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The complexity and responsibilities of public health make collaboration across multiple levels of government critical. The Centers for Disease Control and Prevention (CDC) effectively uses communities of practice (CoPs) to bring its staff together with partners to share, learn, and address public health problems. This paper aims to focus on CoPs.

The paper assesses the value of CoPs to individual members, their organizations, and their public health domains; assesses whether the CoP Program has improved CDC's relationship with participants in various CoPs; and identifies barriers to participation or success factors that could be applied to the development of new CoPs. Responses from a random sample of active CoP members were analyzed using qualitative data analysis software to identify themes and answer research questions.

The results reveal clear benefits to individual members, their organizations, and public health disciplines including daily work efficiencies, expanded infrastructure, and enhanced relationships between CDC and its public health partners.

This qualitative research analyzed a small number of communities of practice spanning their launch through year 2; further study of a larger sample of public health CoPs, including sustainability factors, would build on this case study's implications.

Public health practitioners seeking a collaborative approach to problem solving will find in this study some useful lessons learned from CDC; readers will be introduced to CDC's CoP Resource Kit and a public health collaboration portal, phConnect.

Well‐facilitated, member‐driven, and highly participative CoPs are valuable tools for fostering collaboration essential to improving the public health system, and should be used more broadly across public health.

The disparities of COVID-19 vaccination rates between the rural and urban areas have become apparent during this pandemic. There is a need to understand the root causes of vaccine hesitancy demonstrated by the rural population to increase coverage and to contain the disease spread throughout the United States. This study aimed to explore other factors influencing vaccine hesitancy among rural dwellers besides the geography-related barriers such as poor health care access and individuals having no or suboptimal insurance coverage.

By reviewing existing data and literature about vaccination, health literacy, and behaviors, and prevailing ideologies, we discuss the potential causes of vaccine hesitancy in rural areas that could create barriers for successful public health efforts related to vaccine coverage and provide suggestions to ameliorate the situation.

Geography-related barriers, health literacy, and preconceived notions are key determinants of adopting healthy behaviors and complying with public health authorities' recommendations among rural individuals during a public-health crisis. We argue that ideology, which is much deeper than preconception or misconception on vaccination, should be incorporated as a key factor to redefine the term “vulnerable populations” in public health research.

The limitation of our study is that we have not found an effective way to encourage the populations who hold conservative religious and political ideologies to join the efforts for public health. Even though geography-related barriers may strongly impact the rural dwellers in achieving optimal health, the various forms of ideologies they have toward certain health behaviors cannot be discounted to understand and address vaccine-related disparities in rural areas. There is a need to redefine the term “vulnerable population” particularly as it relates to rural areas in the United States. During large-scale public health disasters, scholars and public health authorities should consider the ideologies of individuals, in addition to other factors such as race/ethnicity, area of residence (rural vs. urban), and socioeconomic factors influencing the existing vulnerabilities and health disparities.

Across the United States (US), COVID-19 vaccination coverage was lower in rural counties compared to urban counties, exacerbating rural health inequities. While rural communities fall short of the public health goal to vaccinate all who are eligible, most rural residents have chosen to vaccinate for COVID-19. The aim of this study was to better understand rural New Mexicans' attitudes and beliefs about COVID-19 vaccines.

We conducted and analyzed 51 in-depth, semi-structured interviews with adults living in rural New Mexican counties, covering a range of topics related to the pandemic, including vaccines. These interviews were conducted in the Summer of 2021 after the vaccines were widely available to all adults over the age of 18 and youth between the ages of 12–17, but not yet available for children under 12 years.

Two major perspectives were identified: (1) the idea that COVID-19 vaccinations are a tool that individuals can use to achieve freedom and protection and (2) the view which regarded vaccines as an infringement of personal rights and one's autonomy of health. For people who viewed the vaccine as a tool for freedom, several themes emerged, including (1) a preference for vaccine manufacturers, specifically a preference for Pfizer, and (2) frustrations related to vaccine access, specifically, older adults expressed frustrations with the difficulty of scheduling vaccination appointments. However, most participants felt as though they had enough vaccination resources. For people who viewed vaccines (and vaccine mandates) as limiting their freedom, additional themes emerged: (1) overarching distrust of government and the perception that vaccines were an extension of government and (2) distrust in the vaccines themselves, including a perceived lack of research on the vaccines and a perception that the vaccine was developed in too short of a period. Some of the people who hold these beliefs are also vaccinated. We draw from social psychology theories to better understand how people who hold a rural identity come to establish different beliefs and practices compared to larger metropolitan regions. While political identity is a contributor, of our participants, the group who were most likely to report not being vaccinated were the “independent” or “unaffiliated voters.” Our findings can help craft culturally responsive vaccine initiatives for rural communities.

Since the development of the COVID-19 vaccinations, questions surrounding race have been prominent in the literature on vaccine uptake. Early in the vaccine rollout, public health officials were concerned with the relatively lower rates of uptake among certain racial/ethnic minority groups. We suggest that this may also be patterned by racial/ethnic residential segregation, which previous work has demonstrated to be an important factor for both health and access to health care.

In this study, we examine county-level vaccination rates, racial/ethnic composition, and residential segregation across the U.S. We compile data from several sources, including the American Community Survey (ACS) and Centers for Disease Control (CDC) measured at the county level.

We find that just looking at the associations between racial/ethnic composition and vaccination rates, both percent Black and percent White are significant and negative, meaning that higher percentages of these groups in a county are associated with lower vaccination rates, whereas the opposite is the case for percent Latino. When we factor in segregation, as measured by the index of dissimilarity, the patterns change somewhat. Dissimilarity itself was not significant in the models across all groups, but when interacted with race/ethnic composition, it moderates the association. For both percent Black and percent White, the interaction with the Black-White dissimilarity index is significant and negative, meaning that it deepens the negative association between composition and the vaccination rate.

The analysis is only limited to county-level measures of racial/ethnic composition and vaccination rates, so we are unable to see at the individual-level who is getting vaccinated.

We find that segregation moderates the association between racial/ethnic composition and vaccination rates, suggesting that local race relations in a county helps contextualize the compositional effects of race/ethnicity.