant individuals.
3. Mobilisation: Ensuring convenient access to vaccines through initiatives like mobile clinics and outreach programs, reducing logistical barriers for residents.
4. Monitoring: Collecting and analysing data on outreach efforts to measure impact, identify gaps, and refine strategies for greater effectiveness.
5. Maintenance: Sustaining engagement with communities through follow-ups and ongoing support to build long-term trust and reinforce vaccination messages.

The 5Ms model combines evidence-based practices with cultural awareness, enabling it to address vaccine hesitancy effectively. Its success lies in its adaptability and focus on community collaboration, making it a replicable model for other public health initiatives.

In urban environments, access to vaccination sites can be one of the most significant barriers to vaccine uptake. The Woodgrange Outreach Team know that in order to reach a wide range of people, they need to ensure that vaccination sites are both convenient and accessible to all residents. At the heart of this initiative was the idea of educating the public about where they could get vaccinated and how easy it was to access these services.

The team took several critical steps to make vaccines more accessible:

• Multilingual Outreach: Understanding that East London is home to a wide variety of linguistic groups, the outreach team made a concerted effort to offer vaccination information and services in multiple languages, including Bangla, Urdu, Gujarati, Tamil, Portuguese and Lithuanian. This multilingual approach has helped address barriers to understanding and encouraged people to seek out the vaccine.
• Inclusive Infrastructure: The team ensures that vaccination sites are accessible to individuals with disabilities. Clinics were equipped with ramps, wide doors, and appropriate signage, ensuring that people with mobility challenges could easily access services.
• Flexible Hours: To accommodate people with irregular working hours, the team offers extended clinic hours, including evenings and weekends. This flexibility allows individuals who might otherwise have been unable to visit during normal working hours to receive their vaccines.

Outcome:

By ensuring that vaccination sites were both accessible and well-publicised, the team is able to reach people who might have otherwise faced difficulties in accessing healthcare services. This strategy removes many of the logistical barriers that contribute to vaccine hesitancy, making it easier for residents to take action and get vaccinated.

One of the most innovative aspects of the Woodgrange Outreach Team’s campaign was the introduction of mobile vaccination units. These units bring vaccines directly to hard-to-reach communities and areas where healthcare access was limited. In addition to physical outreach, the team also emphasise digital inclusion, ensuring that those without internet access or digital literacy were not left out of the vaccination process.

The team have implemented a number of strategic actions to maximise outreach:

• Mobile Vaccination Units: Mobile clinics are deployed to areas with high foot traffic, such as community centres, markets, and places of worship. These units bring vaccines directly to the people, ensuring that those in underserved areas have easy access to healthcare.
• Vaccination Hotline: A dedicated vaccination advice hotline has been set up to assist people with scheduling appointments, answering questions, and providing educational resources about the vaccines. This hotline is essential in ensuring that people who are not comfortable with digital platforms still have access to accurate information and vaccine scheduling support.
• Assisting with the NHS App: The outreach team work with individuals who have limited digital literacy, assisting them with using the NHS App to book appointments and access vaccination records. This is particularly important for older adults or people who have never use digital health services before.

Outcome:

The introduction of mobile clinics significantly expand access to vaccines, bringing them directly to communities in need. Additionally, by focusing on digital inclusion, the team ensure that even those with limited access to the internet can still participate in the vaccination program. These initiatives help educate the public on the importance of getting vaccinated while ensuring accessibility for all.

While the primary goal of the Woodgrange Outreach Team’s campaign is to increase vaccination rates, the team also recognise the importance of overall health promotion. By integrating wellness services and health education alongside vaccination efforts, the team is able to provide more comprehensive care and foster a culture of health in the community.

Key initiatives include:

• Wellness Activities: Partnering with local organisations, the team host wellness activities such as yoga classes, fitness sessions, and creative arts workshops. These events encourage people to view their health holistically and demonstrate that the outreach team care about their well-being beyond just vaccination.
• Making Every Contact Count (MECC): In 2023 the outreach team adopt the MECC framework, which encourages health professionals to use every interaction as an opportunity to educate the community about a wide range of health topics. This approach is used to promote not just vaccination, but also healthy eating, mental health, and smoking cessation.

Outcome:

By integrating wellness services with vaccination outreach, the team not only promote vaccination but also foster a deeper connection with the community. This helps to create a long-term culture of health and well-being, contributing to sustained vaccine uptake and overall improved health outcomes.

Health and social care workers (HSCWs) are essential to the fight against COVID-19 and the flu, yet vaccine uptake in this group has been inconsistent. To address this, the Woodgrange Outreach Team organise a targeted campaign aimed at increasing vaccine uptake among HSCWs in Tower Hamlets.

