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.

总结 在全国范围内，拉丁裔人的SARS-CoV-2诊断率是非拉丁裔人的四倍。 西班牙白人此外，拉丁裔人口在获得SARS-CoV-2检测、接受 测试结果，解释测试结果，并获得适当的后续护理。更好地了解 拉丁裔人群健康公平差异的来源可用于更好地指导资源分配 并为寻求支持最需要帮助的人的提供者组织提供必要的数据。这个雷达- 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（“Promotoras团队”） 罗得岛的一个组织，通过患者导航解决COVID-19检测的障碍， 卫生知识普及支持和后续护理。 这项拟议研究的总体目标是提高对SARS的检测和了解- Latinx人群中的CoV-2结局。我们将与社区诊所建立伙伴关系， 在罗得岛拉丁美洲人比例较高（>50%）。我们将特别强调以下方面的差距： 拉丁裔人口面临的护理和已被确定为影响罗得岛州健康公平的因素 岛屿（综合医疗保健，社区弹性，物理环境，社会经济学和社区 创伤）。从定量和定性方法中获得的见解将用于指导 开展社区运动，以改善已确定的拉丁裔人口的检测 人均测试低于该州其他地区的地点（“测试沙漠”）。 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，包括使用罗得岛的全州健康信息交换（HIE）， 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 在罗得岛接受治疗的大多数人的临床数据，包括来自主要医院的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 质量数据，并根据实施情况研究综合框架进行组织 框架来指导我们的混合方法解释顺序设计。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热点和测试沙漠 （2）确定影响获得SARS-CoV-2检测的社区和提供者障碍; （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 发展以社区为基础的基础设施，使结构化的，纵向的关系， 服务不足的患者群体。这些见解将为人口水平的决策支持提供必要的数据 该系统指导测试优先次序，并为今后考虑疫苗为基础的预防战略。