Evidence map›Paper›PMID 41120921›Full record

ArticleBMC public health2025

Barriers and facilitating factors for COVID-19 vaccination in rural appalachia.

Kathryn M Cardarelli, Rachel Gillespie, Anna Goodman Hoover, Diane B Francis, Marc T Kiviniemi

Abstract read
In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kathryn M CardarelliDepartment of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, 485 E. Gray Street, Louisville, KY, 40202, USA. kathryn.cardarelli@louisville.edu.
Rachel GillespieDepartment of Health, Behavior and Society, College of Public Health, University of Kentucky, 111 Washington Ave Lexington, Lexington, KY, 40506, USA.
Anna Goodman HooverDepartment of Epidemiology and Environmental Health, College of Public Health, University of Kentucky, 111 Washington Ave Lexington, Lexington, KY, 40506, USA.
Diane B FrancisDepartment of Communication Studies, College of Arts, Media and Design, Northeastern University, 360 Huntington Ave, Boston, MA, 02115, USA.
Marc T KiviniemiDepartment of Health, Behavior and Society, College of Public Health, University of Kentucky, 111 Washington Ave Lexington, Lexington, KY, 40506, USA.

Funding

K-VAC: Kentucky Vaccinating Appalachian CommunitiesR01MD016864 · NIMHD · UNIVERSITY OF KENTUCKY · PI CARDARELLI, KATHRYN MARIE, KIVINIEMI, MARC T · 2022 to 2025
$2.5M
NIH HHS R01MD016864NIMHD NIH HHS R01 MD016864
6 · The paper itself

Abstract

backgroundSince the onset of the pandemic, COVID-19 mortality has disproportionately impacted populations impacted by health inequities. This study aimed to identify the barriers and facilitators to COVID-19 vaccination uptake in Appalachian Kentucky as a first step to developing vaccination interventions.

methodsKey informant interviews were conducted with 36 community leaders in 14 Appalachian Kentucky counties from January-June 2023. Interviews focused on leaders' perspectives about their community's COVID-19 experiences, community impacts of the pandemic, and vaccine facilitators and barriers in their communities. Iterative inductive-deductive coding was used to characterize responses.

resultsThere were barriers and facilitators at multiple levels of the socioecological model. For example, individual barriers included distrust of federal government and diminished perceived risk, and interpersonal barriers included anti-vaccination norms. Community barriers included logistical challenges, as well anti-vaccination messages from healthcare providers. Perceived politicization of the vaccine and frequent changes to recommendations during the pandemic presented policy-level barriers. Facilitating factors included pro-vaccine messages from trusted community leaders, beliefs about reducing risk for others, and cues to action such as community events.

conclusionsThe challenges to and opportunities for improving COVID-19 vaccination uptake identified here can inform vaccination education, distribution, and policy efforts in both Appalachian Kentucky and other communities with similar characteristics.

Indexed as

COVID-19COVID-19 VaccinesRural PopulationVaccinationAdultAppalachian RegionFemaleHealth Services AccessibilityHumansInterviews as TopicKentuckyMaleMiddle AgedQualitative ResearchCOVID-19 VaccinesAppalachiaCommunity-based participatory researchCOVID-19Vaccine accessVaccine uptake

Identifiers

PMID41120921
PMCPMC12538790

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.