Communities FOCUS Notification

Evaluation of Communities of FOCUS Learning Collaborative and Immunization Partner Vaccine Confidence and Demand-related Activities

Vaccine hesitancy has increased nationally over the past decade, resulting in decreasing coverage, particularly in some communities, where resistance to vaccination is high. The ensuing low coverage in these communities put them at risk of outbreaks, threatening not only the public health in those communities, but public health at large. Vaccine preventable diseases, such as measles, are at risk of losing their elimination status, attained via high coverage with 2-dose measles, mumps, and rubella (MMR) vaccine. Similarly, the emergence of the first case of polio in the US in 2021 highlighted the threat to public health associated with low vaccine coverage. CDC and the World Health Organization consider the emergence of measles cases as a signal for low coverage with vaccines more generally; persistent outbreaks of measles in communities across the US call for significant efforts to address vaccine hesitancy concerns and raise uptake of vaccines in close-knit communities with low coverage).

Given the elevated risk of outbreaks in close-knit communities with low vaccination coverage, CDC has launched Fostering Overall Community Understanding and Support (FOCUS). It aims to increase vaccination coverage in communities that are at increased risk for vaccine preventable diseases (VPD) as a part of the Let’s RISE initiative[1]. Communities of FOCUS include those that have had consistently lower routine childhood vaccination rates for one or more vaccines, had recent VPD outbreaks, and where continued public health efforts have not increased vaccination coverage.   FOCUS activities will include 3 Phases: 1) Build-Understand community and jurisdictional needs; launch workgroups; 2) Implement- learning collaborative and coordinate with national, state, and local agencies; and 3) Grow- Identify additional communities and areas within jurisdictions for FOCUS expansion.

The FOCUS Learning Collaborative (LC) will provide opportunities for engaging with peers working with similar communities, access to subject matter experts and space for sharing resources. Proposed LC implementation is planned for June –December 2024.  Compilation of strategies will continue for an additional 3 months.

The purpose of the acquisition is to evaluate: 1) experiences implementing or participating in activities to address-barriers to increasing vaccine uptake in communities of focus by jurisdiction, local health department, and the community partner levels, particularly in jurisdictions with low vaccine coverage and at elevated risk of outbreaks of vaccine preventable diseases (i.e., measles) and 2) experiences and learnings derived from participation in the FOCUS Learning Collaborative led by CDC. These evaluations will provide qualitative data. The work will include assessments of feasibility of interventions, barriers to implementation, and facilitators for successful adoption at the community level. Finally, this work aims to identify technical assistance and capacity building needs in program evaluation and the evaluation of interventions at the jurisdiction or other levels.

The contractor shall review and synthesize notes and other documents collected and produced during FOCUS Learning Collaborative sessions convened by CDC and attended by relevant immunization partners from the jurisdiction-level; the contractor shall produce a report summarizing these documents and describing the landscape of vaccine demand generating activities underway. This review and report will be used by the contractor to identify key themes to be explored in focus group sessions and key informant interviews with state immunization program staff and other immunization partners (e.g., local health department staff, community-based organizations).

The first series of focus groups will concentrate on participant feedback about the FOCUS Learning Collaborative. Participants will be asked about their participation, if they found it easy to engage with other participants, their feelings about the value of the information shared and whether they plan to adopt or operationalize any of the interventions discussed by their peers.  

The second series of focus groups and key informant interviews will probe into the details of vaccine confidence and demand interventions within each participating jurisdiction, gathering detailed information about the type, design and implementation of the activities, and barriers or facilitators to implementation. Participants will be asked for their thoughts about the effectiveness of interventions, best ways to reach the communities of FOCUS, future adoption of approaches, other planned interventions, and needs for evaluation or other support, among other topics.

The contractor shall offer evaluation support to jurisdiction partners, where requested and appropriate. Such support may include the development of evaluation plans, methodology, and design of indicators for both process and impact evaluations of vaccine confidence and demand-related activities, as feasible. The contractor will be responsible for providing only assistance and guidance for evaluation plans but not responsible for completing the evaluations.