Understanding Factors Influencing COVID-19 Testing and Vaccination in Immigrant Low-income and Homeless Populations and Testing Targeted Interventions

新冠肺炎疫情对弱势群体和弱势群体的影响不成比例 社区。到目前为止，研究强调了导致这些差异的因素，包括 医疗保健和研究环境中边缘化人群的差别待遇和体验，减少 获得检测和护理，生活在聚居或多代家庭中，经济后果 被诊断为新冠肺炎和隔离，对艾滋病的不同理解和态度 大流行，以及对接触者追踪的担忧。移民和低收入人口，以及 经历无家可归，许多人患有精神疾病，和/或最近被监禁，他们犹豫不决 参与检测并接受新冠肺炎检测和接种。有迫切的需要 了解如何提供可理解并能引起共鸣的检测和疫苗接种信息 在其文化和社会背景下的高风险社区。实现这一目标的有效公共卫生战略 信息必须包括社区投入和伙伴关系。与以下社区合作伙伴密切合作 洞察影响人们测试决策的文化、行为、经济和因素 而疫苗的接受度对于制定有效的沟通和推广战略至关重要 让个人参与检测、接种疫苗和护理。与我们的社区合作伙伴合作，我们将创造和 评估缅因州坎伯兰县地区公共卫生干预的影响，以提供 对来自撒哈拉以南非洲的一大批移民进行外联、检测和疫苗接种教育 中东和中美洲，高风险低收入人群使用公共卫生设施(有 性传播感染诊所、针头交换和免费诊所)，以及个人经历 无家可归。这将是一项纵向研究，以了解对新冠肺炎的信念和知识，以及 关于检测和疫苗接种的障碍和信念。结果将通知一个社区-开发和基于 采取干预措施，让队列和这些人口中的其他成员参与检测和疫苗教育， 并评估这一干预措施对我们移民、低收入、 和无家可归的社区。具体目标：1)了解患者对 新冠肺炎检测和疫苗接种的经验，包括在我们移民、低收入国家和地区的加强疫苗接种 收入和无家可归人口。2)使用目标1的数据来开发和试点公共卫生 信息和测试计划，以增加疫苗和测试在我们感兴趣的人群中的接受度。3)至 评估在AIM 2中开发的公共卫生消息传递和检测计划对快速新冠肺炎的影响 测试和疫苗接种。虽然它需要根据当地社区的文化和需求进行调整， 这项工作可以为制定和维持公共卫生措施奠定基础，这些措施将有助于 控制疫情，缩小美国弱势群体与新冠肺炎相关的差距。

The COVID-19 pandemic has disproportionately affected people from vulnerable and disadvantaged communities. Research to date has highlighted the factors that contribute to these disparities including differential treatment and experience of marginalized populations in healthcare and research settings, reduced access to testing and care, living in congregate or multigenerational households, the economic consequences of being diagnosed with COVID-19 and quarantining, differing understanding of and attitudes towards the pandemic, and concerns about contact tracing. Immigrant and low income populations, and people experiencing homelessness, many with mental illnesses, and/or have been recently incarcerated, are hesitant to participate in testing and to accept COVID-19 testing and vaccination. There is an urgent need to understand how to deliver information about testing and vaccination that is understandable and resonates with higher risk communities in their cultural and social contexts. Effective public health strategies for delivering this information must include community input and partnerships. Working closely with community partners who have insight into cultural, behavioral, economic, and factors impacting people’s decision making about testing and vaccine acceptance is essential to developing effective communication and outreach strategies for engaging individuals in testing, vaccination, and care. Working with our community partners, we will create and evaluate the impact of a public health intervention in the area of Cumberland County, Maine, to provide outreach, testing, and vaccination education to a large community of immigrants from sub-Saharan Africa, the Middle East, and Central America, higher-risk low-income people accessing a public health facility (with a sexually transmitted infections clinic, needle exchange, and a free clinic), and individuals experiencing homelessness. This will be a longitudinal study to understand beliefs about and knowledge of COVID-19, and barriers and beliefs about testing and vaccination. Results will inform a community-developed and based intervention to engage the cohort and other members of these populations in testing and vaccine education, and evaluate the impact of this intervention on testing and vaccination uptake in our immigrant, low-income, and homeless communities. Specific Aims: 1) To understand patient perceptions of, fears about, and experiences with COVID-19 testing and vaccination, including booster vaccination in our immigrant, low- income, and homeless populations. 2) To use the data from Aim 1 to develop and pilot test a public health messaging and testing program to increase vaccine and testing uptake in our populations of interest. 3) To evaluate the impact of a public health messaging and testing program developed in Aim 2 on rapid COVID-19 testing and vaccine uptake. While it will need to be adapted based on local communities’ cultures and needs, this work could be foundational for creating and sustaining public health measures that will contribute to the control of the pandemic and reducing the COVID-19 related disparities of vulnerable populations in the US.