Key elements of the campaign included:

• On-Site Vaccination: The team facilitated on-site vaccinations for HSCWs, making it as easy as possible for them to receive both the flu and COVID-19 vaccines during their shifts.
• Health Screenings: In addition to vaccinations, the outreach team offer blood pressure checks and other health screenings to add value to the events.
• Q&A Sessions: Dedicated sessions were held where healthcare workers could ask questions and address concerns about the vaccines. These sessions were critical in providing education and reassurance about the safety and efficacy of the vaccines.

Outcome:

The targeted campaign has so far successfully vaccinated over 200 HSCWs, with 63% of participants reporting that they would not have been vaccinated otherwise. This highlights the effectiveness of educating and engaging this crucial workforce.

Background

The GPU Fair 2024 presented a unique opportunity to address vaccine hesitancy among the Muslim community. Known for lower vaccine uptake due to cultural and societal barriers, tailored engagement was required. Woodgrange Covax utilised its "5Ms" strategy - Messaging, Mentorship, Mobilisation, Monitoring, and Maintenance - to build trust and boost immunization rates at this culturally significant event.

Activities and Challenges

The Woodgrange Covax team faced logistical hurdles, including objections from venue security and power supply issues, but adapted by engaging proactively with attendees. Over two days, the team held 1,369 vaccine-related conversations and administered 72 flu and 32 COVID vaccines. Challenges like suboptimal van placement and generator restrictions were overcome with persistence and community partnerships.

Outcomes and Impact

The initiative successfully fostered trust within a vaccine-hesitant demographic, demonstrated by meaningful engagement and positive feedback. Partnerships with organisations like BIMA and local businesses bolstered the outreach, showcasing the importance of collaboration in public health efforts.

Lessons and Next Steps

Key lessons include the importance of adaptability, community collaboration, and culturally sensitive messaging. Moving forward, Woodgrange Covax has expanded its outreach, strengthened follow-ups, and replicated the 5Ms model across neighboring boroughs to scale its impact.

Woodgrange Covax has demonstrated a robust commitment to working with inclusion groups, including the homeless, sex workers, and migrants, ensuring equitable access to vaccination and health services. Using the innovative 5Ms approach - Messaging, Mentorship, Mobilisation, Monitoring, and Maintenance - the team tailored culturally sensitive strategies to address barriers unique to these populations.

For the homeless, the team deployed mobile clinics in accessible locations, such as shelters and food distribution points, addressing logistical challenges and offering vaccines without requiring fixed addresses or identification. Collaborative partnerships with local charities such as ‘Crisis’ helped build trust and encourage uptake.

Efforts to engage sex workers involved discreet and stigma-free outreach at trusted community hubs. By collaborating with local advocacy groups, the team ensured a safe and nonjudgmental environment, providing vital health information alongside vaccinations.

With migrants, the outreach focused on addressing cultural and linguistic barriers e.g. at Transitional Hotels culturally tailored messaging and partnerships with trusted community leaders helped dispel vaccine hesitancy.

Across all initiatives, proactive engagement, cultural competence, and partnerships with local organisations have been pivotal in reducing health disparities, fostering trust, and improving vaccination rates among these marginalised groups.

Key Milestones and Outcomes

The outreach campaign so far has achieved remarkable success, with over 1,500 vaccinations administered in Newham outreach settings alone. Across all three boroughs, the team has administered over 3,000 vaccines, demonstrating the scalability and effectiveness of their approach. The success of the campaign is largely attributable to the application of the 5Ms framework: Messaging, Mentorship, Mobilisation, Monitoring, and Maintenance.

As the Woodgrange Outreach Team looks to the future, the 5Ms framework will continue to guide their efforts. By maintaining a focus on education, mobilisation, and cultural sensitivity, the team is poised to continue making strides in improving public health.

Key strategies for sustaining success include:

• Continued diversity and cultural competence in staffing.
• Ongoing community feedback to refine approaches.
• Partnerships with local organizations and ongoing engagement with community leaders.

Outcome:

By focusing on education and sustaining engagement, the team is ensuring that all members of the community remain informed and empowered to protect their health.

Conclusion

The Woodgrange Outreach Team’s Educate to Vaccinate campaign has been a resounding success, utilising the 5Ms framework to overcome barriers and increase vaccine uptake across East London. Through dedication to education, accessibility, and community engagement, the team has made significant strides in improving public health. Moving forward, the team remains committed to educating and vaccinating every individual, ensuring that public health remains a priority for all.