Strengthening COVID-19 vaccine confidence & demand during the US COVID-19 emergency response.

In October 2020, the CDC's Vaccinate with Confidence strategy specific to COVID-19 vaccines rollout was published. Adapted from an existing vaccine confidence framework for childhood immunization, the Vaccinate with Confidence strategy for COVID-19 aimed to improve vaccine confidence, demand, and uptake of COVID-19 vaccines in the US. The objectives for COVID-19 were to 1. build trust, 2. empower healthcare personnel, and 3. engage communities and individuals. This strategy was implemented through a dedicated unit, the Vaccine Confidence and Demand (VCD) team, which collected behavioral insights; developed and disseminated toolkits and best practices in collaboration with partners; and collaborated with health departments and community-based organizations to engage communities and individuals in behavioral interventions to strengthen vaccine demand and increase COVID-19 vaccine uptake. The VCD team collected and used social and behavioral data through establishing the Insights Unit, implementing rapid community assessments, and conducting national surveys. To strengthen capacity at state and local levels, the VCD utilized "Bootcamps," a rapid training of trainers on vaccine confidence and demand, "Confidence Consults", where local leaders could request tailored advice to address local vaccine confidence challenges from subject matter experts, and utilized surge staffing to embed "Vaccine Demand Strategists" in state and local public health agencies. In addition, collaborations with Prevention Research Centers, the Institute of Museum and Library Services, and the American Psychological Association furthered work in behavioral science, community engagement, and health equity. The VCD team operationalized CDC's COVID-19 Vaccine with Confidence strategy through behavioral insights, capacity building opportunities, and collaborations to improve COVID-19 vaccine confidence, demand, and uptake in the US. The inclusion of applied behavioral science approaches were a critical component of the COVID-19 vaccination program and provides lessons learned for how behavioral science can be integrated in future emergency responses.

Walking for Transportation: What do U.S. Adults Think is a Reasonable Distance and Time?

BACKGROUND: Less than one-third of U.S. adults walk for transportation. Public health strategies to increase transportation walking would benefit from knowing what adults think is a reasonable distance to walk. Our purpose was to determine 1) what adults think is a reasonable distance and amount of time to walk and 2) whether there were differences in minutes spent transportation walking by what adults think is reasonable. METHODS: Analyses used a cross-sectional nationwide adult sample (n = 3653) participating in the 2010 Summer ConsumerStyles mail survey. RESULTS: Most adults (> 90%) think transportation walking is reasonable. However, less than half (43%) think walking a mile or more or for 20 minutes or more is reasonable. What adults think is reasonable is similar across most demographic subgroups, except for older adults (≥ 65 years) who think shorter distances and times are reasonable. Trend analysis that adjust for demographic characteristics indicates adults who think longer distances and times are reasonable walk more. CONCLUSIONS: Walking for short distances is acceptable to most U.S. adults. Public health programs designed to encourage longer distance trips may wish to improve supports for transportation walking to make walking longer distances seem easier and more acceptable to most U.S. adults.