Optimization of a new adaptive intervention using the SMART Design to increase COVID-19 testing among people at high risk in an urban community.
Optimization of a new adaptive intervention using the SMART Design to increase COVID-19 testing among people at high risk in an urban community.
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DOI：
10.1186/s13063-022-06216-w
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发表时间：
2022-04-14
期刊：
影响因子：
2.5
通讯作者：
Sarol, Jesus
中科院分区：
文献类型：
--
作者：
Windsor, Liliane;Benoit, Ellen;Pinto, Rogerio M.;Sarol, Jesus
关键词：
新冠肺炎已经影响了生活在美国各地的个人和家庭的健康和社会结构，它对生活在城市社区的并存人群、那些在高危环境中工作、拒绝或无法遵守疾控中心指南的人，以及更多的人造成了不成比例的影响。社会健康决定因素，如污名化、监禁和贫困，与接触新冠肺炎的增加和死亡增加有关。虽然已经有了疫苗和加强疫苗，但达到群体免疫力还需要时间，目前还不清楚新开发的疫苗提供了多长时间的保护，以及它们对新兴变种的效果如何。因此，疾控中心建议的预防方法--即检测、洗手、与社会保持距离、接触者追踪、接种疫苗和加强疫苗以及隔离--对于降低边缘化社区的新冠肺炎发病率至关重要。该项目将沿着预防和治疗级联调整和测试基于证据的艾滋病毒干预措施，以帮助满足新冠肺炎的预防需求。这项研究旨在(1)优化适应性干预措施，以提高高危人群中新泽西州新冠肺炎建议(测试、社会距离、隔离、住院、接触者追踪以及对新冠肺炎疫苗和加强注射的接受程度)的检测率和遵从率，以及(2)确定测试完成情况和遵守新泽西州建议的预测因素。本研究遵循基于社区的参与性研究原则，对670名新冠肺炎医学/社会弱势人群进行了序贯、多任务随机试验。参与者将通过各种策略招募，包括在社交媒体上发布广告、在公共场所张贴传单、街头宣传、基于设施的招募和滚雪球抽样。参与者完成基线调查，并被随机接受导航服务或电子小册子。然后，他们在基线后7天完成随访，并再次随机进行，要么继续他们最初的任务，要么切换到其他干预或关键对话或简短咨询。然后，参与者完成为期5周的基线后随访。在新冠肺炎预防、护理和治疗连续体的指导下，这项分析将在干预后7天内探索与新冠肺炎检测相关的因素。这篇文章描述了第一项研究的方案，该方案使用SMART跟随CBPR来使循证艾滋病毒预防干预措施适用于新冠肺炎。这些发现将为开发有效和可扩展的适应性干预措施提供信息，以增加新冠肺炎测试，并在边缘化和难以参与的人群中遵守公共卫生建议，包括疫苗接种和加强注射。ClinicalTrials.gov.NCT04757298.注册于2021年2月17日。
COVID-19 has impacted the health and social fabric of individuals and families living across the USA, and it has disproportionately affected people living in urban communities with co-morbidities, those working in high-risk settings, refusing or unable to adhere to CDC guidelines, and more. Social determinants of health (SDH), such as stigmatization, incarceration, and poverty, have been associated with increased exposure to COVID-19 and increased deaths. While vaccines and booster shots are available, it will take time to reach herd immunity, and it is unclear how long newly developed vaccines provide protection and how effective they are against emerging variants. Therefore, prevention methods recommended by the Centers for Disease and Control (CDC)—i.e., testing, hand-washing, social distancing, contact tracing, vaccination and booster shots, and quarantine—are essential to reduce the rates of COVID-19 in marginalized communities. This project will adapt and test evidence-based HIV interventions along the prevention and treatment cascade to help address COVID-19 prevention needs. The study aims to (1) optimize an adaptive intervention that will increase rates of testing and adherence to New Jersey State COVID-19 recommendations (testing, social distancing, quarantine, hospitalization, contact tracing, and acceptance of COVID-19 vaccination and booster shots) among high-risk populations and (2) identify predictors of testing completion and adherence to New Jersey recommendations. This study follows Community Based Participatory Research (CBPR) principles to conduct a Sequential, Multiple Assignment Randomized Trial (SMART) with 670 COVID-19 medically/socially vulnerable people. Participants will be recruited using a variety of strategies including advertisements on social media, posting fliers in public places, street outreach, facility-based, and snowball sampling. Participants complete a baseline survey and are randomized to receive navigation services or an electronic brochure. They then complete a follow-up 7 days after baseline and are randomized again to either continue with their original assignment or switch to the other intervention or critical dialog or brief counseling. Participants then complete a 5-week post-baseline follow-up. Guided by the COVID-19 Continuum of Prevention, Care, and Treatment, the analysis will explore the factors associated with COVID-19 testing within 7 days of the intervention. This paper describes the protocol of the first study to use SMART following CBPR to adapt evidence-based HIV prevention interventions to COVID-19. The findings will inform the development of an effective and scalable adaptive intervention to increase COVID-19 testing and adherence to public health recommendations, including vaccination and booster shots, among a marginalized and difficult-to-engage population. ClinicalTrials.govNCT04757298. Registered on February 17, 2021.
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