Increasing COVID-19 vaccine uptake through a patient navigation intervention among underserved populations

项目总结(资金奖励) 新奇的SARS-CoV-2继续在美国传播，已有近500万人 确诊病例超过15万人死亡。鉴于观察到的发病率差异， 住院和死亡率在种族、民族和社会经济地位之间有很大的差异 需要通过快速返回测试结果来增加测试访问和吸收。我们提出了一个 社区卫生工作者(CHW)主导的促进新冠肺炎检测的方法 服务不足的人群，重点是增加检测的可及性、接受度和影响 拉丁裔、非裔美国人、菲律宾人和移民社区使用不同的测试 实施战略。我们的项目将利用现有的新冠肺炎联系人追踪和 社区合作伙伴基础设施，覆盖12岁及以上受感染或高危人群 接触新冠肺炎的人可能检测能力较差。我们将使用随机化的集群 交叉试验以测试移动和基于家庭的测试策略，以提高测试采用率 在接触者中，指的是高危朋友和家人以及更广泛的社区。我们的特定 目标是：1)将新冠肺炎检测融入社区卫生工作者联系 跟踪家访并比较推荐的高危朋友随后接受测试的情况 移动测试和基于家庭的测试方法；2)使用社区主导的快速测试方法 循环研究流程，确定有效策略，促进新冠肺炎测试的采用 通过针对拉丁裔、非裔美国人、菲律宾人和移民群体的移动/弹出测试 暴露在或处于高风险暴露在新冠肺炎中的人，没有进行检测；3)收集CHW 和社区洞察力，为未来的扩展和可持续性建立最佳实践。我们 预计将通过这些努力测试超过4万人。该项目将对健康做出贡献 降低新冠肺炎发病率和死亡率的差距，并通过 我们的核心优势是利用当地的知识，团队现有的社区合作伙伴关系， 使用具有文化能力的社区医护人员，快速而廉价地提供医疗服务 测试，并使用我们的接触者跟踪计划中的实时地理空间数据来确定优先顺序 移动弹出窗口测试的位置。我们的重点是服务不足的高新冠肺炎人群 在没有事先检测机会的情况下暴露，将为未来的检测和疫苗接种工作提供信息。

PROJECT SUMMARY (of funded award) The novel SARS-CoV-2 continues to spread in the United States, with almost 5 million confirmed cases of and over 150,000 deaths. Given observed disparities in morbidity, hospitalization, and mortality across race, ethnicity, and socioeconomic status, there is a great need to increase testing access and uptake with rapid return of test results. We propose a community health worker (CHW)-led approach to facilitate COVID-19 testing for underserved populations, with a focus on increasing testing access, uptake, and impact among Latinx, African American, Filipino, and immigrant communities using different testing implementation strategies. Our project will utilize existing COVID-19 contact tracing and community partner infrastructure to reach individuals aged 12 and above exposed or at high-risk of COVID-19 exposure who may be less able to test. We will use a cluster randomized crossover trial to test mobile and home-based testing strategies for increasing testing uptake among contacts, referred high-risk friends and family, and the broader community. Our specific aims are to: 1) Implement COVID-19 testing integrated into community health worker contact tracing home visits and compare the subsequent uptake of testing for referred high-risk friends and family in a mobile testing vs. home-based testing approach; 2) Using a community-led rapid cycle research process, identify effective strategies to promote uptake of COVID-19 testing through mobile/pop-up testing for Latinx, African American, Filipino, and immigrant populations exposed or at high risk of exposure to COVID-19 who are not accessing testing; 3) Gather CHW and community insights to establish best practices for future scale-up and sustainability. We expect to test over 40,000 individuals through these efforts. The project will contribute to health disparity reductions in COVID-19 morbidity and mortality and produce high impact through the our core strengths in drawing on local knowledge, the team’s existing community partnerships, use of culturally-competent community healthcare workers, point-of-care rapid and inexpensive testing, and the use of real-time geospatial data from our contact tracing program to prioritize locations for mobile pop-up testing. Our focus on underserved populations with high COVID-19 exposures without prior testing access will inform both future testing and vaccination efforts.