Using Intervention Mapping to Develop a Virtual Reality Intervention to Support COVID-19 Vaccination Among Black...

Pediatric uptake of COVID-19 vaccines is low, particularly among Black children. There is a critical need for pediatric clinicians to address COVID-19 vaccine concerns through community-centered, culturally appropriate communication strategies. Virtual reality (VR) may provide a modality to support clinicians' relational skills related to COVID-19 vaccine by providing a safe, realistic environment to practice preferred communication behaviors. The aim of this project was to use Intervention mapping (IM), a six-step framework, to cocreate a VR intervention with Black families to support COVID-19 vaccine uptake. For IM, step 1 (develop a logic model of the problem) and step 2 (identify program objectives and outcomes), our team used quantitative and qualitative methods to identify caregiver, adolescent, and young adult factors associated with intention and decisions to vaccinate against COVID-19. IM step 3 (program design) consisted of assembling planning board sessions with the Black community stakeholders including adolescents, young adults, and caregivers, along with primary care pediatric clinicians. A modified Delphi technique was used to build consensus for salient COVID-19 vaccine concerns and communication preferences. During IM step 4 (program production), the VR intervention (Virtual Immersive Communication Training on Recommending Immunization COVID-19) and accompanying simulation flowsheets were developed. An implementation plan was developed for IM step 5 (program implementation) and an evaluation plan for IM step 6 (evaluation). Through IM, an intervention centered on the needs and preferences of Black families was successfully developed. Lessons learned using IM included: (1) the importance of collaborating with patients and families on clinical topics where there is limited data, (2) the use of rigorous methods such as the modified Delphi approach to help build consensus, and (3) community relationships are critical to drive culturally informed technology-based interventions, especially when urgency is required.