Co-designing an intervention to strengthen vaccine uptake in Congolese migrants in the UK (LISOLO MALAMU): a participatory study protocol
Authors: Crawshaw Alison F , Hickey Caroline , Lutumba Laura Muzinga , Kitoko Lusau Mimi , Nkembi Sarah Luti , Knights Felicity , Ciftci Yusuf , Goldsmith Lucy P , Vandrevala Tushna , Forster Alice S , Hargreaves Sally 
Published: July 2022

AbstractIntroductionAdult migrants are at risk of under-immunisation and are likely to need catch-up vaccination to bring them in line with the UK schedule. The COVID-19 pandemic has highlighted and exacerbated inequities in vaccine uptake, with migrants facing additional barriers to information, low vaccine confidence, and access to vaccine services. There is a need for participatory and theory-based research that meaningfully engages underserved migrant groups to make sense of their experiences and beliefs about vaccination and uses these insights to co-produce tailored interventions which can increase uptake. COVID-19 vaccination provides a unique entry-point and opportunity to explore these issues in tandem with addressing routine immunisation gaps and developing more culturally-sensitive routine vaccination services.Methods and analysisLISOLO MALAMU (‘Good Talk’) is a community-based participatory research study which uses co-design, design thinking and behaviour change theory to engage adult Congolese migrants in developing a tailored intervention to increase vaccine uptake. A community-academic coalition will lead and co-design the study. The study will involve i) in-depth interviews with adult Congolese migrants (foreign-born, >18 years), ii-iii) interviews and consensus workshops with clinical, public health and community stakeholders, and iv) co-design workshops with adult Congolese migrants. Qualitative data will be analysed iteratively, using Thematic Analysis, and mapped to the Theoretical Domains Framework, with participation from the coalition in discussing and interpreting findings and selecting intervention functions to guide the co-design workshops. Sociodemographic data of interview participants will be summarised using descriptive statistics. The study will run from approximately November 2021-November 2022.Ethics and disseminationEthics approval has been granted by the St George’s University Research Ethics Committee (REC reference 2021.0128). Study findings will be widely disseminated by the coalition through local community organisations in Hackney and broader academic and policy stakeholders, including a final celebration event. Recommendations for a future larger scale study and testing of prototyped interventions will be made.Strengths and limitations of this studyStrengthsThis study will directly respond to ongoing calls for community-centred and participatory approaches to engaging migrants in routine and COVID-19 vaccination, by implementing a value-driven and reciprocal approach to conducting a study addressing the needs of an underserved community.The target population was selected following a comprehensive systematic review of the evidence (1) and pre-engagement scoping work conducted with migrant community representatives in London, UK. (2, 3)It aims to co-produce a tailored intervention to address specific barriers to, and strengthen, vaccine uptake for COVID-19 and routine vaccines in adult Congolese migrants (including MMR, Td/IPV, and HPV) as set out by UKHSA guidance (4), and has been co-designed with, and will be co-delivered by, a coalition formed of academic researchers, a council for voluntary service (a local charity which offers services and support for local voluntary and community organisations), and a Congolese community-based organisation.LimitationsAs this study is tailored to the Congolese migrant population, other migrants who also face barriers to vaccine uptake are not included. Whilst we can draw some conclusions about the experiences of other Black migrants who face similar historical and cultural barriers to uptake of routine and COVID-19 vaccines, our ability to generalise the findings to all migrant communities might be limited.Co-designed intervention prototypes will not be formally implemented and evaluated in this study, however recommendations will be made so that this can be done in a future phase.