This PEER project delves into two key aspects of health communication: gotong royong and the protector schema. Gotong royong, rooted in Javanese culture, embodies a sense of communal belonging and contribution. The protector schema serves as a strategy to promote healthy behaviors, such as vaccination, by appealing to individuals to safeguard specific people. Achieving high vaccination coverage is paramount to controlling the spread of vaccine-preventable diseases, and understanding community perceptions is instrumental in improving vaccination rates. Reducing negative perceptions toward vaccines hinges on fostering trust in the healthcare system, which the research team believes can be achieved through gotong royong. The protector schema builds upon these theories by asserting that health promotions emphasizing the positive impact of behavior on specific individuals, like family or teachers, are far more effective than generic messages.

 

In the planned activities, the Principal Investigator (PI) and the team will identify concerns, doubts, fears, and questions regarding the COVID-19 vaccine and its distribution. They will also explore the community's preferences for accessing vaccines and their willingness to support group initiatives. The primary output will be the development of a locally relevant program informed by evidence gathered through the gotong royong and protector schema paradigms. This program will encompass insights on who should deliver the message (considering gotong royong) and the content of the message (in line with the protector schema). The researchers will evaluate the program's effectiveness in a pilot study and share their materials and recommendations for global adoption.

During the recent reporting period, the team conducted in-depth interviews with ten respondents from diverse backgrounds to understand their perspectives on COVID-19 vaccines in their families. They aimed to gather insights on communication strategies, preferred media channels, and vaccine-related information delivery. Additionally, the team explored vaccine acceptance. In July and August, two University of Michigan master's students conducted a research internship at the Center of Health Behavior and Promotion and the Department of Health Behavior, Environment, and Social Medicine at UGM. Their research focused on quantitative data analysis, emphasizing "gotong royong" (community solidarity) and the "protector schema" in COVID-19 vaccine implementation. Site visits included the District Health Office, Primary Health Care centers, and community groups in intervention areas. They analyzed survey data quantitatively, with the goal of publishing their findings in targeted journals. These publications will focus on COVID-19 vaccine acceleration in the context of "gotong royong" and the "protector schema." Bi-weekly Zoom meetings were held for paper development.

 

In response to new regulations in Indonesia shifting the approach from pandemic to endemic, the government disbanded the Committee on CoronaVirus Disease 2019 (COVID-19) and National Economic Recovery. Existing drugs and vaccines procured remain valid. The project continues to prioritize COVID-19 vaccination, adhering to government regulations, and collaborating with communities, village officials, and health facilities to promote vaccine acceptance. High-risk groups will be targeted for vaccination programs starting in January 2024, using InaVac and IndoVac vaccines. The team collaborates with the Indonesian Society of Internal Medicine Specialists to update vaccine implementation guidelines, especially in intervention areas.

 

During the election period in Indonesia, the team is creating educational materials, including videos and pocketbooks, to promote vaccine awareness without addressing sensitive political or religious issues. They emphasize vaccine benefits and debunk misconceptions. Online capacity-building activities, regular meetings, and door-to-door pre-post tests are planned to engage the community. Reviewers from healthcare, media, and psychology sectors provided feedback for material improvement.

 

Challenges have arisen during the intervention, including the transition from pandemic to endemic, the disbandment of the COVID-19 task force, and low public enthusiasm for vaccination. The team adapted by intensifying collaboration with primary healthcare and engaging multiple stakeholders. In the upcoming activities, capacity-building sessions will target community leaders, and a door-to-door approach will be used for priority groups. The team will conduct pre- and post-tests to assess intent to receive the vaccine.

 

In the next phase, from February to March 2024, the team will disseminate the intervention report online and prepare manuscripts for international journal publication.