{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T07:28:12Z","timestamp":1793604492401,"version":"4.5.0"},"reference-count":15,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Promotion Practice"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:p>Civic engagement is an important example of health and health care inequity in the United States, with voting being an active form of civic engagement that allows citizens to be involved in the political processes that directly impact their health. Existing literature indicates that health care workers are willing to assist in voter registration efforts and are a trusted, nonpartisan source for patients. As such, Vot-ER was founded in 2019 to support nonpartisan voter registration efforts through health care sites, initially through emergency departments. Despite improvements in voter representation in recent elections, voter registration rates remain suboptimal in community health settings, where historically marginalized populations, young adults, and people with lower incomes\u2014who may also find voting inaccessible\u2014often go for their health care. We describe the lessons learned from health care workers in our pilot program who were provided Vot-ER badges for use at their community health sites and shared their experiences. The simplified introduction of the Vot-ER badge led to provider and patient use, though limited in number. Our survey of participants revealed that health care workers felt pressed for time and expressed a desire for a dedicated staff member to facilitate this conversation and\/or signage and handouts that would act as support and reminders for both the providers and patients. Among this group, resources such as dedicated time, dedicated role, or signage and handouts would be necessary and non-negotiable to increase Vot-ER use. Insights from this pilot will be used to plan subsequent voter registration programs in our community health activities.<\/jats:p>","DOI":"10.1177\/15248399261481144","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T09:45:21Z","timestamp":1789811121000},"page":"1030-1035","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["What Can a Badge Do? A Pilot Study of the Vot-ER Badge in a Community Health Setting"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3296-5698","authenticated-orcid":false,"given":"Misato","family":"Shimizu","sequence":"first","affiliation":[{"name":"University of Pennsylvania, Philadelphia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Ortiz-Polanco","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Klusaritz","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Ruggieri","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1502-360X","authenticated-orcid":false,"given":"Ren\u00e9e M.","family":"Betancourt","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,19]]},"reference":[{"key":"e_1_3_2_2_1","unstructured":"AMA acknowledges voting is a social determinant of health. (2022 June 14). https:\/\/www.medpagetoday.com\/meetingcoverage\/ama\/99223"},{"key":"e_1_3_2_3_1","doi-asserted-by":"crossref","unstructured":"Batiste-Brown Q. Katz J. R. Canty L. Coleman C. L. Wallace L. Moore A. D. Bartlett R. Gomes M. (2024). Why voting and voter disenfranchisement matter to health. AJN American Journal of Nursing 124(10) 9\u201311. https:\/\/doi.org\/10.1097\/01.NAJ.0001069456.19849.89","DOI":"10.1097\/01.NAJ.0001069456.19849.89"},{"key":"e_1_3_2_4_1","doi-asserted-by":"crossref","unstructured":"Brown C. L. Raza D. Pinto A. D. (2020). Voting health and interventions in healthcare settings: A scoping review. Public Health Reviews 41 16. https:\/\/doi.org\/10.1186\/s40985-020-00133-6","DOI":"10.1186\/s40985-020-00133-6"},{"key":"e_1_3_2_5_1","doi-asserted-by":"crossref","unstructured":"Callaway J. (2021). Vot-ER. 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Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health 23(11). https:\/\/escholarship.org\/uc\/item\/7wd0x0x6"},{"key":"e_1_3_2_11_1","doi-asserted-by":"crossref","unstructured":"McCabe K. Zhu Y. Bajaj S. S. Martin A. F. (2024). Increasing voter participation through health care\u2013based voter registration. JAMA Health Forum 5(6) Article e241563. https:\/\/doi.org\/10.1001\/jamahealthforum.2024.1563","DOI":"10.1001\/jamahealthforum.2024.1563"},{"key":"e_1_3_2_12_1","doi-asserted-by":"crossref","unstructured":"Metzl J. M. Hansen H. (2014). Structural competency: Theorizing a new medical engagement with stigma and inequality. Social Science & Medicine 103 126\u2013133. https:\/\/doi.org\/10.1016\/j.socscimed.2013.06.032","DOI":"10.1016\/j.socscimed.2013.06.032"},{"key":"e_1_3_2_13_1","doi-asserted-by":"crossref","unstructured":"Ruxin T. R. Ha Y. P. Grade M. M. Brown R. Lawrence C. Martin A. F. (2022). 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