Digital contact tracing and case investigation application on the Navajo Nation

项目摘要 COVID-19大流行对纳瓦霍民族产生了不成比例的影响，其中有更高的 糖尿病、心脏病和肺病等健康并发症的患病率。总体生活条件和长期的 不公平的历史导致对西方医学和卫生系统的不信任， 病毒的传播。该项目是对现有项目的紧急竞争性修订，以应对PA- 18-935.该项目补充了正在进行的SBIR第一阶段项目，以研究 COPECare是一个新的数字系统，用于支持纳瓦霍民族的护理协调，特别是那些 患有癌症或有患癌症的高风险。COPECare旨在促进社区卫生工作 在向卫生组织成员提供卫生教育和指导方面发挥关键作用的卫生代表， 纳瓦霍族自从纳瓦霍民族爆发COVID-19以来，CHR和其他受过训练的非专业工作人员 已被要求使用数字接触者追踪支持整个社区的接触者追踪工作， 案件调查工具。这个紧急补充的目标是研究数字化的过程和早期结果。 接触者追踪和病例调查工具，专门用于纳瓦霍族， 部署以支持管理和控制COVID-19疫情的努力。我们将在以下方面实现这一目标： 以下两个具体目标：在目标1中，我们将使用关键指标评估数字工具，以衡量计划 个案面谈的表现和系统效率的衡量。在目标2中，我们将进行一次形成性的 评估包括与接触者追踪者（CHR， 公共卫生官员，以及为纳瓦霍民族服务的两家大医院的医院工作人员）和癌症幸存者 及直接或间接受COVID-19影响的家人。这项补充工作的结果将直接告知 COPEC的设计和开发关注并有助于更广泛地了解如何开发有效的 以社区为基础的数字解决方案，以支持和促进纳瓦霍民族和其他潜在部落的健康 美国各地的社区。

PROJECT SUMMARY The COVID-19 pandemic has had a disproportionate effect on the Navajo Nation, in which there is a higher prevalence of health complications such as diabetes, heart and lung disease. Overall living conditions and a long history of inequities resulting in a distrust of western medicine and health systems are believed to contribute to the spread of the virus. This project is an urgent competitive revision to an existing project in response to PA- 18-935. The project supplements an ongoing SBIR Phase I project to study the feasibility and acceptability of COPECare, a novel digital system to support care coordination on the Navajo Nation, particularly those who have or are at high risk of cancer. COPECare is designed to facilitate the work of community health representatives (CHRs) who play a critical role in delivering health education and guidance to members of the Navajo Nation. Since the outbreak of COVID-19 on the Navajo Nation, CHRs and other trained and lay workers have been tasked to support contact tracing efforts throughout the community using a digital contact tracing and case investigation tool. The goal of this urgent supplement is to study the process and early outcomes of a digital contact tracing and case investigation tool that was customized for use on the Navajo Nation and rapidly deployed to support efforts to manage and control the COVID-19 outbreak. We will address this goal in the following two specific aims: In Aim 1, we will evaluate the digital tool using key metrics to gauge program performance for case interviewing and measures of system efficiency. In Aim 2, we will conduct a formative assessment consisting of qualitative one-on-one and group interviews with cadres of contact tracers (CHRs, public health officials, and hospital staff at two large hospitals serving the Navajo Nation) and cancer survivors and their families directly or indirectly affected by COVID-19. Results of this supplement work will directly inform the design and development of COPECare and contribute to a broader understanding of how to develop effective community-based digital solutions to support and promote health on Navajo Nation and potentially other tribal communities across the US.