Disinformation in the age of the Covid-19 pandemic: How does belief in fake news and conspiracy theories affect canadians' reactions to the crisis?

This chapter examines the concepts of mistrust, news habits, and attitudes toward social and health measures associated with Covid-19 crisis. The aim is to assess how beliefs in fake news and conspiracy theories impact the reaction of the Canadian population to the coronavirus pandemic. The analyses presented in this chapter aim to answer specific research questions who want (1) to investigate to what extent the pandemic-related conspiracy theories and fake news permeated the beliefs of Canadians;(2) to find the socio-demographic characteristics of the Canadian who subscribes to pandemic-related conspiracy theories and fake news;(3) to bring out the types of information sources used by the Canadians who subscribes to pandemic-related conspiracy theories and fake news;and (4) to reveal the social attitudes of the Canadian who subscribes to pandemic-related conspiracy theories and fake news. © Springer Nature Switzerland AG 2023. All rights reserved.

Avoiding Covid-19 risk information in the United States: The role of attitudes, norms, affect, social dominance orientations, and perceived trustworthiness of scientists.

This study seeks guidance from the planned risk information avoidance model to explore drivers of risk information avoidance in the context of COVID-19. Data were collected early during the pandemic. Among our most notable results is that participants who are more oriented toward social dominance and are more skeptical of scientists' credibility have (1) more supportive attitudes toward risk information avoidance and (2) feel social pressure to avoid risk information. The findings of this study highlight how the role of skepticism in science and intergroup ideologies, such as social dominance, can have important implications for how people learn about health-related information, even in times of heightened crisis.

Factors Associated With Coronavirus Disease 2019 Vaccine Uptake Among Pregnant Women and Nonpregnant Women of Reproductive Age in Jamaica.

Background: Despite high rates of coronavirus disease 2019 (COVID-19)-related maternal mortality, Jamaica currently has little data on COVID-19 vaccine uptake among pregnant women. Methods: We conducted a cross-sectional, web-based survey of 192 reproductive-aged women in Jamaica from February 1 to 8, 2022. Participants were recruited from a convenience sample of patients, providers, and staff at a teaching hospital. We assessed self-reported COVID-19 vaccination status and COVID-19-related medical mistrust (operationalized as vaccine confidence, government mistrust, and race-based mistrust). We used multivariable modified Poisson regression to test the association between vaccine uptake and pregnancy. Results: Of 192 respondents, 72 (38%) were pregnant. Most (93%) were Black. Vaccine uptake was 35% in pregnant women versus 75% in nonpregnant women. Pregnant women were more likely to cite healthcare providers versus the government as trustworthy sources of COVID-19 vaccine information (65% vs 28%). Pregnancy, low vaccine confidence, and government mistrust were associated with a lower likelihood of COVID-19 vaccination (adjusted prevalence ratio [aPR] = 0.68 [95% confidence interval {CI}, .49-.95], aPR = 0.61 [95% CI, .40-.95], and aPR = 0.68 [95% CI, .52-.89], respectively). Race-based mistrust was not associated with COVID-19 vaccination in the final model. Conclusions: Pregnancy, low vaccine confidence, and government mistrust were associated with a lower likelihood of COVID-19 vaccination among reproductive-aged women in Jamaica. Future studies should evaluate the efficacy of strategies proven to improve maternal vaccination coverage, including standing "opt-out" vaccination orders and collaborative provider and patient-led educational videos tailored for pregnant individuals. Strategies that decouple vaccine messaging from government agencies also warrant evaluation.

More than a Message: Public Health Advocacy, Political Cartooning and COVID-19 Challenges in Pakistan

Political cartooning has a long history in news media across the globe. The literature supports the view that these cartoons have the capacity to convey hard-hitting information within the context of satirical humor. Their importance and impact are unquestioned, including during times of crisis. Within the COVID-19 global pandemic, the unique focus that political cartoons place on a variety of institutions has been noteworthy. These include governments, especially those that have responded inadequately. Perhaps most notable is the United States. The degree of American government failure is highlighted when juxtaposed with similar failures of "Third World” nations and their governments. Pakistan is one example. During the pandemic, the approach of Pakistan's government has been consistent with its past behavior - subjugating enemies while abandoning the public. Political cartoonists uniquely analyze events and issues through their visual commentary, often in ways that narrative op-ed pieces do not. This chapter examines political cartooning during the pandemic with a global focus, examining cartoons in the Pakistani news media primarily. Political cartooning was a kind of protective reaction to the alarming situation in which the world was found. Warning, mistrust, aggression, depression, frustration, loss, anger, disappointment, terror, and fear have been the most prominent labels that were reflected in almost all political cartoons of COVID-19 in Pakistan. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Equity and Perioperative Care

