Source is Important: A Look at the Information Four Culturally and Linguistically Diverse Communities in the U.S. Used to Make COVID-19 Vaccination Decisions

Institute for Science, Society and Policy
Faculty of Social Sciences
Health sciences
Health and wellness

By Rukhsana Ahmed

Faculty Affiliate, Institute for Science, Society & Policy

Masked public transit passengers.

Authored by Dr. Rukhsana Ahmed and Mary C. Avery of the University at Albany at the State University of New York, this blog synthesizes their chapter published alongside a team of researchers titled  “Exploring the role of information sources in vaccine decision-making among four culturally and linguistically diverse communities in the U.S” in the ISSP open-access publication Democratizing risk governance - Bridging science, expertise, deliberation and public values.

With the 2023-2024 flu season upon us and the ever-evolving COVID-19 virus, the findings of this research are critical in understanding how and where to best communicate with culturally and linguistically diverse communities about public health, safety measures and vaccination.  


Culturally and Linguistically Diverse (CALD) communities in the U.S., consisting of foreign-born individuals who speak English as a non-native language, are at higher risk during a health crisis like COVID-19 due to their unique challenges. For example, many CALD communities cannot obtain health information for several reasons, including language barriers that limit their access to needed information and resources.

To address this, health communication strategies must be tailored to reach them, instead of using a “one-size-fits-all” approach. A key first step is to understand which sources of information community members rely on to make their health decisions. These findings can help medical practitioners, policymakers, and other professionals communicate important health messages more effectively, and ultimately reduce health disparities.

Our study examined the role of information sources in COVID-19 vaccine decision-making among four CALD communities -- Arabic, Bengali, Chinese, and Spanish-speaking in the U.S. Specifically, we were interested to know: 1) whether the decision to vaccinate against COVID-19 differed across these four communities, 2) if members were able to find sources of health information that they trusted in the first place, and 3) which information sources were used regularly by vaccinated or intended-to-be vaccinated members in each community.

How was this research done?

From March to June 2021, an online survey was completed by 318 members in the four CALD communities. These members were recruited through partnerships with community-based organizations and social media platforms. They were foreign-born adults living in the U.S., speaking primarily Arabic, Bengali, Chinese, or Spanish. They answered questions about their intent to vaccinate against COVID-19, their ability to find health information they trusted, and the information sources they used.

What did the researchers find?

1) Vaccination Decisions

  • Most members (regardless of community) were vaccinated or intended to be vaccinated, with a little over a third not receiving a vaccine at all.
  •  There were clear differences among the communities in their vaccination decisions: most Spanish-speaking members were vaccinated or intended-to-be vaccinated, but only a quarter of Arabic-speaking members were vaccinated or had the intention to vaccinate.

2) Ability to Find Trusted Health Information

  • Most vaccinated community members reported they could find health information they trusted.
  • Nearly all Spanish-speaking members could find trusted health information, but only a quarter of the Arabic-speaking members reported the same.

3) Information Sources Used

  • Across communities, the most commonly used information sources were digital media in members’ native language and ethnic TV and radio channels.
  • Spanish-speaking members relied primarily on those two sources.
  • Most Chinese-speaking members also used digital media in their native language, followed by friends and family.
  • Bengali-speaking members used friends and family and ethnic TV and radio channels.
  • The Arabic-speaking members relied on social media the most, followed by print media in their native language.

How can these research findings be used?

Communities make different health decisions regarding vaccination:  

First, members of CALD communities were unique in their decision to vaccinate and thus should not be treated in the same way as if they make similar health decisions. Some community members (e.g., Arabic-speaking) were less apt to vaccinate, perhaps because the sources they relied on for health information were not the same as those used by agencies in charge of communicating important health messages.

Communities use different sources of health information to make these decisions:

Second, to effectively communicate with these distinct CALD community members, policymakers and practitioners should utilize sources that are already used by communities, especially for those with lower vaccination rates. For example, for the Arabic-speaking community, this could mean disseminating health information on social media and in print media in Arabic. For the Chinese-speaking community, effective sources can include digital media in Chinese and friends and family.

Tailor health messages and present them in native languages:

Lastly, across the CALD communities, members preferred information sources in their native language, though the exact format (digital, interpersonal, etc.) varied. Thus, it is important to provide information in their native language and use existing sources they rely on for health information.

For example, the Spanish-speaking community had a high vaccination rate. This could be due to health information being more readily available in Spanish and using the community’s preferred information source. This combination may explain the Spanish community’s high vaccination rate as compared to other communities in our study.

Who conducted this research?

The interdisciplinary, faculty-led team of researchers at the University at Albany, State University of New York:

  • Dr. Rukhsana Ahmed, Department of Communication
  • Dr. Dina Refki, Center for Women in Government & Civil Society, Rockefeller College of Public Affairs & Policy
  • Dr. Jeanette Altarriba, Department of Psychology

The graduate researchers are:

  • Ms. Erting Sa, Department of Communication
  • Ms. Mary C. Avery, Department of Psychology
  • Ms. Sana Abdelkarim, Department of Public Administration & Policy


This project has been made possible through funding from the SUNY Prepare Innovation and Internship Seed Grant Program. We also thank our community partners:

Arab American Association of New York; Arab American Family Support Center (AAFSC); Bangladeshi American Foundation of Albany (BAFA); Bengali Association of America; Center for the Integration and Advancement of New Americans (CIANA); Chinese Community Center of Capital District of New York; Albany Latin Festival Association; Centro Cívico Inc.