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

项目摘要（资金补助金） 新的SARS-CoV-2继续在美国传播，几乎有500万 确诊病例超过15万例死亡。鉴于观察到的发病率差异， 住院率、死亡率和种族、民族和社会经济地位之间， 需要增加检测的获取和利用，并迅速返回检测结果。我们提出了一个 社区卫生工作者（CHW）主导的方法，以促进COVID-19检测， 服务不足的人群，重点是增加测试的获得，吸收和影响， 拉丁裔、非裔美国人、菲律宾人和移民社区使用不同的测试 执行战略。我们的项目将利用现有的COVID-19接触者追踪， 社区伙伴基础设施，以接触12岁及以上受影响或处于高风险的个人 COVID-19暴露的人可能不太能够测试。我们将使用一个随机化的集群 交叉试验，以测试移动的和基于家庭的测试策略，以增加测试吸收 在接触者、被推荐的高风险朋友和家人以及更广泛的社区中。我们的具体 目标是：1）将COVID-19检测纳入社区卫生工作者接触中 跟踪家访，并比较随后对转介的高风险朋友进行检测的情况 和家庭在移动的测试与基于家庭的测试方法; 2）使用社区主导的快速 循环研究过程，确定有效的战略，以促进COVID-19检测的采用 通过移动的/弹出式测试，针对拉丁裔、非裔美国人、菲律宾人和移民人群 暴露于COVID-19或处于COVID-19暴露高风险中但未进行检测的人; 3）收集CHW 和社区见解，为未来的规模扩大和可持续性建立最佳实践。我们 预计将通过这些努力对4万多人进行测试。该项目将有助于健康 COVID-19发病率和死亡率的差异降低，并通过 我们的核心优势是利用当地知识，团队现有的社区合作伙伴关系， 使用有文化能力的社区卫生保健工作者，快速和廉价的护理点 测试，并使用我们的接触追踪计划的实时地理空间数据， 移动的弹出测试的位置。我们专注于COVID-19高水平的服务不足人群 未经事先检测的暴露将为今后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.