PROJECT SUMMARY/ABSTRACT Community-based Design and Evaluation of A Conversational Agent to Promote SARS- COV2 Vaccination in Black Churches African Americans have suffered a disproportionate burden from COVID-19, with significantly higher rates of infection, hospitalization, and mortality compared to Whites. These findings may be compounded by the fact that African Americans are also at higher risk for vaccine hesitancy. As limited health literacy has been identified as a key mediator of racial and ethnic disparities, interventions that address health literacy barriers have the potential to ameliorate these disparities. Over the past decade we have developed and tested embodied conversational agents (ECA) — computer characters that simulate face-to-face counseling using voice, hand gesture, gaze cues and other nonverbal behavior, and successfully used them in health behavior interventions for populations with low health literacy. We have developed ECA-based interventions to address a wide range of health problems among low literacy populations, including physical activity, diet, and medication adherence promotion, providing access to and explanation of healthcare documents, and collection of family health histories. In this project, we propose to create an effective and sustainable smartphone-based ECA intervention designed to deliver personalized and tailored education about SARS-CoV-2 and Influenza vaccination. We will collaborate with the Black Ministerial Alliance TenPoint (BMATP) of Greater Boston to develop the intervention app and evaluate it in a clinical trial involving 600 congregants from 12 predominately African American churches. Our primary hypothesis is that participants will have significantly greater SARS-CoV-2 and Influenza vaccination series completion at 6 months (H1) and 12 months (H2) in versions of the app that promote engagement and incorporate spiritual tailoring. Our secondary hypotheses are that, among participants who have not been vaccinated, those in the high engagement and tailored conditions will have significant improvements in intent to obtain SARS-CoV-2 and Influenza vaccination and attitudes towards SARS-CoV-2 and Influenza vaccination.

PROJECT NARRATIVE We will collaborate with the Black Ministerial Alliance TenPoint (BMATP) of Greater Boston to develop a smartphone-based Embodied Conversational Agent app that provides education about SARS-CoV-2 and influenza vaccination, and motivates vaccination completion, following public health guidelines. We will evaluate the intervention in a clinical trial involving 600 congregants from 12 predominately African American churches.