Expanding population-level interventions to help more low-income smokers quit

摘要 许多低收入美国人、少数族裔和其他边缘群体生活在信息时代-- 恶劣的环境，不成比例地接触到关于新冠肺炎的错误信息，以及不信任医疗， 政府、科学机构和领导人。这些以及其他社会、文化和行为因素构成了 在大流行期间增加人口检测和疫苗接种的公共卫生努力面临重大障碍。 迫切需要有效的卫生沟通，以帮助应对这些挑战，缩小 新冠肺炎的S冲击。我们与四个州和全国的2-1-1求助热线密切合作， 提出快速循环研究，从受众分析转移到优先事项中的消息测试 在鼻咽癌中发现的种群。我们的方法建立在我们团队数十年来的强有力证据基础上 健康传播研究计划，以消除差异，特别是经过验证的消息策略，如 文化价值观、差异框架和叙事，将应用于新冠肺炎语境。具体来说，我们 将对43,000+新冠肺炎测试询问进行多方法内容分析，以2-1-1(目标1)，调查 并采访350名2-1-1呼叫者和电话接线员(目标2)，并在随机A-B中进行开发和评估 在300个2-1-1呼叫者中测试新的新冠肺炎测试消息(目标3)。总而言之，这些活动将 确定向弱势群体宣传新冠肺炎检测的基本背景和内容， 将这些知识整合到经过验证的信息策略中，并确定它们对以下方面的兴趣和意图的影响 接受测试和其他关键结果。我们与2-1-1s的合作伙伴关系是拟议研究的核心。在24个人中 在NOSI中确定的优先群体，2-1-1服务于几乎每个群体的更高比例的呼叫者 与他们在美国人口中的比例相比，包括60%-80%的种族或少数民族，40%-55%的 家庭收入低于10,000美元，四分之一的人没有完成高中学业。新冠肺炎期间，36秒2-1-1 美国各州已经回复了964,286条新冠肺炎请求。这些来自未得到充分服务的美国人的第一手资料 关注或受新冠肺炎影响必须通知沟通工作，2-1-1的基础设施是 非常适合支持对有前景的方法进行快速测试。

ABSTRACT Many low-income Americans, racial and ethnic minorities, and other marginalized groups live in information- poor environments, disproportionately exposed to misinformation about COVID-19, and distrusting medical, government and scientific institutions and leaders. These and other social, cultural and behavioral factors pose significant obstacles to public health efforts to increase population testing and vaccination in a pandemic. Effective health communication is urgently needed to help counter these challenges and reduce disparities in COVID-19's impact. Working in close partnership with 2-1-1 helplines in four states and nationwide, we propose rapid-cycle research that moves from audience analysis to message testing among priority populations identified in the NOSI. Our approach builds on strong evidence from our team's decades-long program of health communication research to eliminate disparities, especially proven message tactics such as cultural values, disparity framing, and narratives, that will be applied to the COVID-19 context. Specifically, we will conduct a multi-method content analysis of 43,000+ COVID-19 testing inquiries to 2-1-1 (Aim 1), survey and interview 350 2-1-1 callers and phone operators (Aim 2), and develop and evaluate in randomized A-B testing new COVID-19 testing messages among 300 2-1-1 callers (Aim 3). Taken together, these activities will identify essential context and content for communicating about COVID-19 testing to vulnerable populations, integrate this knowledge into proven message tactics, and determine their impact on interest in and intention to be tested and other key outcomes. Our partnership with 2-1-1s is central to the proposed research. Of the 24 priority populations identified in the NOSI, 2-1-1s serve a higher proportion of callers from nearly every group compared to their proportion of the U.S. population, including 60-80% racial or ethnic minorities, 40-55% with household income below $10,000, and 1 in 4 not completing high school. During COVID-19, 2-1-1s in 36 states have fielded 964,286 COVID-19 requests. These first-hand accounts from underserved Americans concerned about or affected by COVID-19 must inform communication efforts, and the infrastructure of 2-1-1 is well suited to support rapid testing of promising approaches.