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Dissertation Defense: Bridging Gaps: Evaluating Strategies to Improve Vaccine Uptake and Strengthen Clinical and Translational Research Recruitment Among U.S. Adult Populations

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Amanda Hensley

Dissertation Defense: Bridging Gaps: Evaluating Strategies to Improve Vaccine Uptake and Strengthen Clinical and Translational Research Recruitment Among U.S. Adult Populations

Amanda Hensley

Graduate Student, Translational Biology, Medicine, and Health
Graduate Research Assistant, Center for Public Health Practice & Research
May 4, 2026, at 3 p.m.
College of Veterinary Medicine, Classroom 121
Visit the Center for Public Health Practice & Research

About this Dissertation

Vaccines and medical research have prevented many deaths and suffering every year. Vaccines have protected people, young and old alike, from diseases that could otherwise have hospitalized or killed them. Medical research has generated the treatments and tools that healthcare providers have relied on to keep communities healthy. But here has been the problem: both vaccines and medical research have tended to reach the same groups of people over and over again, often healthier, wealthier, and more connected, while the people who have needed these services the most have often been left out.
This dissertation has asked a simple but uncomfortable question: who has this research been for?
In the first project, the question was about vaccines. The United States passed a major healthcare law in 2010, the Affordable Care Act, which eliminated most out-of-pocket costs for recommended vaccines. The thinking was that cost was the barrier. But despite this policy, vaccination rates for influenza, shingles, HPV, and COVID-19 have remained far below national health goals. This dissertation reviewed 92 research studies from 2010 to 2025 to understand which strategies worked to increase vaccine uptake. The findings showed that strategies involving community partnerships, direct service improvement, and focused outreach to specific populations performed significantly better than broad general messaging campaigns. In other words, making vaccines available was not enough. Researchers and public health professionals should go where people are and work with communities to build and develop trust, and to make vaccination easy rather than just possible.
The second project turned to a different but related problem: who has participated in clinical and translational research? For more than 30 years, federal law has required that NIH-funded studies include women and people from underrepresented and vulnerable groups, such as racial and ethnic minorities, low-income individuals, rural residents, persons with disabilities, and others who have historically been excluded. The existing literature has continued to not reflect the diversity of the U.S. population or of the people most burdened by the health conditions being studied. This dissertation reviewed 43 studies that measured how well their recruitment strategies worked. The results showed that two approaches consistently produced better enrollment: recruiting through electronic health records or patient registries, which helped identify eligible persons through trusted clinical channels, and using community-based participatory research approaches, which built partnerships with communities as co-leaders in the research.
The third and final part of this dissertation took the lessons from the recruitment review and turned them into a practical framework called ReFrame, the Recruitment Strategy Evaluation Framework. ReFrame is a step-by-step guide for researchers to plan, carry out, evaluate, and share what they learn about their recruitment strategies. It is specifically designed to help research teams think about equity at every step as a standard practice.
Taken together, this dissertation has made a case that the people who designed vaccine campaigns and research studies should stop asking, “How do we engage more people?” and begin asking, “How do we reach the people who actually need this research most?” The two questions may sound similar, but they lead to very different decisions about where to look and whom to partner with. The communities most burdened by preventable illness and health disparities deserve to be centered in research that is meant to address these conditions.

More About the Candidate and Project

Education

Virginia Tech, Translational Biology, Medicine, and Health, Ph.D. Candidate

Radford University, M.H.A., Healthcare Administration

Hollins University, B.S., Biology

University of Georgia, B.A., Journalism

Training

Graduate Research Assistant, Center for Public Health Practice & Research

Mentor

Kathy Hosig, MPH, RD, Ph.D., Professor, Director, Center for Publich Health Practice & Research, Virginia-Maryland College of Veterinary Medicine

Committee Members

Publications

  • Hensley, AA, Jiles, KA, Edwards, S, Clinchard, C, Hosig, K. A systematic review and meta-analysis of strategies to recruit underrepresented U.S. adult populations in NIH-funded clinical and translational research (1993-2025). JAMA Network (In preparation)

  • Hensley, AA, Jiles, KA, Edwards, S, Clinchard, C, Hosig, K. A systematic review and meta-analysis of strategies to increase vaccine intention and improve vaccine uptake for U.S. adult populations in the Affordable Care Act Era (2010-2025). Vaccine (In preparation)

  • Hensley, AA, Jiles, KA, Edwards, S, Hosig, K. Characteristics of strategies to recruit underrepresented U.S adult populations in NIH-funded Clinical and Translational Research (1993-2025): Protocol of a Systematic Review, Systematic Reviews Journal (In Review)


  • Hensley, AA, Jiles, KA, Edwards, S, Hosig, K. Characteristics of successful and unsuccessful strategies to increase vaccine intention and improve vaccine uptake for U.S. adult populations in the Affordable Care Act Era (2010-2025): Systematic Reviews Protocol, Systematic Reviews Journal (In Review)


  • Lewis, A. S. L., O’Malley, G., Palissery, G. K., Hensley, A., López Lloreda, C., Perez, C., & Bueren, E. K. (2023). Flipped Science Fair Invites Children to Judge Graduate Student Posters Through a University-Community Partnership. Journal of STEM Outreach, 6(1), 1–12. https://doi.org/10.15695/jstem/v6i1.14
Posters
  • Hensley, A. A team science approach to research with community partners. Poster presentation. Interfaces of Global Change Symposium, Virginia Tech, Blacksburg, VA, April 2025.

