New Jersey Alliance for Clinical Translational Science: NJ ACTS

摘要 新冠肺炎大流行对代表不足的少数族裔社区成员的影响不成比例- 领带。不幸的是，URM和其他脆弱社区仍然严重缺乏测试。因此，新的AP- 要传播和完成可能在全美推广的测试，就需要专业人员。新泽西 可以作为一个独特的虚拟测试实验室，在美国人口排名第11，在美国(仅次于纽约)排名第2 人均新冠肺炎死亡率，在总病例中排名第五，代表着一个高度多样化的州 黑人和拉丁裔少数民族人口。在罗格斯大学，我们召集了一批医疗工作者(HCW)来 监测新冠肺炎的传播，并招募受试者参加临床和疫苗试验。在建立我们的队伍时， 我们认识到，许多市建局局长担任医务工作者或个人护理助理，通常担任较低收入的职位。此外，我们还 发现这些工人比那些收入更高的职业的人更容易感染。考虑到这些 根据观察，我们假设从事低收入职业的医务工作者将有助于在他们的房子中进行测试- 据点和他们的社区。从某种意义上说，这些医务工作者可以充当大使，催化以社区为基础的 新冠肺炎测试。新泽西州英雄(新泽西州医疗保健基本工作者外展和教育研究 -测试被忽视的职业)建议接近我们已确定为索引个人的URM卫生工作者- 他们将担任大使，帮助在他们的家庭和扩展的网络中扩大测试。在目标1中，我们 将共同设计、开发和实施以医疗保健为中心的创新外展干预战略，以吸引黑人参与 和拉丁裔少数族裔社区。我们将探索社区对新冠肺炎检测、治疗和 接种疫苗以设计新冠肺炎检测材料和信息，这些材料和信息是根据文化定制的，以解决人们的担忧 黑人和拉丁裔少数族裔社区。在目标2中，我们将进行一项混合方法研究，以评估该方法的效果。 效率和成本：(1)以妇幼保健为重点的外展干预战略与(2)标准社区参与 与以社区为基础的组织(CBO)合作进行外联。我们将探索背景因素(个人、 家庭和社区)影响新冠肺炎测试实施结果和可扩展性。主要的输出是- 未来将在目标人群中接受新冠肺炎测试。我们建议用小说《罗格斯》进行测试 临床基因组实验室/RUCDR唾液测试，第一个FDA授权的诊断测试，使用唾液检测 SARS-CoV-2用于非侵入性、基于家庭的自我检测。我们假设参与式外展策略 将重点放在确定的指标上的方法将动员在社区环境中更快地采用测试，而不是 最佳做法CBO招聘方法。我们还假设，通过索引卫生工作者招募人员将是 与传统的CBO方法相比，对于难以接触到的参与者来说，更成功。专注于以下方面的战略 卫生福利院可以很容易地扩展到其他一线和基本工作人员，使该战略具有普遍性和 可持续发展。

SUMMARY The COVID-19 pandemic disproportionately impacts members of under-represented minority (URM) communi- ties. Unfortunately, URM and other vulnerable communities remain profoundly under-tested. As such, new ap- proaches are needed to disseminate and accomplish testing that could be generalized across the US. New Jersey can serve as a unique, virtual testing laboratory, ranking 11th in the US in population, 2nd in the US (after NY) in the per capita rate of COVID-19 deaths, and 5th in total cases and represents a highly diverse state with substantial Black and Latinx minority populations. At Rutgers, we have assembled cohorts of healthcare workers (HCWs) to monitor the spread of COVID-19 and to enroll subjects for clinical and vaccine trials. While building our cohorts, we recognized many URMs serve as HCWs or personal care aides often in lower-income roles. Further, we also found these workers were more often infected compared with those with higher income occupations. Given these observations, we posit that HCWs in occupations at lower incomes would facilitate testing among their house- holds and their communities. In a sense, these HCWs can serve as ambassadors to catalyze community-based COVID-19 testing. NJ HEROES TOO (New Jersey Healthcare Essential WoRker Outreach and Education Study - Testing Overlooked Occupations) proposes to approach URM HCWs who we have identified as index individu- als who will act as ambassadors to help expand testing in their households and extended networks. In Aim 1, we will co-design, develop and implement an innovative, HCW-centric outreach intervention strategy to engage Black and Latinx minority communities. We will explore community perceptions about COVID-19 testing, treatment, and vaccination to design COVID-19 testing materials and messages that are culturally tailored to address concerns of Black and Latinx minority communities. In Aim 2, we will conduct a mixed methods study to evaluate the effec- tiveness and cost of: (1) the HCW-focused outreach intervention strategy versus (2) standard community engaged outreach, working with community based organizations (CBOs). We will explore contextual factors (individual, family, and community) affecting COVID-19 testing implementation outcomes and scalability. The primary out- come will be uptake of COVID-19 testing in the targeted populations. We propose testing with the novel Rutgers Clinical Genomics Laboratory/RUCDR saliva test, the first FDA-authorized diagnostic test using saliva to detect SARS-CoV-2 for non-invasive, home based self-testing. We hypothesize that a participatory outreach strategy approach focused on identified index HCWs will mobilize quicker uptake of testing within community settings than best-practice CBO recruitment approaches. We also hypothesize that recruitment through index HCWs will be more successful for hard to reach participants compared to a traditional CBO approach. The strategy focusing on HCWs could easily be expanded to other front-line and essential workers, making the strategy generalizable and sustainable.