The COVID-19 pandemic, with its disproportionate impact on historically marginalized populations, highlighted underlying inequities in society that can lead to disparate health outcomes and increased attention to the need to address health disparities. Although different countries may have different issues relating to health disparities, this chapter describes approaches that can be broadly applied to improve health equity and reduce disparities in perioperative care. © 2023 Elsevier Inc. All rights reserved.

THE FOURTH ETHICAL COMMENT TOWARDS COVID-19 (three years later). TRUST AND FAITH: SOCIAL AND MORAL PROFILE OF VACCINATION.

The summarizing up the semantic and systemic results should comprise the next phase to provide insights into COVID-19 pandemic and consider it as a modern epidemic and humanitarian crisis on global level. The journal <<Infection and Immunity>> regularly and consistently present the results of ethically viewed legal framework of the pandemic and the administrative regulation of the public health system. Analysis and ethical assessment of the situation covers a wide range of issues, including the provision and operational adaptation of the regulatory framework, the problems of medical care, the processes and conditions for developing diagnostics, treatment and prevention, as well as all aspects related to the organization and implementing vaccination. Three previous ethical comments presented in 2020-2022 during the pandemic were devoted to these issues. Current study within the framework of the <<fourth ethical commentary>> follows directly from the data obtained while evaluating and analysing real-world experience on vaccination in the context of a regional cluster - the CIS member states, presented in the previous article. The perceived need and obvious significance of the study is to highlight objective factors of vulnerability in the vaccination during the COVID-19 pandemic and identify the response spectrum to form trust/or distrust to vaccination in various sectors of society, depending on a set of social and moral factors, including those coupled to a religious denomination. The data obtained are of paramount importance to find the moral ways to support and stabilize a responsible attitude with the aim to protect moral, social and physical health in emergency situations.Copyright © 2023 Saint Petersburg Pasteur Institute. All rights reserved.

At the intersection of trust and mistrust: A qualitative analysis of motivators and barriers to research participation at a safety-net hospital.

INTRODUCTION: The underrepresentation of Black, Indigenous, and People of Color (BIPOC) individuals in healthcare research limits generalizability and contributes to healthcare inequities. Existing barriers and attitudes toward research participation must be addressed to increase the representation of safety net and other underserved populations. METHODS: We conducted semi-structured qualitative interviews with patients at an urban safety net hospital, focusing on facilitators, barriers, motivators, and preferences for research participation. We conducted direct content analysis guided by an implementation framework and used rapid analysis methods to generate final themes. RESULTS: We completed 38 interviews and identified six major themes related to preferences for engagement in research participation: (1) wide variation in research recruitment preferences; (2) logistical complexity negatively impacts willingness to participate; (3) risk contributes to hesitation toward research participation; (4) personal/community benefit, interest in study topic, and compensation serve as motivators for research participation; (5) continued participation despite reported shortcomings of informed consent process; and (6) mistrust could be overcome by relationship or credibility of information sources. CONCLUSION: Despite barriers to participation in research studies among safety-net populations, there are also facilitators that can be implemented to increase knowledge and comprehension, ease of participation, and willingness to join research studies. Study teams should vary recruitment and participation methods to ensure equal access to research opportunities. PATIENT/PUBLIC CONTRIBUTION: Our analysis methods and study progress were presented to individuals within the Boston Medical Center healthcare system. Through this process community engagement specialists, clinical experts, research directors, and others with significant experience working with safety-net populations supported data interpretation and provided recommendations for action following the dissemination of data.

Understanding medical mistrust and HPV vaccine hesitancy among multiethnic parents in Los Angeles.

