Invest in Trust: A Guide for Building COVID-19 Vaccine Trust and Increasing Vaccination Rates Among CNAs

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

Invest in Trust: A Guide for Building COVID-19 Vaccine Trust Among Certified Nursing Assistants (CNAs) is designed to help nursing home leaders build COVID-19 vaccine confidence among CNAs and overcome barriers to vaccination by applying insights from social, behavioral and cognitive science. 

The guide sheds light on CNAs’ reasons for not getting vaccinated and the challenges they face to getting a vaccine. It also offers practical advice on how to have conversations with CNAs about the vaccine, what kinds of messages to use, and how to support CNAs in making their decisions. Use it to help improve staff vaccination rates in your nursing home.”

This 50-page AHRQ guide can be found here.  The landing page for this guide and resources is found here

Invest in Trust is a comprehensive guide to building COVID-19 vaccine confidence among CNAs, and we encourage you to download and read it in its entirety. But you may want to jump quickly to key sections, depending on your needs and interests:

  • To better understand why CNAs aren’t getting vaccinated, read Section 2 (page 8).
  • For research-based insights on building vaccine trust, read Section 3 (page 10).
  • For specific actions to build vaccine confidence and reduce barriers, read Section 4 (page 13).
  • For guidance and resources on how to have conversations with CNAs about getting vaccinated, read Section 5 (page 19).
  • To see effective messages that support building vaccine confidence in CNAs, read Section 6 (page 25).
  • For advice on how to use these messages and to access sample communications materials, read Section 7 (page 34).

The guide provides several resources for nursing homes to build confidence including conversation guides, posters, information cards, and designs for pins to celebrate vaccination status.

Conversation Guides

Use these specific recommendations for your one-on-one conversations.


Download these posters to promote helping people find vaccines, office hours and other vaccine-related messages.

Information Cards: Scheduling Your Vaccination

Print these cards with information about how to schedule or find vaccines locally.

Enamel Pins

Use these pins to present to staff who have been vaccinated with a handwritten thank you note from a supervisor.

The Center for Public Interest Communications at the University of Florida developed this guide for AHRQ in collaboration with Project ECHO at the University of New Mexico Health Science Center, in support of the AHRQ ECHO National Nursing Home COVID-19 Action Network.