Pelvic floor disorder assessment of knowledge and symptoms: an educational intervention for Spanish-speaking women (PAKS study).

INTRODUCTION AND HYPOTHESIS: Educational interventions have been effective in improving postpartum knowledge, performance of pelvic floor exercises, and bowel-specific quality-of-life. Our primary objective was to determine if a video-based educational intervention on pelvic floor disorders (PFDs) would increase Spanish-speaking women's knowledge of PFDs, and secondarily to assess if it would decrease pelvic floor symptoms. We hypothesized that Spanish-speaking women would improve their pelvic floor knowledge and symptoms post-intervention. METHODS: Inclusion criteria included women age 18 years and older and self-reported as a predominantly Spanish-speaker or equally bilingual English- and Spanish-speaker. Changes in knowledge were assessed with the Prolapse and Incontinence Knowledge Questionnaire (PIKQ). Changes in symptoms were assessed with the Pelvic Floor Distress Inventory-20 (PFDI-20). Linear regression assessed for independent effects. RESULTS: One hundred and fourteen women were enrolled and 112 completed the pre- and post-intervention PIKQ. Mean (standard deviation [SD]) age was 50 (14) years. Immediate post-intervention scores showed significant improvement in knowledge. Total PIKQ score improved by 5.1 (4.7) points (p < 0.001). POP subscore improved by 2.7 (2.7) points (p<0.001) and UI subscore improved by 2.3 (2.5) points (p < 0.001). Improvement in knowledge continued after four weeks (p < 0.001). PFDI-20 prolapse (p=0.02), colorectal-anal (p < 0.001) and urinary (p = 0.01) scores significantly improved only for the most symptomatic women at baseline. Using linear regression, total PIKQ (p = 0.03) and total PFDI-20 scores (p = 0.04) were associated with predominantly Spanish-speakers versus fully bilingual. CONCLUSION: Findings support the efficacy of a video-based educational intervention to improve knowledge of PFDs in Spanish-speaking women. The most symptomatic women benefitted from this intervention.

Supporting clinical competency in managing peripherally inserted central catheters during the COVID-19 pandemic: an education evaluation.

INTRODUCTION: Hospitals had to create new practices and training due to the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) pandemic. An increase in patient acuity and the need for peripherally inserted central catheters (PICC) across the hospital required an urban community hospital to educate and support in-patient nurses to manage PICCs in acute and complex care units. Traditionally, these skills were performed by specialized registered nurses (RNs) from the Vascular Access Team (VAT). This paper highlights the education plan, implementation, and evaluation of a hospital-wide training for RNs and registered practical nurses (RPNs) in in-patient units during the SARS-CoV-2 pandemic. METHODS: Clinical Resource Leaders (CRLs) created a modular approach to upskill existing nurses and train new hires. Various education strategies, such as the use of competency assessments, creating practice supports, and incorporating specialists as a resource, were utilized to ensure knowledge transfer, application, and guidance of evidence-informed clinical practices. Vascular Access Team documentation was utilized to obtain Kirkpatrick's (2021) level 4 evaluation. RESULTS: This training program was implemented after the second wave of the pandemic and was also embedded into nursing orientation. This structured approach ensured that nurses were competent to support the increased acuity and needs of patients. Eighty percent of full-time and part-time nurses were trained to manage PICC lines. CONCLUSION: Education evaluation results show a decrease in PICC-related VAT assistance requests with a baseline of 570 calls down to 149 six months after education was implemented. Leaders are encouraged to ensure teams have role clarity, policies, and practice supports to be successful.

Healthcare Personnel (HCP) Attitudes About Coronavirus Disease 2019 (COVID-19) Vaccination After Emergency Use Authorization.