Determinants of parental HPV vaccine hesitancy, including medical mistrust and exposure to negative vaccine information, are understudied in racial/ethnic minority communities where vaccine uptake is low. We conducted a cross-sectional survey (March 2021) among parents of adolescents, ages 9-17 years, from an academic enrichment program serving low-income, first-generation, underrepresented minority families in Los Angeles to understand determinants of parental HPV vaccine hesitancy. Parents completed self-administered surveys, including a 9-item HPV vaccine hesitancy scale, in either English, Spanish, or Chinese. Logistic regression was used to identify individual and interpersonal factors associated with parental hesitancy and adolescent HPV vaccination. One-fifth of parents (n = 357) reported high HPV vaccine hesitancy and > 50% reported concerns about safety or side effects. High medical mistrust was associated with high parental HPV vaccine hesitancy (adjusted-OR 1.69, 95% CI: 1.13, 2.37). Community-tailored and multilevel strategies to increase vaccine confidence are needed to improve HPV and other adolescent vaccinations.

COVID-19 Vaccine Hesitancy, Medical Mistrust, and Mattering in Ethnically Diverse Communities.

OBJECTIVES: Uptake of the COVID-19 vaccine continues to be lower in ethnically diverse communities in the UK even though they are disproportionally affected by the negative effects of the virus. To better understand why uptake is lower, we explored factors that may underpin vaccine hesitancy and intention to vaccinate in these communities with an emphasis on medical mistrust and feelings of mattering. DESIGN: One hundred and sixty-one adults from ethnically diverse backgrounds who had not had a COVID-19 vaccination completed an online questionnaire that contained closed (quantitative) and open (qualitative) questions. RESULTS: Analyses of quantitative questions revealed that medical mistrust, but not feelings of mattering, was related to COVID-19 hesitancy and likelihood of getting a COVID-19 vaccination. Of the three components of medical mistrust, suspicion was the only unique predictor and was related to higher hesitancy towards the COVID-19 vaccine and lower likelihood of getting a COVID-19 vaccine. Analyses of the responses to the qualitative questions were organised into four themes: (1) Beliefs that taking the vaccine is an important social responsibility; (2) Experiences of pressure to take the vaccine and limited choice; (3) General mistrust linked to personal experiences and the health system; (4) Being concerned about social/medical restrictions if not vaccinated. CONCLUSION: The findings suggest that medical mistrust may partly explain why uptake of the COVID-19 vaccine is lower in ethnically diverse communities in the UK and appears to play a role in how people weigh a sense of responsibility and pressure against health and social concerns in making the decision to be vaccinated.

Public health response to COVID-19 pandemic and drivers of mistrust in Ghana

Recent studies suggest that trust in government and public health experts is vital for acceptance of public health recommendations during the COVID-19 pandemic. It is increasingly clear that mistrust in public health recommendation affects efforts to slowdown the spread of COVID-19 in many countries. The objective of this study is to identify perceived drivers of mistrust in public health responses to COVID-19 in Ghana, using concept mapping with a range of local stakeholders (n = 21). The study was conducted between July and August 2020. Fifty-two items describing factors that influence mistrust in COVID-19 response were identified across eight themes. Out of eight clusters that emerged, participants rated weak health system, distrust in politicians and state institutions, and politicization of response measures as the most important and prevalent drivers of mistrust. The results show that the old narrative of cultural beliefs and illiteracy is not sufficient for understanding mistrust in public health programs during epidemics in SSA, at least in the case of COVID-19 in Ghana. This study demonstrates the need for global health practitioners to pay attention to structural forces and political relations in order to paint a fuller picture of mistrust during epidemics and pandemics. [ FROM AUTHOR] Copyright of African Geographical Review is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Human Rights Violations and Mistrust among Refugees in South Africa: Implications for Public Health during the COVID Pandemic

Despite the open policy of integration, refugees in South Africa have been experiencing increasing exclusion and discrimination in socio-economic development and from social services. State-sanctioned discrimination contributes to mistrust among marginalized groups toward the government and its institutions. However, public trust towards healthcare authorities and government institutions is critical during pandemic outbreaks to ensure the population's willingness to follow public health initiatives and protocols to contain the spread of a pandemic. Eleven key informants, including refugee community leaders and refugee-serving NGOs, were virtually interviewed about refugees' access to healthcare in South Africa during the COVID-19 pandemic and the consequences of inconsistent access and discrimination on their trust of public healthcare initiatives. Interviews were analyzed using critical thematic analysis. The results suggest that refugees' access to public healthcare services were perceived as exclusionary and discriminatory. Furthermore, the growing mistrust in institutions and authorities, particularly the healthcare system, and misperceptions of COVID-19 compromised refugees' trust and adherence to public health initiatives. This ultimately exacerbates the vulnerability of the refugee community, as well as the wellbeing of the overall population.

