Campaign Approach to Reaching American Indian/Alaska Natives

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Overview

  • American Indian/Alaska Natives (AIAN) have faced unique challenges during the COVID-19 pandemic. Historic AIAN mistrust in the federal government, including the Indian Health Service, the principal provider of health care service for the AIAN population, continues and impacts perception of COVID-19 vaccinations.
  • The AIAN population also faces disproportionate risks from COVID-19 due to significant underlying disparities in health, social and economic factors, and challenges in accessing quality healthcare.
  • According to CDC’s weekly tracker on vaccine demographics, 1.3% of people who had initiated a first dose in the two weeks prior to March 15, 2022, and .9% of all people with at least one dose of the COVID vaccine were in the AIAN population, despite only making up .8% of the total population. However, AIAN are trailing White, Non Hispanic populations by nearly 10% on the rate of booster uptake, with only 45.2% of those eligible having received a booster dose.
  • Testimonials from trusted messengers, particularly Tribal elders and leaders, are key for this audience as well as acknowledging the importance of preserving culture as a motivator for protecting the community from COVID-19.
  • Many Tribal nations have experienced great cultural and traditional knowledge loss due to deaths among elders and other cultural leaders from COVID-19 and spikes in mental health issues, including depression and suicide, due to lockdowns and social isolation.
  • To address these barriers, the Campaign takes a regional approach to messaging and outreach, incorporating authentic voices and images of Tribal Leaders, influencers, and community members to provide relevant messages from trusted sources.

Audience Market Research and Testing

A robust and continuous cycle of research drives all Campaign activities, including the approach to reaching AIAN audiences.

  • Primary research includes focus groups and interviews, creative testing surveys, and a weekly current events survey (a probability-based survey of 1,000 representative U.S. adults 18 and older), with findings provided by key demographic groups. Additional research includes audience segmentation and monitoring of news stories, social media, and secondary research. Findings are summarized for use across the Campaign.
  • Additional outcome surveys and analysis, along with social listening, enable performance tracking and real-time impact assessment to inform quick adjustments to messaging in a rapidly changing environment.

Key Messages for Audience

Messaging guidance is based upon qualitative and quantitative message testing insights, guidance from the Centers for Disease Control and Prevention (CDC), expert recommendations of audience-specific creative agencies, environmental scans, credible external research results, social listening, and iterative testing, among other inputs.

Campaign research demonstrated that across all audiences, framing messages that pointed to the severity of COVID and the benefits of the vaccines were generally most effective. Research found that for the AIAN audience specifically, the below messages, when used together, were the most effective at driving intention to vaccinate.

  • Even mild cases of COVID-19 have caused damage to the lungs, heart, brain, and many other organs, leading to an increased risk of long-term health problems such as strokes or seizures.
  • As the temperature drops and people gather indoors, COVID will have more opportunities to spread. You can help stop it by getting vaccinated and wearing a mask in indoor public spaces.
  • The American Medical Association reports 96% of doctors have been fully vaccinated against COVID-19.
  • Everyone in the U.S. ages 5 and older is eligible to get vaccinated. Vaccines are free and available at a location near you. Getting vaccinated has never been easier or more convenient.
    • Visit your local Indian Health Service, Tribal or urban Indian organization site for vaccines.
    • If you don’t live near a site, visit vaccines.gov to find a vaccine near you.

Campaign research did not show any booster messages effective specifically for this audience; however, the following messages were the top performers for all audiences to encourage boosters:

  • COVID can cause severe disease, hospitalization, or death. Vaccines and boosters offer you the best protection from the worst outcomes of COVID.
  • Over time, vaccines may become less effective at preventing COVID. Getting your COVID booster extends your protection and keeps you safer from emerging variants.
  • We’re making progress to move past the pandemic. We know more about the virus than ever before, and we know that if you're vaccinated and boosted, you're 10x less likely to get COVID than if you're unvaccinated. Getting vaccinated and boosted is your best defense against COVID.
  • Just because you had COVID doesn’t mean you can’t get it again. A COVID vaccine and booster are the best way to protect yourself against serious illness, hospitalization, and death.
  • CDC recommends that everyone ages 12 and older who are vaccinated get a COVID booster 5 months after their Pfizer or Moderna vaccination, or 2 months after a Johnson & Johnson vaccination.

