Using the GRADE Evidence to Decision Framework to reach recommendations together with ethnic minority community organisations: the example of COVID-19 vaccine uptake in the UK.

OBJECTIVE To make recommendations regarding factors that affect COVID-19 vaccine uptake by ethnic minority individuals in the UK, together with strategies that could be used to increase uptake. STUDY DESIGN AND SETTING The results of two rapid systematic reviews- one identifying factors that affect respiratory vaccine uptake in ethnic minority adults, the other identifying experimental evaluations of strategies to increase vaccine uptake in ethnic minority adults- were put into GRADE Evidence to Decision Frameworks to support discussion with a panel of ethnic minority community organisations, community-focused small companies and academics of the relevance of the review findings to the UK COVID context. Aided by the Frameworks, the panel made recommendations for factors that need to be addressed to increase vaccine uptake, and for which strategies might be used to increase uptake. RESULTS Our two reviews contained 31 relevant research studies published in English between 2016 and 2021, all of which were from the UK (8/31), the US (20) and Australia (3). We identified six factors- two linked to trust, three linked to information and one on accessibility - that affected uptake. Strategies that had been evaluated fell into three categories: using trusted messengers, tailoring the message and increasing convenience. These were put into GRADE Evidence to Decision Frameworks and discussed over a series of meetings with individuals from nine ethnic minority community organisations, two community-focused small companies and academics. Community partners provided insight into why ethnic minority individuals in the UK had lower vaccine uptake, particularly with regard to the impact of non-health related UK Government policy on individuals' heath decision-making. Recommendations included recognising that trust will be low among some ethnic groups, thinking more broadly as to who messengers should be in a low-trust environment, ensuring that information is tailored to the information needs of specific ethnic groups and working to increase convenience. Our results are at https://www.collaborationforchange.co.uk. CONCLUSION GRADE Evidence to Decision Frameworks could be used more widely to structure discussions of research evidence between researchers, community organisations and other non-research partners.