FIU Center for Reducing Health Disparities in Substance Abuse & HIV in South Florida

金融情报机构减少药物滥用健康差异中心

• 批准号: 10203496
• 负责人: ERIC F WAGNER
• 金额: $ 19.56万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-20 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10203496
• 关键词: Affect; African American; Alaska Native; American Indians; COVID-19; Caring; Cessation of life; Color; Communities; County; Crowding; Data; Death Rate; Discrimination; Disease Outbreaks; Epidemic; Ethnic Origin; Federal Government; Feedback; Florida; General Population; Government; HIV; Health; Health Policy; Health behavior; Healthcare Systems; Incidence; Infection; Intervention; Interview; Local Government; Measures; Minority; Modeling; Occupations; Outcome; Patients; Perception; Policies; Population; Poverty; Prevalence; Preventive; Provider; Public Health; Published Comment; Race; Relaxation; Reporting; Resources; Risk Factors; Role; Services; Social Policies; Source; Substance abuse problem; Survival Rate; Underrepresented Minority; United States; Virus; World Health Organization; adverse outcome; care delivery; care providers; community based care; coronavirus disease; density; design; effective intervention; ethnic difference; ethnic minority population; experience; health care service; health difference; health disparity; health service use; high risk; improved outcome; member; minority communities; mortality; novel coronavirus; pandemic disease; protective factors; public health emergency; racial and ethnic; racial minority; racism; response; screening; social; social health determinants; statistics; stem

SUMMARY Background: The United States (US) remains one of the epicenters of the global COVID-19 public health emergency, resulting in the government’s implementation of mitigation policies to stem and contain the virus. Despite these measures, people of color (POC - Blacks, Latinx and American Indian/Alaska Native populations) in the US are disproportionately represented in the epidemic. Objectives: The overall objective of this study is to evaluate the impact of macro and ecological policies by (a) using state and county level data to report on COVID-19 health outcomes experienced by communities of color and (b) conducting in-depth interviews among community members and providers to understand their perceptions about accessing and providing healthcare services. Design: Firstly, there will be an ecological study at the US state and county levels examining the relationship between racial/ethnic density and COVID-19 outcomes, considering selected COVID-19 risk factors (crowding, poverty level, percentage of essential workers) as moderators in that relationship. Secondly, there will be a policy study of differences on timing, interpretation and implementation of federal and state level mitigation policies on COVID-19 outcomes. Finally, interviews will be conducted to understand provider and patient viewpoints about how macro level social and health policies implemented by federal and local governments influence providers’ perception about delivery of care and community members’ perception about accessing COVID-19 healthcare services. Analysis: Descriptive statistics will be used to describe COVID-19 prevalence by racial/ethnic density in states and counties, followed by bivariate correlations. Any statistically significant correlation (<0.10) in the bivariate correlations will be incorporated into the regression models with COVID-19 incidence, prevalence and death rate as outcomes. Regression models will be used to determine the relationship between COVID-19 outcomes and state and county level demographic data and COVID-19 policy data. For the interviews, content analysis will be used to analyze qualitative data about perceived barriers and facilitators accessing and providing care. Significance: The results of this study will help to understand the underpinnings of social mechanisms and disparities contributing to the overrepresentation of underrepresented minority populations in the COVID-19 public health crisis. The study objectives are in line with recent NIMHD priorities issued for the COVID-19 response to support studies that investigate the “influence of state and local mitigation policies on differences in health services utilization and health outcomes, the role of community-level protective factors and interventions in mitigating the adverse consequences of the sector disruptions caused by the outbreak, the influence of COVID-19–related racism and other types of discrimination, and the role of social determinants of health in influencing preventive health behaviors”.

总结