Understanding and minimizing coronavirus disease 2019 (COVID‐19) vaccine hesitancy is critical to population health and minimizing health inequities, which continue to be brought into stark relief by the pandemic. We investigate questions regarding vaccine hesitancy in a sample (n = 1205) of Arkansas adults surveyed online in July/August of 2020. We examine relationships among sociodemographics, COVID‐19 health literacy, fear of COVID‐19 infection, general trust in vaccines, and COVID‐19 vaccine hesitancy using bivariate analysis and a full information maximum likelihood (FIML) logistic regression model. One in five people (21,21.86%) reported hesitancy to take a COVID‐19 vaccine. Prevalence of COVID‐19 vaccine hesitancy was highest among Black/African Americans (50.00%), respondents with household income less than $25K (30.68%), some college (32.17%), little to no fear of infection from COVID‐19 (62.50%), and low trust in vaccines in general (55.84%). Odds of COVID‐19 vaccine hesitancy were 2.42 greater for Black/African American respondents compared to White respondents (p < 0.001), 1.67 greater for respondents with some college/technical degree compared to respondents with a 4‐year degree (p < 0.05), 5.48 greater for respondents with no fear of COVID‐19 infection compared to those who fear infection to a great extent (p < 0.001), and 11.32 greater for respondents with low trust in vaccines (p < 0.001). Sociodemographic differences in COVID‐19 vaccine hesitancy raise concerns about the potential of vaccine implementation to widen existing health disparities in COVID‐19 related infections, particularly among Black/African Americans. Fear of infection and general mistrust in vaccines are significantly associated with vaccine hesitancy.

Arkansas COVID-19 vaccine uptake has been lower than the national average. This study examined associations between sociodemographic factors and COVID-19 vaccine hesitancy, fear of infection, and protection self-efficacy. Adults either residing, having employment, or receiving health care in Arkansas (n = 754) participated in an online survey between October 30, 2020 and January 16, 2021. Participants were recruited in both rural and urban areas from 6 Arkansas primary care clinics. Survey questions addressed sociodemographic factors, COVID-19 infection fear, protection self-efficacy, and COVID-19 vaccine attitudes. Bivariate and multivariable logistic regression models were used to assess associations between dependent variables and respondents’ sociodemographic characteristics, COVID-19 infection fear, and COVID-19 protection self-efficacy. About 38% of participants reported COVID-19 vaccine hesitancy. Age, sex, race, and education were significantly associated with COVID-19 and general vaccine attitudes. Odds of COVID-19 vaccine hesitancy decreased as age increased (OR = 0.98; P < .01). Women had higher odds of COVID-19 vaccine hesitancy than men (OR = 1.52; P < .05). Respondents with a high school diploma and below and respondents with some college or a technical degree had greater odds of COVID-19 vaccine hesitancy (OR = 2.58; P < .001; and OR = 1.97; P < .01, respectively) compared to respondents with a 4-year college degree. Black/African American respondents had greater odds of COVID-19 vaccine hesitancy compared to White respondents (OR = 3.08; P < .001). No significant difference was observed among rural and urban respondents regarding COVID-19 vaccine hesitancy; however, respondents in rural areas were more likely to report low general vaccine trust compared to those in urban areas (OR = 1.87; P < .01). Respondents reporting no fear (OR = 5.51; P < .001) and very little fear (OR = 1.95; P < .05) of COVID-19 had greater odds of COVID-19 vaccine hesitancy compared to respondents who feared COVID-19 infection to a great extent. COVID-19 vaccine hesitancy and general trust in vaccines differ significantly among age, sex, race, and education. These trust and hesitancy patterns are challenges for achieving population immunity and follow similar patterns of vulnerability to COVID-19. Vaccination programs and interventions must consider these differences in COVID-19 vaccine hesitancy and general vaccine trust to alleviate COVID-19 disparities. Findings make a significant contribution in evaluating vaccine hesitancy among a large, diverse sample from a rural state.

(1) Background: Prior studies have documented that access to testing has not been equitable across all communities in the US, with less testing availability and lower testing rates documented in rural counties and lower income communities. However, there is limited understanding of the perceived barriers to coronavirus disease 2019 (COVID-19) testing. The purpose of this study was to document the perceived barriers to COVID-19 testing. (2) Methods: Arkansas residents were recruited using a volunteer research participant registry. Participants were asked an open-ended question regarding their perceived barriers to testing. A qualitative descriptive analytical approach was used. (3) Results: Overall, 1221 people responded to the open-ended question. The primary barriers to testing described by participants were confusion and uncertainty regarding testing guidelines and where to go for testing, lack of accessible testing locations, perceptions that the nasal swab method was too painful, and long wait times for testing results. (4) Conclusions: This study documents participant reported barriers to COVID-19 testing. Through the use of a qualitative descriptive method, participants were able to discuss their concerns in their own words. This work provides important insights that can help public health leaders and healthcare providers with understanding and mitigating barriers to COVID-19 testing.

The Republic of the Marshall Islands is a sovereign nation previously under the administrative control of the United States. Since 1986, the Compacts of Free Association (COFA) between the Republic of the Marshall Islands and the United States allows Marshall Islands citizens to freely enter, lawfully reside, and work in the United States, and provides the United States exclusive military control of the region. When the COFA was signed, COFA migrants were eligible for Medicaid and other safety net programs. However, these migrants were excluded from benefits as a consequence of the Personal Responsibility and Work Opportunity Reconciliation Act. Currently, COFA migrants have limited access to health care benefits in the United States, which perpetuates health inequalities.

Background: The study identifies the experiences, preferences, and perceptions of research participants regarding dissemination of research findings at the participant level and community level. Methods: The qualitative study utilized focus-group methodology to explore research participants' experiences and preferences for the dissemination of research findings. Five focus groups were held with 53 participants who were recruited through existing community advisory boards in Arkansas. Results: Participants stated that researchers should always offer to share research findings. Participants explained that disseminating findings is appropriate because of their sense of ownership of results, it encourages participation facilitating higher quality research, and it may foster greater trust between researchers and participants. Participants also provided insights on how research findings should be shared, including recommendations for appropriate mode, timing, and context, as well as ways to share sensitive findings and the role of community partners in dissemination. Conclusions: This study is consistent with other studies that document participants' desire to receive research findings and expands our knowledge by documenting participants' rationale for why they think it is important and their recommendations for how to share results. Further research is needed to understand why researchers are not disseminating study findings to participants and to test the best ways to share results.