BACKGROUND: We previously reported on coronavirus disease 2019 (COVID-19) vaccination intent among healthcare personnel (HCP) before emergency use authorization. We found widespread hesitancy and a substantial proportion of HCP did not intend to vaccinate. METHODS: We conducted a cross-sectional survey of HCP, including clinical and nonclinical staff, researchers, and trainees between 21 February and 19 March 2021. The survey evaluated vaccine attitudes, beliefs, intent, and acceptance. RESULTS: Overall, 3981 (87.7%) of respondents had already received a COVID-19 vaccine or planned to get vaccinated. There were significant differences in vaccine acceptance by gender, age, race, and hospital role. Males (93.7%) were more likely than females (89.8%) to report vaccine acceptance (P < .001). Mean age was higher among those reporting vaccine acceptance (P < .001). Physicians and scientists showed the highest acceptance rate (97.3%), whereas staff in ancillary services showed the lowest acceptance rate (79.9%). Unvaccinated respondents were more likely to be females, to have refused vaccines in the past due to reasons other than illness or allergy, to care for COVID-19 patients, or to rely on themselves when making vaccination decision. Vaccine acceptance was more than twice previous intent among Black respondents, an increase from 30.8% to 73.8%, and across all hospital roles with all > 80% vaccine acceptance. CONCLUSIONS: The majority of HCP were vaccinated, much higher than reporting intent before vaccine was available. However, many HCP-particularly ancillary services-are still hesitant. Feasible and effective interventions to address the hesitant, including individually-tailored education strategies are needed, or vaccine can be mandated.

Mutable polyelectrolyte tube arrays: mesoscale modeling and lateral force microscopy.

In this study, the pH-dependent friction of layer-by-layer assemblies of poly(allylamine hydrochloride) and poly(acrylic acid) (PAH/PAA) are quantified for microtube array structures via experimental and simulated lateral force microscopy (LFM). A novel coarse-grain tube model is developed, utilizing a molecular dynamics (MD) framework with a Hertzian soft contact potential (such that F ∼ δ3/2) to allow the efficient dynamic simulation of 3D arrays consisting of hundreds of tubes at micrometer length scales. By quantitatively comparing experimental LFM and computational results, the coupling between geometry (tube spacing and swelling) and material properties (intrinsic stiffness) results in a transition from bending dominated deformation to bending combined with inter-tube contact, independent of material adhesion assumptions. Variation of tube spacing (and thus control of contact) can be used to exploit the normal and lateral resistance of the tube arrays as a function of pH (2.0/5.5), beyond the effect of areal tube density, with increased resistances (potential mutability) up to a factor of ∼60. This study provides a novel modeling platform to assess and design dynamic polyelectrolyte-based substrates/coatings with tailorable stimulus-responsive surface friction. Our results show that micro-geometry can be used alongside stimulus-responsive material changes to amplify and systematically tune mutability.

Geometry-dependent compressive responses in nanoimprinted submicron-structured shape memory polyurethane.

High resolution surface textures, when rationally designed, provide an attractive surface engineering approach to enhance surface functionalities. Designing smart surfaces by coupling surface texture with shape memory polymers has garnered attention in achieving tunable mechanical properties. We investigate the structure-mechanical property relationships for programmable, shape-memorizing submicron-scale pillar arrays subjected to flat-punch compression. The geometrically-dependent deformation of structured surfaces with two different aspect ratios (250 nm-pillars 1 : 1 and 550 nm-pillars 2.4 : 1) were investigated, and their moduli were found to be lower than that of non-patterned surface. From finite element analysis, the pillar deformation is correlated to a mechanistic transition from a discrete, unidirectional compression of 250 nm-pillars to lateral constraints caused by interpillar contact in 550 nm-pillars. This lateral pillar-pillar contact in the 550 nm-pillars resulted in an increased and maximum strain-dependent modulus but lower elastic recovery and energy dissipation as compared with the 250 nm-pillars. Furthermore, the compressive responses of temporarily shaped pillars (programmed by stretching) were compared with the permanently shaped pillars. The extent of lateral constraints controlled by pillar shape and spacing in 550 nm-pillars was responsible for the modulus differences between the original and stretched patterns, whereas the modulus of 250 nm-pillars remained as a constant value with different levels of stretching. This study provides mechanistic insights into how the mechanical behavior can be modulated by designing the aspect ratio of shape memory pillar arrays and by programming the surface geometry, thus revealing the potential of developing ingenious designs of responsive surfaces sensitive to mechanical deformation.

Morphometric structural diversity of a natural armor assembly investigated by 2D continuum strain analysis.

Many armored fish scale assemblies use geometric heterogeneity of subunits as a design parameter to provide tailored biomechanical flexibility while maintaining protection from external penetrative threats. This study analyzes the spatially varying shape of individual ganoid scales as a structural element in a biological system, the exoskeleton of the armored fish Polypterus senegalus (bichir). X-ray microcomputed tomography is used to generate digital 3D reconstructions of the mineralized scales. Landmark-based geometric morphometrics is used to measure the geometric variation among scales and to define a set of geometric parameters to describe shape variation. A formalism using continuum mechanical strain analysis is developed to quantify the spatial geometry change of the scales and illustrate the mechanisms of shape morphing between scales. Five scale geometry variants are defined (average, anterior, tail, ventral, and pectoral fin) and their functional implications are discussed in terms of the interscale mobility mechanisms that enable flexibility within the exoskeleton. The results suggest that shape variation in materials design, inspired by structural biological materials, can allow for tunable behavior in flexible composites made of segmented scale assemblies to achieve enhanced user mobility, custom fit, and flexibility around joints for a variety of protective applications.