  • Hensley, A. Characteristics of successful and unsuccessful strategies to recruit underrepresented populations into clinical research. Poster presentation. TBMH Symposium, Virginia Tech, Roanoke, VA, December 2023.

  • Hensley, A. Characteristics of successful and unsuccessful strategies to recruit underrepresented populations into clinical research. Poster presentation. Recruitment Innovation Center's Recruitment and Retention Symposium, Vanderbilt University, Nashville, TN, June 2023.
Oral Presentations
  • Hensley, A, Lowery, A. Flip the fair: Elementary school students visit public library to judge graduate student science projects. Oral Presentation/Learning Session. American Library Association's LibLearnX Conference, Baltimore, MD, January 2024.
  • Hensley, A. A team science approach to research with community partners. Oral presentation. Appalachian Translational Research Network, Abingdon, VA, October 2025.
  • Bueren, E, Hensley, A, Lewis, A, O'Malley, G, Wander, H, Lopez Lloreda. In flipped science fair, children judge graduate posters and see themselves as scientists. Oral Presentation. Global Change Center's Interfaces of Global Change Symposium, Virginia Tech, Blacksburg, VA, April 2022.
    Lewis, A, Hensley, A, Lopez Lloreda, C, Bueren, E, O'Malley, G, Wander, H. Flip the fair: An intersection of science communication, outreach and empowerment. Oral presentation. Virginia Tech Life Science Seminars: Communicating Science: Celebrating Opportunities and Outreach, Blacksburg, VA, February 2022.
Film Festivals
  • Hensley, A. iTHRIV learning shorts: Team science with community partners, conversation series. APHA Film Festival. American Public Health Association Annual Meeting and Expo, Minneapolis, MN, November 2024.
  • Hensley, A. Clinical research engagement learning short series. APHA Film Festival. American Public Health Association Annual Meeting and Expo, Atlanta, GA, November 2023.
  • TBMH Student of the Year Award, Community, 2020-2021
  • Aspire! Award, Commit to Unwavering Curiosity, February 2025
  • Producer, iTHRIV Learning Shorts Series: "What is Clinical Research?"; "Safety in Clinical Research"; "Understanding Research Consent"

  • Producer, iTHRIV Learning Shorts Series, Team Science with Community Partners: "What is Team Science?", "Funding Opportunities"; "Characteristics of Effective Engagement"; "Community Perspectives in Team Science"; "Conversations" (4 videos); "Featured Project 1"; Featured Project 2"

  • Reviewer, Abstracts, Virginia Public Health Association (also member)

  • Reviewer, Films and Abstracts, American Public Health Association (also member)

  • Facilitator, Virginia State Cancer Plan (2023-2027), pediatric cancer working group (revised 5-year pediatric plan)
  • Member, Community Advisory Board for the VT Center for Communicating Science (2024-present)

  • Graduate Teaching Assistant, TBMH Program, 2020-2021

  • Mentor to Graduate Teaching Assistant, TBMH Program, 2021-2022

  • Instructor of Record and Graduate Teaching Assistant, Science of COVID-19, pathways course, Biol2984D, 2021


  • Intern, Carilion Clinic Community Health and Outreach Department, Roanoke, 2019-2026

  • Scribe, COVID-19 mass vaccination clinics, VDH and Carilion Clinic, 2021

  • Editor, Easy Health quarterly publication, Carilion Clinic, 2019-2022

  • GCC Interfaces of Global Change Fellow, 2020-2026

  • Medical Reserve Corps volunteer: Health Equity Review Board, REVIVE! Lay Rescuer Trainer Certification (VDH), Virginia Behavioral Health MRC Unit Team, MRC Community Animal Shelter Team, Certified Health Emergency Coordinator, Psychological/Mental Health First Aid Certification, 2021-2026

  • Organizer, Flip the Fair annual outreach project (in partnership with Roanoke Public Libraries and Roanoke City Public Schools), 2022-2026

  • Farm 2 School Advisory Board Member, 2021-2022

  • Organizer, ComSciCon, VT, 2022

  • Co-President, Communicating Science Club, VT, 2021-2022

  • Science Policy Education and Advocacy Club member, VT: Co-author and Designer of policy brief "Tick-Borne Disease Mitigation for Town of Blacksburg", 2021-2022

  • IG3C Representative, IGC Graduate Student Organization, 2021-2022

  • VT Graduate Academy of Teaching Excellence, Member, 2020-2024

  • TBMH Liaison, Roanoke Graduate Student Association, 2020-2021

  • Diversity & Inclusion Advisory Taskforce, FBRI@VTC, 2020-2021

  • Academic Leadership Program at VT, 2020-2021