Partnerships and Outreach

Key Activities and Metrics to Date

  • We have routinely held virtual AIAN town halls featuring experts from the Indian Health Service and local communities and jurisdictions, which have led more people to volunteer as trusted messengers in their respective communities.
    • Speakers have included Tribal Leaders, Indian Health Service representatives, Tribal community advocates, Native American healthcare providers and parents and other healthcare providers who serve the AIAN population. More than 150 AIAN organizations have participated in the Town Halls.
    • Town halls are livestreamed on YouTube Live and Facebook Live and each event averages a reach of 10,000 people, including people watching it live and the recording 1-2 weeks after the event. Moreover, video highlights are produced to point viewers to the "We Can Do This" website and generate interest in future town halls.
  • AIAN toolkits were developed and provided to regional Tribal Nation Consortia and Tribal leaders with regionally appropriate materials designed to instill vaccine confidence and encourage preventative measures against COVID-19.
    • The messages, design and imagery are specific to each region and include factsheets, talking points, drop-in newsletter articles, social media templates, and posters.
    • Customized toolkits have reached 12 Regional Tribal Consortia, with a combined membership of 352 Tribal nations.
  • To date we have produced four culturally competent videos for use in partnership activities. The videos are available across Urban Indian Organizations social media platforms, websites, and e-newsletters.

Paid Media

Key Activities and Metrics to Date

  • Comprehensive paid advertising is directed to total market audiences including national and local television and national radio. Custom creative for AIAN is additionally developed for local radio, digital, social and print, in regional markets that vary by campaign.
    • Ads are tailored to population needs to increase vaccine confidence while reinforcing basic prevention measures.
    • Ads align with the total market campaign with a focus on young adults age 18 to 25, seniors age 65 and older, the "Movable Middle" (adults 18-40) and Parents of children ages 5 and older.
  • Nearly 90% of the media spend for AIAN audiences to date was spent with AIAN owned-and-operated media partners.

Milestones

  • Early in the Campaign, Slow the Spread efforts included customized AIAN collateral, reinforced basic prevention measures with ads in radio, newspaper, digital, and social media.
  • Building Vaccine Confidence efforts, the Campaign’s advertising push focused on building vaccine confidence, initially focusing on seniors as the first eligible for vaccinations, then targeting health navigators — the healthcare decisionmakers in families, young adults, and adding parents of children eligible for vaccination as CDC announced new eligibilities.

Earned Media

Key Activities and Metrics to Date

  • Local and regional media interviews with AIAN trusted messengers, such as Tribal Leaders and health care providers, were arranged in the top 25 AIAN markets — as well as the 10 AIAN markets with the lowest vaccination rates.

Trusted Messengers

Knowing that the AIAN audience is best served overall on a regional level, local Tribal Leadership, Tribal Health Care Directors, and other representatives are our most trusted messengers to reach the six regions representing over 500 State and Federally recognized Tribes in the United States, including Alaska.

The creative campaign has also featured a nationally known AIAN talent to broaden its reach.

Creative/Partnership

Snapshot: Creative for Partnership Resources and Toolkits

Sample Social Media Post for American Indians/Alaska Natives

Together We Can Do This – Fact Sheets for NE, NW, Plains, SW and All Regions

Together We Can Do This – Flyers for NE, NW, Plains, SW and All Regions

Let’s Do Our Part – Posters, NE, NW, Plains, SW and All Regions

Mommy’s Baby :15

Modern Day Warrior :15

Let’s Get Back to Making History :15

Contact Us

Please visit cdc.gov/coronavirus for more COVID-19 information or Contact Us for questions about HHS’s work to boost public confidence in vaccines.