Pervasive nanoscale deformation twinning as a catalyst for efficient energy dissipation in a bioceramic armour.

Hierarchical composite materials design in biological exoskeletons achieves penetration resistance through a variety of energy-dissipating mechanisms while simultaneously balancing the need for damage localization to avoid compromising the mechanical integrity of the entire structure and to maintain multi-hit capability. Here, we show that the shell of the bivalve Placuna placenta (~99 wt% calcite), which possesses the unique optical property of ~80% total transmission of visible light, simultaneously achieves penetration resistance and deformation localization via increasing energy dissipation density (0.290 ± 0.072 nJ µm(-3)) by approximately an order of magnitude relative to single-crystal geological calcite (0.034 ± 0.013 nJ µm(-3)). P. placenta, which is composed of a layered assembly of elongated diamond-shaped calcite crystals, undergoes pervasive nanoscale deformation twinning (width ~50 nm) surrounding the penetration zone, which catalyses a series of additional inelastic energy dissipating mechanisms such as interfacial and intracrystalline nanocracking, viscoplastic stretching of interfacial organic material, and nanograin formation and reorientation.

Flexibility and protection by design: imbricated hybrid microstructures of bio-inspired armor.

Inspired by the imbricated scale-tissue flexible armor of elasmoid fish, we design hybrid stiff plate/soft matrix material architectures and reveal their ability to provide protection against penetration while preserving flexibility. Indentation and bending tests on bio-inspired 3D-printed prototype materials show that both protection and flexibility are highly tunable by geometrical parameters of the microstructure (plate inclination angle and volume fraction). We show that penetration resistance can be amplified by a factor of 40, while flexibility decreases in less than 5 times. Different deformation resistance mechanisms are found to govern flexibility (inter-plate matrix shear) versus penetration resistance (localized plate bending) for this microstructural architecture which, in turn, enables separation of these functional requirements in the material design. These experiments identify the tradeoffs between these typically conflicting properties as well as the ability to design the most protective material architecture for a required flexibility, providing new design guidelines for enhanced flexible armor systems.

Molecular adhesion between cartilage extracellular matrix macromolecules.

In this study, we investigated the molecular adhesion between the major constituents of cartilage extracellular matrix, namely, the highly negatively charged proteoglycan aggrecan and the type II/IX/XI fibrillar collagen network, in simulated physiological conditions. Colloidal force spectroscopy was applied to measure the maximum adhesion force and total adhesion energy between aggrecan end-attached spherical tips (end radius R ≈ 2.5 µm) and trypsin-treated cartilage disks with undamaged collagen networks. Studies were carried out in various aqueous solutions to reveal the physical factors that govern aggrecan-collagen adhesion. Increasing both ionic strength and [Ca(2+)] significantly increased adhesion, highlighting the importance of electrostatic repulsion and Ca(2+)-mediated ion bridging effects. In addition, we probed how partial enzymatic degradation of the collagen network, which simulates osteoarthritic conditions, affects the aggrecan-collagen interactions. Interestingly, we found a significant increase in aggrecan-collagen adhesion even when there were no detectable changes at the macro- or microscales. It is hypothesized that the aggrecan-collagen adhesion, together with aggrecan-aggrecan self-adhesion, works synergistically to determine the local molecular deformability and energy dissipation of the cartilage matrix, in turn, affecting its macroscopic tissue properties.

High-bandwidth AFM-based rheology reveals that cartilage is most sensitive to high loading rates at early stages of impairment.