Vaccine mistrust among Black individuals in Canada: The major role of health literacy, conspiracy theories, and racial discrimination in the healthcare system.

The COVID-19 pandemic disproportionately affected Black communities in Canada in terms of infection and mortality rates compared to the general population. Despite these facts, Black communities are among those with the highest level of COVID-19 vaccine mistrust (COVID-19 VM). We collected novel data to analyze the sociodemographic characteristics and factors associated with COVID-19 VM among Black communities in Canada. A survey was conducted among a representative sample of 2002 Black individuals (51.66% women) aged 14-94 years (M = 29.34; SD = 10.13) across Canada. Vaccine mistrust was assessed as the dependent variable and conspiracy theories, health literacy, major racial discrimination in healthcare settings, and sociodemographic characteristics of participants were assessed as independent variables. Those with a history of COVID-19 infection had higher COVID-19 VM score (M = 11.92, SD = 3.88) compared to those with no history of infection (M = 11.25, SD = 3.83), t (1999) = -3.85, p < 0.001. Participants who reported having experienced major racial discrimination in healthcare settings were more likely to report COVID-19 VM (M = 11.92, SD = 4.03) than those who were not (M = 11.36, SD = 3.77), t (1999) = -3.05, p = 0.002. Results also showed significant differences for age, education level, income, marital status, provinces, language, employment status, and religion. The final hierarchical linear regression showed that conspiracy beliefs (B = 0.69, p < 0.001) were positively associated with COVID-19 VM, while health literacy (B = -0.05, p = 0.002) was negatively associated with it. The mediated moderation model showed that conspiracy theories completely mediated the association between racial discrimination and vaccine mistrust (B = 1.71, p < 0.001). This association was also completely moderated by the interaction between racial discrimination and health literacy (B = 0.42, p = 0.008), indicating that despite having a high level of health literacy, those who experienced major racial discrimination in health services developed vaccine mistrust. This first study on COVID-19 VM exclusively among Black individuals in Canada provides data that can significantly impact the development of tools, trainings, strategies, and programs to make the health systems free of racism and increase their confidence in vaccination for COVID-19 and other infectious diseases.

'15 days to slow the spread': Covid-19 and collective resilience

This essay is an exploration of how collective resilience can arise even in the worst of circumstances: a global pandemic that has adversely affected millions. Resilience can be a source of positivity, optimism and hope, and guide the kinds of behaviour to help overcome the challenges posed by COVID-19. This essay have identified three research pathways for collective resilience, but they are by no means exhaustive. People and communities will find other pathways to resilience;my hope is that this essay may spur future researchers to identify new possibilities, to good effect. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

An online investigation into factors related to Black maternal mortality using retrospective recall of a prior birth hospitalization with a risk of death- predicting medical mistrust

The problem that this study addressed was the high rate of maternal mortality for Black women in the United States, which has been rising, including before the COVID-19 pandemic. The goal was to identify significant predictors of medical mistrust. The study recruited a convenience sample via an online social media campaign. The resultant sample was 100% Black and female (N=192) with a mean age of 33.23 (SD= 4.980, min=24, max=61), while 94.8% were born in the United States (n=182). Using background stepwise regression, the following were found to be significant predictors of a higher level of medical mistrust: older age (B = .033, p = .001);higher levels of education (B = 0.205, p = .000);lower annual household income (B = -.055, p = .026);higher level of perceived racism, discrimination, and inequity in treatment from medical staff (B = 0.137, p = .046);lower levels of cultural sensitivity/ competence/ humility ratings for medical staff (B = -.155, p = .002);higher past year mental distress (i.e., Depression, Anxiety, Insomnia and Trauma) (B = .369, p = .000);and lower levels of social support post-partum (B = -0.162, p = .004)-with 46.5% of the variance predicted by the model (R2 = 0.698, Adjusted R2 = 0.465).The study findings highlight a crisis of Black maternal mortality in the United States, as well as a crisis in healthcare service delivery to Black women, as uncovered via this study. The data betrays a dimension of the crisis in healthcare service delivery to Black women who report experiencing discrimination for being Black at 75.5%, for their appearance (skin tone, hair, etc.) at 62.0%, and for being overweight or obese at 28.6%. Implications of the findings are discussed, while recommendations for future research are offered. In terms of those implications, perhaps most importantly, this data effectively identifies the year after a high-risk birth hospitalization as an essential time for ensuring Black women enter counseling with licensed and certified mental health professionals. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Coronavirus conspiracy beliefs, mistrust, and compliance: taking measurement seriously.

