Format and Structure of the Capstone Paper:
The Capstone paper will take the form of a peer-reviewed journal article, such as articles that appear in the Research and Practice section of the American Journal of Public Health (AJPH). The main text of the capstone paper will be 3000-5000 words in length of the main text, excluding abstract, table of contents, references, tables, and figures. There will be a title page, structured abstract and table of contents, followed by the main text, references and then tables and figures (one to a page). If there is an appendix, it is placed at the end. Grammar, quality of writing, illustrations and overall presentation are considered when the paper is being evaluated.
The paper follows the outline below.
Title page
Structured abstract (250 words)
Introduction & literature review/problem statement/background (750 – 1250)
Agency background, purpose and project rationale (450-750)
Methods/project description/process (750-1250)
Results/project outcomes (450)
Discussion, limitations, recommendations (450-750)
Conclusions (150)
References
Tables, graphs, figures, etc.
Appendices
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Below is my own Capstone Project Proposal
1) What is the specific question that your capstone will address?
– What are the potential impacts of health literacy on COVID-19 vaccination hesitancy among the Bronx residents?
2) What is the relevance of your question to public health?
Health literacy refers to an individual’s ability to understand and use health-related information and services. It is an important factor in determining an individual’s ability to make informed decisions about their health and seek out necessary medical care (Liu et al, 2022). In the context of the COVID-19 pandemic, health literacy is especially important because it can influence an individual’s willingness to get vaccinated against the virus. COVID-19 vaccines have been developed and distributed globally to control the spread of the disease, but there has been some hesitation among some individuals about getting vaccinated.
In the Bronx, NY, health literacy may play a role in vaccine hesitation among some members of the community. The Bronx has a high percentage of residents who are racial and ethnic minorities, and these populations have historically experienced disparities in health care access and quality. These disparities can contribute to lower levels of health literacy among some individuals in the Bronx. Additionally, the Bronx has a high rate of poverty, and research has shown that individuals with lower income and education levels tend to have lower health literacy. This may make it more challenging for some residents of the Bronx to access and understand information about the COVID-19 vaccine and its benefits, as well as to navigate the process of getting vaccinated.
3) Based on the literature what is known so far about your question?
Health literacy is an important factor in understanding and addressing vaccine hesitancy. It refers to an individual’s ability to access, understand, and use health information and services in order to make appropriate health decisions (Peerson and Saunders, 2009). There is evidence that lower levels of health literacy are associated with greater vaccine hesitancy. This may be because individuals with lower health literacy may have difficulty understanding and interpreting information about vaccines, may be less confident in their ability to make health decisions, or may be more susceptible to misinformation about vaccines (Montagni et al, 2021).
In the Bronx, a borough of New York City, there are several factors that may contribute to vaccine hesitancy, including lower levels of health literacy, lack of access to reliable health information, and mistrust of the healthcare system (Hasanzad et al. 2022). Some studies have also suggested that certain racial and ethnic minority groups in the Bronx may be more likely to express vaccine hesitancy due to historical and ongoing experiences of discrimination and mistrust in the healthcare system.
It is important for healthcare providers and public health officials to address these issues to increase vaccination rates in the Bronx and protect the community from the spread of COVID-19. This may involve providing accessible, easy-to-understand information about vaccines, addressing concerns and misinformation, and building trust and partnerships with community organizations and leaders
4) Based on the literature what is the gap in knowledge concerning your question?
There is a gap in knowledge concerning the relationship between health literacy and COVID-19 vaccination hesitancy in the Bronx. According to the Centers for Disease Control and Prevention (CDC), health literacy is defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. COVID-19 vaccination hesitancy refers to the reluctance or refusal to get vaccinated against COVID-19 and remains a barrier to full population inoculation against coronavirus (Dror, et al, 2020). Studies have shown that health literacy is an important predictor of vaccination behavior, including influenza vaccination and HPV vaccination (Lorini et al, 2018). However, little is known about the specific role of health literacy in COVID-19 vaccination hesitancy, particularly in the Bronx.
