CRISOL: Building Community Resilience and Integrating Efforts to Understand and Address Syndemic Health Conditions Afflicting Young LatinoImmigrants

此次竞争性修订的目标是扩展我们的原始项目，以适应、实施和评估多个 年，采取水平干预措施，以减轻柯萨奇病毒19在拉美裔移民社区中造成的多方面损失 费城。遏制疫情、缩小差距和减轻其影响的有效战略的证据 是缺乏的，而且非常紧迫。在美国，拉美裔移民是受疫情影响最严重的群体之一， 最近这一群体中新冠肺炎死亡人数的急剧增加证实了他们风险的持续增加 感染的可能性和易感性的增加。长期以来，拉美裔移民在糖尿病、肥胖症方面表现出差异 高血压，已知会增加新冠肺炎相关严重程度的因素，以及药物滥用， 暴力暴露、艾滋病毒/艾滋病和精神健康(SAVAME)。这些共同的条件一直是 在新冠肺炎的背景下变得更糟。拉美裔移民代表着一种难以接近和被边缘化的群体 人口，获得适当医疗保健和安全网的机会极其有限。这个群体面临着许多 结构性障碍和社会脆弱性，阻碍他们访问新冠肺炎测试和 提供治疗服务，并坚持公共卫生干预措施和措施，以减少艾滋病的传播 新冠肺炎。拉美裔人通常依赖于一个由医疗和社会服务组织组成的单薄而分散的网络。 为减轻新冠肺炎对这一人群的影响而进行的干预需要有广泛的利益相关者 参与并解决广泛的健康决定因素。同行驱动的干预措施一直很有效 在拉丁美洲人口中预防和控制艾滋病毒、性传播感染等传染病。 加强社区成员与这些组织之间的联系，促进社区成员之间的相互 组织协调，以满足拉丁裔的共同健康、行为、经济和法律需求 社区是缓解新冠肺炎对这一低资源人群影响的基本要素。在……里面 直接响应我们正在进行的社区-学术合作伙伴关系NOT-MD-20-022/PAR PA-18-935 建议对“Crisol Contigo”进行评估，这是一种多层次的干预措施，旨在解决创建或放大的需求 费城拉丁裔社区中的新冠肺炎大流行。Crisol Contigo包括一个同龄人- 推动拉美裔服务组织的计划和动员。在目标1中，我们将改编一个正在流行的 意见领袖(POL)计划，以满足与新冠肺炎相关的独特健康、社会和经济需求 还有SAVAME SYDEMIC。在目标2中，我们将评估Crisol Contigo改善新冠肺炎的疗效 相关预防性健康行为以及新冠肺炎相关检测和护理的使用和获得(共同小学 结果)。在目标3中，我们将检查Crisol Contigo对社区资产、跨部门的影响 费城拉丁裔服务组织之间的合作和协调。差不多有20个 美国有数百万拉美裔移民，他们在维持美国经济的关键部分方面发挥着核心作用 迫切需要考虑拉美裔独特需求的量身定做的多层次干预措施，以缓解 这次和未来新冠肺炎的爆发对这一弱势群体的影响。

This goal of this competitive revision is to expand our original project to adapt, implement and evaluate a multi- level intervention to mitigate the multi-dimensional toll of COVID19 among Latino immigrant communities in Philadelphia. Evidence of effective strategies to curb the pandemic, reduce disparities and mitigate its impact is lacking and very urgent. In the US, Latino immigrants are one of the groups hardest hit by this pandemic, with recent steep increases in COVID-19 deaths among this group corroborating their continued increased risk of infection and increased susceptibility. Latino immigrants have long exhibited disparities in diabetes, obesity and hypertension, factors known to increase COVID-19 related severity, and also in Substance Abuse, Violence exposure, HIV/AIDS, and MEntal health (SAVAME) syndemic. These syndemic conditions have been worsened in the context of COVID-19. Latino immigrants represent a hard-to-reach and marginalized population, with extremely limited access to adequate health care and safety nets. This group faces many structural barriers, and social vulnerabilities, that hinder their capacity to access COVID-19 testing and treatment services and to adhere to public health interventions and measures to decrease the spread of COVID-19. Latinos often rely on a thin and fragmented network of health and social services organizations. Intervention to mitigate the impact of COVID-19 on this population will need to have a broad stakeholder engagement and address a wide range of health determinants. Peer-driven interventions have been effective for the prevention and control of infectious diseases such as HIV, STIs among Latino populations. Strengthening the links between community members and these organizations and promoting inter- organizational coordination to meet syndemic health, behavioral, economic, and legal needs of Latino communities are essential elements to mitigate the impact of COVID-19 on this low-resource population. In direct response to the NOT-MD-20-022/PAR PA-18-935, our ongoing community-academic partnership proposes to evaluate “CRISOL Contigo,” a multi-level intervention to address the needs created or magnified by the COVID-19 pandemic among Latino communities in Philadelphia. CRISOL Contigo includes a peer- driven program and mobilization of Latino-serving organizations. In aim 1, we will adapt an ongoing Popular Opinion Leader (POL) program to address the unique health, social, and economic needs related to COVID-19 and the SAVAME syndemic. In aim 2, we will assess the efficacy of CRISOL Contigo to improve COVID-19 related preventive health behaviors and use and access to COVID-19 related testing and care (co-primary outcomes). In aim 3, we will examine the impact of CRISOL Contigo on community assets, interagency collaborations and coordination among the Latino-serving organizations in Philadelphia. There are almost 20 million Latino immigrants in the US, and they play a central role in sustaining the vital parts of the US economy Tailored, multi-level interventions that consider the unique needs of Latinos are urgently needed to mitigate the impact of this and future outbreaks of COVID-19 on this disadvantaged population.