Attitudes and Beliefs of Older Black Americans Toward the COVID-19 Virus and Vaccine

The COVID-19 pandemic, an unprecedented health emergency, has devastated the nation, and disproportionately affected persons of color, especially Black Americans. It has forced health officials to rapidly develop and distribute COVID-19 vaccines, resulting in the importance of understanding Black Americans’ attitudes and beliefs about COVID-19. We analyzed experiences of 167 Black Americans, ages 65 and older, recruited from Wayne State Institute of Gerontology Healthier Black Elders Center and surrounding communities. Participants were telephoned starting September 2020 and given the GAD-7 anxiety scale and a COVID-19 questionnaire measuring demographics, stressors, and emotional responses associated with the COVID-19 pandemic. A scale was also designed, adapted from the Health Belief Model, to measure fear of getting COVID-19, beliefs about the origins of COVID-19, uncertainty about vaccine safety, and intent to be vaccinated (5-point Likert scale). Of the 167 participants, 112 (67%) said they would agree to vaccination, 24 (14%) were ambivalent, and 31 (19%) said they would decline. T-tests comparing pro- and anti-vaccine participants showed that those not planning to get vaccinated expressed lower generalized anxiety (p=.002), COVID-19 fear (p<.001), and concerns about vaccine safety (p=.01), but greater belief that COVID-19 is man-made (p=.05). The current study provides a snapshot of urban Black American older adults who are in general eager to get vaccinated for COVID-19. Counterintuitively, those unwilling to accept the COVID-19 vaccine also had lower concerns for vaccine safety. More research is needed to fully understand the attitudes and beliefs of this underserved population regarding the COVID-19 virus and vaccine.

The Effect of Vaccines on Older African Americans Emotional Experiences During the COVID-19 Pandemic

The COVID-19 pandemic is an unprecedented health emergency that has forced a change in the daily life of all individuals across the nation for over a year. As vaccinations have begun in Detroit, we examined their effect on older African Americans’ emotional experiences and intent to get vaccinated during the pandemic to help understand how persons make decisions to accept vaccinations. For this study, 194 community-dwelling older African Americans (mean age = 75, age range = 64-94) were recruited from the Wayne State Institute of Gerontology Healthier Black Elders Center and general Detroit area. A telephone survey was administered to assess pandemic experience including demographics, emotional responses (e.g., gratitude, happiness, anger, fear), everyday stressors (e.g., economic problems, reduced privacy), and vaccination attitude (e.g., concern over safety, intent to vaccinate). Of the 194 participants, 149 completed the survey before the first vaccination occurred in the United States on December 15, 2020, and 45 completed the survey after. Participants had not yet been vaccinated, but 67% said they would as soon as available. Participants in the post-vaccination group, as compared to pre-vaccination group, showed increases in stress-related locus of control (p=.03) and reported being more likely to get vaccinated (p=.02). They showed decreased worry about availability of health and safety supplies (p=.01), reduced perceived stress (p=.02), and a decrease in fears of COVID-19 (p=.05) and vaccination safety (p<.001). The current study highlights the effect of vaccinations on the attitudes and emotions experienced by an older minority population living in an urban area.

Promoting Connections Through Creative Approaches to Research Engagement for Older African Americans

This presentation will feature innovative retention approaches that contributed to sustaining connections to older Black participants in the long-standing Healthier Black Elders Center (HBEC). The HBEC aims to address and reduce health disparities through research and education. In 2020, this outreach has included a telephone outreach program and a weekly social group, “The Party Line,” to promote connections and collect data on mental health, coping mechanisms and newly acquired skills, as well as health care access including access to masks, testing and tele-health. The presentation will also describe tailored approaches to initiating a Community Advisory Board and programming in Flint, MI and creative efforts to retain participants in Detroit, MI, thus ensuring the relationships between researchers and older community members are sustained despite program modifications.

Not out-of-reach: Engaging the older old isolated African Americans with and without MCI

The Internet-Based Conversational Engagement Clinical Trial (I-CONECT, ClinicalTrials.gov: NCT02871921) is a multi-center randomized, 12-month efficacy study. There is converging evidence that social isolation is a risk factor of cognitive decline and dementia. We hypothesized that increasing social interaction in older adults with normal cognition or mild cognitive impairment (MCI) could improve or sustain cognitive function through internet-based conversational engagement. African Americans (AA) are at higher risk for developing dementia but their participation in clinical trials is low. Objectives: (1) discuss the effective outreach process to recruit urban AA older old adults (mean targeted age of 80+); (2) describe how we retained participants in a yearlong study using technology-based interventions. The most successful outreach and recruitment sources were the voter registration mass mailings and the Healthier Black Elders Research Center. Successful recruitment methods included: hiring diverse staff, compensating participants’ time, and adjusting research protocols for opting out of MRIs and genetic saliva samples. Technology intervention strategies included: providing user-friendly Chromebooks and free internet connections, simple instructions with pictures, vision and hearing correction, and in-home training with technology support backup. During the pandemic, we could assists participants in learning to use the laptop remotely. Over 12,000 subjects were contacted, which led to 39 randomized participants. Our retention rate thus far is over 75%. This demonstrates that AA older adults are reachable, willing to participate in research and able to use communication technology with appropriate supports for long-term sustainable interaction that may improve cognition and health equity.

Chronic Pain and Psychological Distress Among Older Adults: A National Longitudinal Study

This research examines whether unobserved time-stable influences confound the association between chronic pain and psychological distress in older adults as well as how race and ethnicity combine with subjective social status (SSS) to modify the association. In a nationally representative longitudinal survey, holistically controlling for unobserved time-stable influences using fixed-effects models substantially reduces the pain–depression relationship and eliminates the overall pain–anxiety relationship. The association with depression is stronger for Black and Hispanic elders, illustrating a process of double-jeopardy. Black elders with severe pain experience lower anxiety, as do Black elders with moderate pain and low SSS, which we suggest may be due to the enervating effects of undermanaged pain. Black elders at high SSS experience greater anxiety with moderate pain. This research suggests that undermanagement of chronic pain among racial and ethnic minorities differentiates the association between pain and distress in late life and especially creates stronger associations with depression.