RI-Center for Clinical and Translational Science

RI-临床和转化科学中心

• 批准号: 10413517
• 负责人: Sharon Irene Smith Rounds
• 金额: $ 109.12万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-10 至 2023-09-09
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10413517
• 关键词: 2019-nCoV; Address; Adult; Area; Awareness; COVID-19; COVID-19 diagnostic; COVID-19 monitoring; COVID-19 pandemic; COVID-19 test; COVID-19 testing; COVID-19 vaccination; COVID-19 vaccine; Caregivers; Caring; Censuses; Child; Child Welfare; Childhood; Clinic; Clinical; Clinical Data; Clinical Sciences; Collaborations; Communities; Community Health; Community Health Aides; Consolidated Framework for Implementation Research; Data; Decision Support Systems; Development; Diagnostic tests; Disease Outbreaks; Dose; Ecosystem; Effectiveness; Family Caregiver; Focus Groups; Group Interviews; Health; Health Resources; Health Services; Healthcare; Hospitalization; Individual; Infection; Information Networks; Infrastructure; Intervention; Interview; Length of Stay; Measures; Methods; Modeling; Monitor; Office Visits; Parents; Patient Recruitments; Pattern; Phase; Physical environment; Population; Positioning Attribute; Process; Provider; Public Health; RADx Underserved Populations; Reporting; Rhode Island; SARS-CoV-2 positive; Safety; Schedule; Structure; System; Test Result; Testing; Time; Time trend; Translational Research; Trauma; Vaccinated; Vaccination; Virus; Vulnerable Populations; Work; base; care coordination; care outcomes; caregiver education; clinical center; community clinic; density; design; digital health; education resources; experience; family structure; health disparity; health equity; health information technology; health literacy; healthcare community; high risk; hospitalization rates; implementation framework; improved; member; mortality; patient population; resilience; side effect; social; social factors; socioeconomics; success; testing uptake; tool; uptake; vaccination strategy; vaccine acceptance; vaccine hesitancy

SUMMARY Nationally, Latinx individuals have four times the rate of SARS-CoV-2 diagnoses compared to Non- Hispanic Whites. Furthermore, Latinx populations may face barriers in accessing SARS-CoV-2 tests, receiving test results, interpreting test results, and getting appropriate follow-up care. Improved understanding of the sources of health equity differences for Latinx populations can be used to better guide allocation of resources and provide essential data for provider organizations seeking to support those in the most need. This RADx- UP project will establish a statewide research and monitoring infrastructure in partnership with community clinics. We will develop community health teams (“Promotoras Teams”) with the largest Latinx community organization in Rhode Island to address identified barriers to COVID-19 testing through patient navigation, health literacy support, and follow-up care. The overall goals of the proposed study are to improve testing uptake and the understanding of SARS- CoV-2 outcomes among Latinx populations. We will build on partnerships with community clinics that serve a high proportion of Latinx individuals (>50%) in Rhode Island. We will place particular emphasis on disparities in care faced by Latinx populations and factors that have been identified as impacting health equity in Rhode Island (integrated healthcare, community resilience, physical environment, socioeconomics, and community trauma). The insights gained from the quantitative and qualitative approaches will be used to guide the implementation of community campaigns to improve testing among Latinx populations that are in identified locations with lower per capita testing than other parts of the state (“testing deserts”). This RADx-UP project will utilize a unique approach and infrastructure to monitor SARS-CoV-2 testing rates, including the use of the statewide Health Information Exchange (HIE) in Rhode Island that connects data across primary care, urgent care, specialty care, and acute care clinical environments. The HIE contains clinical data for most people receiving care in Rhode Island including SARS-CoV-2 test results from major laboratories and other facilities (e.g., CVS MinuteClinic). These quantitative data will be combined with qualitative data and organized according to the Consolidated Framework for Implementation Research framework to guide our mixed-methods explanatory sequential design. The specific aims of this project are to: (1) Identify COVID-19 hotspots and testing deserts using a near-real time geographic information system monitoring system; (2) Determine community and provider barriers that impact access to SARS-CoV-2 testing; and, (3) Implement community-based approaches to improve SARS-CoV-2 testing. This RADx-UP project will develop a community-based infrastructure to enable structured, longitudinal relationships with a historically underserved patient population. Such insights will provide essential data for a population level decision support system guiding testing prioritization and for future consideration of vaccine-based prevention strategies.

概括 在全国范围内，拉丁裔人群的 SARS-CoV-2 诊断率是非拉丁裔人群的四倍 西班牙裔白人。此外，拉丁裔人群在获得 SARS-CoV-2 检测、接受检测方面可能面临障碍。 测试结果、解释测试结果并获得适当的后续护理。增进了对 拉丁裔人口健康公平差异的来源可用于更好地指导资源分配 并为寻求支持最有需要的人的提供商组织提供必要的数据。这个 RADx- UP 项目将与社区合作建立全州范围的研究和监测基础设施 诊所。我们将与最大的拉丁裔社区一起发展社区卫生团队（“Promotoras Teams”） 罗德岛州组织通过患者导航解决已发现的 COVID-19 检测障碍， 健康素养支持和后续护理。 拟议研究的总体目标是提高检测的采用率和对 SARS 的理解 拉丁裔人群中的 CoV-2 结果。我们将与社区诊所建立合作伙伴关系，为患者提供服务 罗德岛州拉丁裔人口比例很高（>50%）。我们将特别强调以下方面的差异： 拉丁裔人口面临的护理以及已确定影响罗德岛健康公平的因素 岛屿（综合医疗保健、社区复原力、自然环境、社会经济和社区 创伤）。从定量和定性方法中获得的见解将用于指导 开展社区活动，以改善对已确定的拉丁裔人群的检测 人均检测率低于该州其他地区的地区（“检测沙漠”）。 该 RADx-UP 项目将利用独特的方法和基础设施来监测 SARS-CoV-2 测试 费率，包括使用罗德岛州连接数据的全州健康信息交换 (HIE) 涵盖初级护理、紧急护理、专科护理和急症护理临床环境。 HIE 包含 大多数在罗德岛州接受护理的人的临床数据，包括来自主要机构的 SARS-CoV-2 检测结果 实验室和其他设施（例如 CVS MinuteClinic）。这些定量数据将与 定性数据并根据实施研究综合框架组织 指导我们的混合方法解释性顺序设计的框架。该项目的具体目标是： (1) 使用近实时地理信息系统识别 COVID-19 热点并测试沙漠 监控系统； (2) 确定影响 SARS-CoV-2 检测的社区和提供者障碍； (3) 实施基于社区的方法来改进 SARS-CoV-2 检测。该 RADx-UP 项目将 开发基于社区的基础设施，以实现与历史上的结构化、纵向关系 服务不足的患者群体。这些见解将为人口层面的决策支持提供必要的数据 系统指导测试优先顺序以及未来考虑基于疫苗的预防策略。