BACKGROUND: Freeman et al. (2020a, Psychological Medicine, 21, 1-13) argue that there is widespread support for coronavirus conspiracy theories in England. We hypothesise that their estimates of prevalence are inflated due to a flawed research design. When asking respondents to their survey to agree or disagree with pro-conspiracy statements, they used a biased set of response options: four agree options and only one disagree option (and no 'don't know' option). We also hypothesise that due to these flawed measures, the Freeman et al. approach under-estimates the strength of the correlation between conspiracy beliefs and compliance. Finally, we hypothesise that, due to reliance on bivariate correlations, Freeman et al. over-estimate the causal connection between conspiracy beliefs and compliance. METHODS: In a pre-registered study, we conduct an experiment embedded in a survey of a representative sample of 2057 adults in England (fieldwork: 16-19 July 2020). RESULTS: Measured using our advocated 'best practice' approach (balanced response options, with a don't know option), prevalence of support for coronavirus conspiracies is only around five-eighths (62.3%) of that indicated by the Freeman et al. approach. We report mixed results on our correlation and causation hypotheses. CONCLUSIONS: To avoid over-estimating prevalence of support for coronavirus conspiracies, we advocate using a balanced rather than imbalanced set of response options, and including a don't know option.

COVID-19 vaccine hesitancy in the UK: the Oxford coronavirus explanations, attitudes, and narratives survey (Oceans) II.

BACKGROUND: Our aim was to estimate provisional willingness to receive a coronavirus 2019 (COVID-19) vaccine, identify predictive socio-demographic factors, and, principally, determine potential causes in order to guide information provision. METHODS: A non-probability online survey was conducted (24th September-17th October 2020) with 5,114 UK adults, quota sampled to match the population for age, gender, ethnicity, income, and region. The Oxford COVID-19 vaccine hesitancy scale assessed intent to take an approved vaccine. Structural equation modelling estimated explanatory factor relationships. RESULTS: 71.7% (n=3,667) were willing to be vaccinated, 16.6% (n=849) were very unsure, and 11.7% (n=598) were strongly hesitant. An excellent model fit (RMSEA=0.05/CFI=0.97/TLI=0.97), explaining 86% of variance in hesitancy, was provided by beliefs about the collective importance, efficacy, side-effects, and speed of development of a COVID-19 vaccine. A second model, with reasonable fit (RMSEA=0.03/CFI=0.93/TLI=0.92), explaining 32% of variance, highlighted two higher-order explanatory factors: 'excessive mistrust' (r=0.51), including conspiracy beliefs, negative views of doctors, and need for chaos, and 'positive healthcare experiences' (r=-0.48), including supportive doctor interactions and good NHS care. Hesitancy was associated with younger age, female gender, lower income, and ethnicity, but socio-demographic information explained little variance (9.8%). Hesitancy was associated with lower adherence to social distancing guidelines. CONCLUSIONS: COVID-19 vaccine hesitancy is relatively evenly spread across the population. Willingness to take a vaccine is closely bound to recognition of the collective importance. Vaccine public information that highlights prosocial benefits may be especially effective. Factors such as conspiracy beliefs that foster mistrust and erode social cohesion will lower vaccine up-take.

Feeling too isolated to be vaccinated? The contributing role of subjective interpersonal isolation factors towards COVID-19 vaccine hesitancy and resistance.

