RI-Center for Clinical and Translational Science

摘要 在全国范围内，拉丁裔患者的SARS-CoV-2诊断率是非拉丁裔患者的四倍 西班牙裔白人。此外，拉丁裔人群在获得SARS-CoV-2检测、接受 测试结果，解释测试结果，并得到适当的后续护理。更好地理解 拉丁裔人群健康公平差异的来源可以用来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基本数据。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发展社区卫生团队(“促进者团队”)。 位于罗德岛州的组织通过患者导航解决新冠肺炎检测的已知障碍， 提供健康素养支持，并提供后续护理。 拟议研究的总体目标是改善对SARS的测试吸收和了解- 拉丁裔人群中的CoV-2结局。我们将加强与社区诊所的伙伴关系，为 罗德岛的拉美裔人比例很高(&gt；50%)。我们将特别强调以下方面的差距 罗德州拉丁裔人口面临的护理和被确定为影响健康公平的因素 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 开展社区宣传活动，以改进对已确定的拉丁裔人群的检测 人均检测水平低于该州其他地区的地区(“测试沙漠”)。 这个RADX-UP项目将利用一种独特的方法和基础设施来监测SARS-CoV-2检测 费率，包括使用罗德岛州的全州健康信息交换(HIE)连接数据 跨初级护理、紧急护理、专科护理和急性护理临床环境。HIE包含 罗德岛大多数接受护理的人的临床数据，包括来自主要医疗机构的SARS-CoV-2检测结果 实验室和其他设施(如CVS MinuteClinic)。这些量化数据将与 定性数据，并根据实施研究综合框架组织 框架来指导我们的混合方法解释性顺序设计。该项目的具体目标是： (1)利用近乎实时的地理信息系统识别新冠肺炎热点和测试沙漠 监测系统；(2)确定影响获得SARS-CoV-2检测的社区和提供者障碍； 以及，(3)实施以社区为基础的方法，以改善SARS-CoV-2检测。这个RADx-Up项目将 开发基于社区的基础设施，以实现与历史上 服务不足的病人群体。这些洞察力将为人口层面的决策支持提供必要的数据 指导测试优先顺序的系统，并用于未来考虑基于疫苗的预防策略。

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.