Utilizing a newly developed atomic-force-microscopy-based wide-frequency rheology system, we measured the dynamic nanomechanical behavior of normal and glycosaminoglycan (GAG)-depleted cartilage, the latter representing matrix degradation that occurs at the earliest stages of osteoarthritis. We observed unique variations in the frequency-dependent stiffness and hydraulic permeability of cartilage in the 1 Hz-to-10 kHz range, a frequency range that is relevant to joint motions from normal ambulation to high-frequency impact loading. Measurement in this frequency range is well beyond the capabilities of typical commercial atomic force microscopes. We showed that the dynamic modulus of cartilage undergoes a dramatic alteration after GAG loss, even with the collagen network still intact: whereas the magnitude of the dynamic modulus decreased two- to threefold at higher frequencies, the peak frequency of the phase angle of the modulus (representing fluid-solid frictional dissipation) increased 15-fold from 55 Hz in normal cartilage to 800 Hz after GAG depletion. These results, based on a fibril-reinforced poroelastic finite-element model, demonstrated that GAG loss caused a dramatic increase in cartilage hydraulic permeability (up to 25-fold), suggesting that early osteoarthritic cartilage is more vulnerable to higher loading rates than to the conventionally studied "loading magnitude". Thus, over the wide frequency range of joint motion during daily activities, hydraulic permeability appears the most sensitive marker of early tissue degradation.

Age-related nanostructural and nanomechanical changes of individual human cartilage aggrecan monomers and their glycosaminoglycan side chains.

The nanostructure and nanomechanical properties of aggrecan monomers extracted and purified from human articular cartilage from donors of different ages (newborn, 29 and 38 year old) were directly visualized and quantified via atomic force microscopy (AFM)-based imaging and force spectroscopy. AFM imaging enabled direct comparison of full length monomers at different ages. The higher proportion of aggrecan fragments observed in adult versus newborn populations is consistent with the cumulative proteolysis of aggrecan known to occur in vivo. The decreased dimensions of adult full length aggrecan (including core protein and glycosaminoglycan (GAG) chain trace length, end-to-end distance and extension ratio) reflect altered aggrecan biosynthesis. The demonstrably shorter GAG chains observed in adult full length aggrecan monomers, compared to newborn monomers, also reflects markedly altered biosynthesis with age. Direct visualization of aggrecan subjected to chondroitinase and/or keratanase treatment revealed conformational properties of aggrecan monomers associated with chondroitin sulfate (CS) and keratan sulfate (KS) GAG chains. Furthermore, compressive stiffness of chemically end-attached layers of adult and newborn aggrecan was measured in various ionic strength aqueous solutions. Adult aggrecan was significantly weaker in compression than newborn aggrecan even at the same total GAG density and bath ionic strength, suggesting the importance of both electrostatic and non-electrostatic interactions in nanomechanical stiffness. These results provide molecular-level evidence of the effects of age on the conformational and nanomechanical properties of aggrecan, with direct implications for the effects of aggrecan nanostructure on the age-dependence of cartilage tissue biomechanical and osmotic properties.

Mechanical reinforcement of polymeric fibers through peptide nanotube incorporation.

High aspect ratio nanotubular assemblies can be effective fillers in mechanically reinforced composite materials. However, most existing nanotubes used for structural purposes are limited in their range of mechanical, chemical, and biological properties. We demonstrate an alternative approach to mechanical reinforcement of polymeric systems by incorporating synthetic D,L-cyclic peptide nanotube bundles as a structural filler in electrospun poly D-, L-lactic acid fibers. The nanotube bundles self-assemble through dynamic hydrogen bonding from synthetic cyclic peptides to yield structures whose dimensions can be altered based on processing conditions, and can be up to hundreds of micrometers long and several hundred nanometers wide. With 8 wt % peptide loading, the composite fibers are >5-fold stiffer than fibers composed of the polymer alone, according to atomic force microscopy-based indentation experiments. This represents a new use for self-assembling cyclic peptides as a load-bearing component in biodegradable composite materials.

Protection mechanisms of the iron-plated armor of a deep-sea hydrothermal vent gastropod.

Biological exoskeletons, in particular those with unusually robust and multifunctional properties, hold enormous potential for the development of improved load-bearing and protective engineering materials. Here, we report new materials and mechanical design principles of the iron-plated multilayered structure of the natural armor of Crysomallon squamiferum, a recently discovered gastropod mollusc from the Kairei Indian hydrothermal vent field, which is unlike any other known natural or synthetic engineered armor. We have determined through nanoscale experiments and computational simulations of a predatory attack that the specific combination of different materials, microstructures, interfacial geometries, gradation, and layering are advantageous for penetration resistance, energy dissipation, mitigation of fracture and crack arrest, reduction of back deflections, and resistance to bending and tensile loads. The structure-property-performance relationships described are expected to be of technological interest for a variety of civilian and defense applications.

Poroelastic behavior and water permeability of human skin at the nanoscale.