There are several potential reasons for this gap in knowledge. First, the COVID-19 pandemic is relatively new, and there has not been enough time to conduct research on the relationship between health literacy and vaccination hesitancy. Second, the Bronx is a diverse borough with a large immigrant population, which may present unique challenges in terms of understanding and addressing vaccination hesitancy. Third, the COVID-19 vaccine rollout has been complex and constantly evolving, making it difficult to study the relationship between health literacy and vaccination hesitancy.
5) How does your proposal address this gap?
This practice paper will examine the influence of health literacy on vaccine hesitancy in the Bronx. Since the beginning of the pandemic, numerous spreads of false information and misinformation about the safety and efficacy of COVID-19 vaccines has led to confusion and distrust among some individuals (Lee et al, 2022). Health literacy is one of the factors that contribute to COVID-19 vaccination hesitancy in the Bronx and needs to be addressed.
6) What data will you use to answer your question?
Where/how are you going to get it?
There are many online resources to retrieved health literacy and COVID-19 vaccination hesitancy data. However, I am going to conduct a comprehensive systematic review and data analysis. I will choose peer reviewed articles by using PubMed database. I am going to use relevant keywords, such as “health literacy,” COVID-19 vaccination,” and “vaccination hesitancy.” Additionally, I will use the Centers for Disease Control and Prevention DATA (CDC Data), the New York City Department of Health and Hygiene DATA (NYC DOH Data), Google Scholar, and other search engines.
7) What analysis are you going to conduct?
I am going to conduct quantitative analysis in this practice paper following PRISMA standard guidelines. It would be important to gather quantitative data of the COVID-19 vaccination rates in the Bronx from year 2021 to year 2022. It involves analyzing data on vaccination rates in different zip codes and examining any potential associations with health literacy for the low vaccination rate in the Bronx.
References
Charles Shey Wiysonge, Duduzile Ndwandwe, Jill Ryan, Anelisa Jaca, Oumarou Batouré, Blanche-Philomene Melanga Anya & Sara Cooper (2022) Vaccine hesitancy in the era of COVID-19: could lessons from the past help in divining the future?, Human Vaccines & Immunotherapeutics, 18:1, 1-3, DOI: 10.1080/21645515.2021.1893062
Anita Peerson, Margo Saunders, Health literacy revisited: what do we mean and why does it matter?, Health Promotion International, Volume 24, Issue 3, September 2009, Pages 285–296,
Chiara Lorini, Francesca Santomauro, Martina Donzellini, Leonardo Capecchi, Angela Bechini, Sara Boccalini, Paolo Bonanni & Guglielmo Bonaccorsi (2018) Health literacy and vaccination: A systematic review, Human Vaccines & Immunotherapeutics, 14:2, 478-488, DOI: 10.1080/21645515.2017.1392423
Dror, A.A., Eisenbach, N., Taiber, S. et al. Vaccine hesitancy: the next challenge in the fight against COVID-19. Eur J Epidemiol 35, 775–779 (2020). https://doi.org/10.1007/s10654-020-00671-y
Hasanzad, Mandana et al. “COVID-19 anti-vaccine attitude and hesitancy.” Journal of diabetes and metabolic disorders, 1-4. 5 Nov. 2022, doi:10.1007/s40200-022-01018-y
I Montagni, K Ouazzani-Touhami, A Mebarki, N Texier, S Schück, C Tzourio, the CONFINS group, Acceptance of a Covid-19 vaccine is associated with ability to detect fake news and health literacy, Journal of Public Health, Volume 43, Issue 4, December 2021, Pages 695–702,
Lee, Sun Kyong, et al. “Misinformation of COVID-19 Vaccine and Vaccine Hesitancy.” Scientific Reports, vol.12, no. 1, Aug. 2022, pp. 1-11 EBSCOhost, https://doi-org.york.ezproxy.cuny.edu/10.1038/s41598-022-17430-6.
Liu, Chenxi et al. “What is the meaning of health literacy? A systematic review and qualitative synthesis.” Family medicine and community health vol. 8,2 (2020): e000351. doi:10.1136/fmch-2020-000351
“What Is Health Literacy? Take Action. Find Out.” Centers for Disease Control and Prevention, 2 Feb. 2022, www.cdc.gov/healthliteracy/learn.
