Victoria Niederhauser, dean of the College of Nursing, has been a pediatric nurse practitioner for over 38 years. One of her primary interests has long been increasing vaccination rates among our most vulnerable populations.
“Low immunization rates among children and older adults have been a long-standing issue in our country,” said Niederhauser. “There are different barriers that parents and older adults face, so deploying registered nurses to help navigate these challenges can help improve vaccine rates.”
In 2020, Niederhauser was approached by a colleague at UT Extension about expanding a Tennessee Department of Health grant with a focus on decreasing vaccination barriers. Niederhauser jumped at the opportunity.
“We were in the midst of COVID, so funds were more readily available for vaccine program expansion,” she said.
Niederhauser received two grants that year that focused on reducing barriers to vaccines in children and seniors and on distribution, especially in rural Tennessee counties. This is where the Community Registered Nurse Navigator project was born.
The project, led by Niederhauser and Nan Gaylord, recently retired associate dean of practice and global affairs, had one vision: to increase vaccination rates and thereby promote better health outcomes for the state.
“What inspired us was not only the alarming disparity in immunization rates across our state but the impact the pandemic had on immunizations,” said Gaylord. “Many people fell behind in their routine vaccinations, and hesitancy grew. We saw a need to bridge the gap and ensure equitable access to vaccines for everyone, regardless of their background or location.”
The project isn’t just about COVID-19 vaccine barriers. It provides county-level engagement to improve routine immunization rates. The project has placed 16 registered nurses, dubbed community registered nurse navigators, or CRNNs, across the state to investigate barriers to routine immunizations.
“The role of the nurse navigator is unique in that they have the opportunity and capacity to get to know communities and identify what barriers there are but also their resources and strengths,” said Elizbeth Sowell, advanced practice RN director for the project. “By understanding the community and their available resources, they can utilize those resources and other strengths to address the barriers. The nurse navigators work as coordinators, educators, patient advocates, and problem-solvers.”
In many underserved and rural areas, CRNNs are working with local leaders and stakeholders that serve those most profoundly impacted by disparities.
“Our purpose isn’t necessarily to administer vaccines,” explained Niederhauser. “We’re here to listen, understand, and address the unique needs of each community we serve. It’s about building trust and empowering individuals to take charge of their health.”
From attending community events to leading health fairs, the nurses cast a wide net. Through these collaborations the project team disseminates information and fosters a sense of community ownership over public health initiatives.
“Building trust within communities also depends on building solid relationships with trusted community partners and leaders,” said Denette Jackson, a CRNN in East Tennessee. “As a nurse, I’m not just focused on medical care—I’m all about looking at the big picture of a person’s well-being. That’s why it’s crucial to team up with others to tackle issues like vaccines, food insecurity, and other health concerns.”
The project has not been without challenges. In a world where vaccine conversations are increasingly sensitive, the team has navigated through misinformation and mistrust with compassion and understanding.
For Sowell, many conversations about vaccines are charged with beliefs, thoughts, and ideals that are challenging to address. The CRNNs have worked to build trust with both communities and individuals.
“In all my counties I have heard numerous people say they are not taking vaccines or are not getting their kids vaccinated because they do not trust the vaccines,” said Teresa Gower, a CRNN in Middle Tennessee. “I am providing pamphlets, flyers, and have been verbally offering education to community members. Our goal is to educate, not coerce. By providing accurate information and addressing concerns, we are aiming to empower individuals to make informed decisions about their health.”
As the project moves into its third year, the team is excited for the future.
“Beyond the grant period, we can sustain our interventions and improvements by utilizing our partnerships with students, leaders, and organizations,” said Sowell. “Our nurses have empowered and enabled local stakeholders and students to continue these efforts. With the tools that are also being developed and designed to meet needs identified, interventions will continue beyond our designated grant period.”
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Media Contact:
Kara Clark (865-974-9498, kmclark2@utk.edu)