Topical skin care products and hydrating compositions (moisturizers or injectable fillers) have been used for years to improve the appearance of, for example facial wrinkles, or to increase "plumpness". Most of the studies have addressed these changes based on the overall mechanical changes associated with an increase in hydration state. However, little is known about the water mobility contribution to these changes as well as the consequences to the specific skin layers. This is important as the biophysical properties and the biochemical composition of normal stratum corneum, epithelium, and dermis vary tremendously from one another. Our current studies and results reported here have focused on a novel approach (dynamic atomic force microscopy-based nanoindentation) to quantify biophysical characteristics of individual layers of ex vivo human skin. We have discovered that our new methods are highly sensitive to the mechanical properties of individual skin layers, as well as their hydration properties. Furthermore, our methods can assess the ability of these individual layers to respond to both compressive and shear deformations. In addition, since human skin is mechanically loaded over a wide range of deformation rates (frequencies), we studied the biophysical properties of skin over a wide frequency range. The poroelasticity model used helps to quantify the hydraulic permeability of the skin layers, providing an innovative method to evaluate and interpret the impact of hydrating compositions on water mobility of these different skin layers.

Three-dimensional structure of the shell plate assembly of the chiton Tonicella marmorea and its biomechanical consequences.

This study investigates the three-dimensional structure of the eight plate exoskeletal (shell) assembly of the chiton Tonicella marmorea. X-ray micro-computed tomography and 3D printing elucidate the mechanism of conformational change from a passive (slightly curved, attached to surface) to a defensive (rolled, detached from surface) state of the plate assembly. The passive and defensive conformations exhibited differences in longitudinal curvature index (0.43 vs. 0.70), average plate-to-plate overlap (∼62% vs. ∼48%), cross-sectional overlap heterogeneity (60-82.5% vs. 0-90%, fourth plate), and plate-to-plate separation distance (100% increase in normalized separation distance between plates 4 and 5), respectively. The plate-to-plate interconnections consist of two rigid plates joined by a compliant, actuating muscle, analogous to a geometrically structured shear lap joint. This work provides an understanding of how T. marmorea achieves the balance between mobility and protection. In the passive state, the morphometry of the plates and plate-to-plate interconnections results in an approximately continuous curvature and constant armor thickness, resulting in limited mobility but maximum protection. In the defensive state, the underlying soft tissues gain protection and the chiton gains mobility through tidal flow, but regions of vulnerability open dorsally, due to the increase in plate-to-plate separation and decrease in plate-to-plate overlap. Lastly, experiments using optical and scanning electron microscopy, mercury porosimetry, and Fourier-transform infrared spectroscopy explore the microstructure and spatial distribution of the six layers within the intermediate plates, the role of multilayering in resisting predatory attacks, and the detection of chitin as a major component of the intra-plate organic matrix and girdle.

Drastically lowered protein adsorption on microbicidal hydrophobic/hydrophilic polyelectrolyte multilayers.

Polyelectrolyte multilayer films assembled from a hydrophobic N-alkylated polyethylenimine and a hydrophilic polyacrylate were discovered to exhibit strong antifouling, as well as antimicrobial, activities. Surfaces coated with these layer-by-layer (LbL) films, which range from 6 to 10 bilayers (up to 45 nm in thickness), adsorbed up to 20 times less protein from blood plasma than the uncoated controls. The dependence of the antifouling activity on the nature of the polycation, as well as on assembly conditions and the number of layers in the LbL films, was investigated. Changing the hydrophobicity of the polycation altered the surface composition and the resistance to protein adsorption of the LbL films. Importantly, this resistance was greater for coated surfaces with the polyanion on top; for these films, the average zeta potential pointed to a near neutral surface charge, thus, presumably minimizing their electrostatic interactions with the protein. The film surface exhibited a large contact angle hysteresis, indicating a heterogeneous topology likely due to the existence of hydrophobic-hydrophilic regions on the surface. Scanning electron micrographs of the film surface revealed the existence of nanoscale domains. We hypothesize that the existence of hydrophobic/hydrophilic nanodomains, as well as surface charge neutrality, contributes to the LbL film's resistance to protein adsorption.

Direct quantification of the mechanical anisotropy and fracture of an individual exoskeleton layer via uniaxial compression of micropillars.