OBJECTIVE: The present research examines how different forms of subjective isolation predict COVID-19 vaccine hesitancy and resistance with two online studies conducted in the U.S. METHODS: Study 1 (n = 695), conducted before COVID-19 vaccines were available, tested if different forms of subjective isolation predicted lower trust in potential COVID-19 vaccines. Study 2 (n = 674), conducted almost a year after COVID-19 vaccines were available, tested if different forms of subjective isolation predicted not being vaccinated. RESULTS: In Study 1, existential isolation and alienation predicted lower trust in potential COVID-19 vaccines, while loneliness did not. In Study 2, existential isolation and alienation, but not loneliness, predicted not getting vaccinated. CONCLUSION: Existential isolation and alienation are associated with negative attitudes and behavior towards vaccines and may contribute to decreased participation in public health-related behaviors.

Latent class analysis of medical mistrust and COVID-19 vaccine hesitancy among adults in the United States just prior to FDA emergency use authorization.

Using a nationally representative household sample, we sought to better understand types of medical mistrust as a driver of COVID-19 vaccine hesitancy. We used survey responses to conduct a latent class analysis to classify respondents into categories and explained this classification as a function of sociodemographic and attitudinal variables using multinomial logistic regression models. We then estimated the probability of respondents agreeing to receive a COVID-19 vaccine conditional on their medical mistrust category. We extracted a five-class solution to represent trust. The high trust group (53.0 %) is characterized by people who trust both their doctors and medical research. The trust in own doctor group (19.0 %) trust their own doctors but is ambiguous when it comes to trusting medical research. The high distrust group (6.3 %) neither trust their own doctor nor medical research. The undecided group (15.2 %) is characterized by people who agree on some dimensions and disagree on others. The no opinion group (6.2 %) did not agree nor disagree with any of the dimensions. Relative to the high trust group, those who trust their own doctors are almost 20 percentage points less likely to plan to get vaccinated (average marginal effect (AME) = 0.21, p <.001), and those who have high distrust are 24 percentage points less likely (AME = -0.24, p <.001) to report planning to get the vaccine. Results indicate that beyond sociodemographic characteristics and political attitudes, people's trust archetypes on parts of the medical field significantly predict their probability of wanting to get vaccinated. Our findings suggest that efforts to combat vaccine hesitancy should focus on building capacity of trusted providers to speak with their patients and parents of their patients, to recommend COVID-19 vaccination and build a trusting relationship; and increase trust and confidence in medical research.

Identity resilience, science mistrust, COVID-19 risk and fear predictors of vaccine positivity and vaccination likelihood: A survey of UK and Portuguese samples.

Based on Identity Process Theory, we hypothesised that two elements of identity resilience (identity worth and identity continuity) differentially predict variance in COVID-19 fear and risk, science mistrust, vaccine positivity, and vaccination likelihood. Data from an online survey of 643 UK and 485 Portuguese adults collected during March 2021 showed the UK and Portuguese did not differ significantly on vaccination likelihood or identity resilience. UK respondents reported less science mistrust, COVID-19 risk, and fear, but higher vaccine positivity than the Portuguese. Identity worth and identity continuity differed between countries in their effects on science mistrust, COVID-19 fear, risk, vaccine positivity and vaccination likelihood. Science mistrust and COVID-19 fear proved key factors in predicting vaccine positivity and vaccination likelihood. We conclude the roles of discrete elements of identity resilience in health behaviour require further examination and action reducing prevalence of specific forms of science mistrust can improve vaccination likelihood.

Narratives from African American/Black, American Indian/Alaska Native, and Hispanic/Latinx community members in Arizona to enhance COVID-19 vaccine and vaccination uptake.

The state of Arizona has experienced one of the highest novel coronavirus disease 2019 (COVID-19) positivity test rates in the United States with disproportionally higher case rates and deaths among African-American/Black (AA/B), American Indian/Alaska Native (Native), and Hispanic/Latinx (HLX) individuals. To reduce disparities and promote health equity, researchers from Arizona State University, Mayo Clinic in Arizona, Northern Arizona University, and the University of Arizona formed a partnership with community organizations to conduct state-wide community-engaged research and outreach. This report describes results from 34 virtually-held focus groups and supplemental survey responses conducted with 153 AA/B, HLX, and Native community members across Arizona to understand factors associated with COVID-19 vaccine hesitancy and confidence. Focus groups revealed common themes of vaccine hesitancy stemming from past experiences of research abuses (e.g., Tuskegee syphilis experiment) as well as group-specific factors. Across all focus groups, participants strongly recommended the use of brief, narrative vaccination testimonials from local officials, community members, and faith leaders to increase trust in science, vaccine confidence and to promote uptake.