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Implementation of culturally responsive communication for racial, ethnic, sexual, and gender minoritized patients when screened for COVID-19 vaccinations: A scoping review

Kalita, N.; Corr, P. G.; Ward, M. C.; Xavier, J.; McDonald, P. L.

2025-04-01 primary care research
10.1101/2025.03.30.25324915 medRxiv
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IntroductionThe COVID-19 pandemic exacerbated long-standing healthcare disparities, disproportionately affecting racial, ethnic, sexual, and gender minoritized populations. Structural inequities fuel medical mistrust and hinder equitable vaccine access. Culturally responsive communication (CRC) is a critical strategy in primary care that has the potential to improve patient-provider interactions and vaccine acceptance. ObjectivesThis scoping review examines how CRC is conceptualized and implemented in clinical interactions related to COVID-19 vaccination and booster screening for minoritized populations. It assesses the scope of CRC research, the clarity of definitions, the extent of implementation, and its clinical applicability. MethodsFollowing Arksey and OMalleys framework and PRISMA-ScR guidelines, we conducted a literature search across four databases, analyzing studies published between November 2019 and 2022. Extracted data included CRC definitions, communication strategies, and interventions from 22 eligible studies. ResultsResearch on CRC in the context of COVID-19 vaccination is limited and inconsistent. Most studies focused on Black and Hispanic populations, with a critical gap in research addressing sexual and gender minorities. CRC terminology was often interchangeable with concepts like cultural competence, leading to definitional inconsistencies. Because public health messaging was a primary focus, direct clinical applications of CRC were underexplored. DiscussionOur findings highlight an urgent need for a standardized CRC framework to enhance healthcare equity. The absence of a clear, universally accepted definition hinders CRCs practical application and measurability in clinical settings. Future research should refine CRC conceptualization, establish measurable interventions, and expand inclusivity to sexual and gender minorities to foster more equitable healthcare practices.

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