A common feature of the outer layer of protective biological exoskeletons is structural anisotropy. Here, we directly quantify the mechanical anisotropy and fracture of an individual material layer of a hydroxyapatite-based nanocomposite exoskeleton, the outmost ganoine of Polypterus senegalus scale. Uniaxial compression was conducted on cylindrical micropillars of ganoine fabricated via focused ion beam at different orientations relative to the hydroxyapatite rod long axis (θ = 0°, 45°, 90°). Engineering stress versus strain curves revealed significant elastic and plastic anisotropy, off-axial strain hardening, and noncatastrophic crack propagation within ganoine. Off-axial compression (θ = 45°) showed the lowest elastic modulus, E (36.2 ± 1.6 GPa, n ≥ 10, mean ± SEM), and yield stress, σ(Y) (0.81 ± 0.02 GPa), while compression at θ = 0° showed the highest E (51.8 ± 1.7 GPa) and σ(Y) (1.08 ± 0.05 GPa). A 3D elastic-plastic composite nanostructural finite element model revealed this anisotropy was correlated to the alignment of the HAP rods and could facilitate energy dissipation and damage localization, thus preventing catastrophic failure upon penetration attacks.

Aggrecan: Approaches to Study Biophysical and Biomechanical Properties.

Aggrecan, the most abundant extracellular proteoglycan in cartilage (~35% by dry weight), plays a key role in the biophysical and biomechanical properties of cartilage. Here, we review several approaches based on atomic force microscopy (AFM) to probe the physical, mechanical, and structural properties of aggrecan at the molecular level. These approaches probe the response of aggrecan over a wide time (frequency) scale, ranging from equilibrium to impact dynamic loading. Experimental and theoretical methods are described for the investigation of electrostatic and fluid-solid interactions that are key mechanisms underlying the biomechanical and physicochemical functions of aggrecan. Using AFM-based imaging and nanoindentation, ultrastructural features of aggrecan are related to its mechanical properties, based on aggrecans harvested from human vs bovine, immature vs mature, and healthy vs osteoarthritic cartilage.

Socially-Directed Development of Materials for Structural Color.

Advancing a socially-directed approach to materials research and development is an imperative to address contemporary challenges and mitigate future detrimental environmental and social impacts. This paper reviews, synergizes, and identifies cross-disciplinary opportunities at the intersection of materials science and engineering with humanistic social sciences fields. Such integrated knowledge and methodologies foster a contextual understanding of materials technologies embedded within, and impacting broader societal systems, thus informing decision making upstream and throughout the entire research and development process toward more socially responsible outcomes. Technological advances in the development of structural color, which arises due to the incoherent and coherent scattering of micro-and nanoscale features and possesses a vast design space, are considered in this context. Specific areas of discussion include material culture, narratives, and visual perception, material waste and use, environmental and social life cycle assessment, and stakeholder and community engagement. A case study of the technical and social implications of bio-based cellulose (as a source for structurally colored products) is provided. Socially-directed research and development of materials for structural color hold significant capacity for improved planetary and societal impact across industries such as aerospace, consumer products, displays and sensors, paints and dyes, and food and agriculture.

COVID-19 Vaccination Among Environmental Service Workers Using Agents of Change.

Introduction: Vaccine hesitancy remains a barrier to community immunity against SARS-CoV-2 infection. Health care workers are at risk both of infection and for nosocomial transmission, but have low rates of vaccine uptake due to hesitancy. This project sought to improve the SARS-CoV-2 vaccine uptake among environmental services (EVS) workers at a large academic regional medical center using a community-based participatory approach (CBPA). Methods: The CBPA engaged environmental service workers from January 2021 to March 2021. Public health experts and environmental services department leaders developed a 1-hour training for peer lay health educators (N=29), referred to as agents of change (AOC). AOC were trained on COVID-19 infection, benefits of SARS-CoV-2 vaccination, and techniques to address vaccine misinformation among their peers. Following the program, we conducted semistructured interviews with the AOC to document their experiences. Results: Analysis of the semistructured interviews shows that 89.6% of participants (N=26) felt the training was informative; 79.3% of participants (N=23) reported using personal testimony while engaging in discussions about vaccination with their peers, and the majority of participants (N=26, 89.6%) discussed vaccination outside of the workplace in other community settings. During the 2-month time span of the program, mRNA COVID-19 vaccination rates among the EVS staff increased by 21% (N=126 to N=189). Conclusion: Our CBPA program demonstrated an increase in mRNA COVID-19 vaccine uptake through using an AOC lay health educator model. As the need for COVID-19 vaccination continues, we must continue to investigate barriers and sources of hesitancy in order to address these through tailored interventions.