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

了解影响移民低收入和无家可归人群的 COVID-19 检测和疫苗接种的因素以及测试有针对性的干预措施

• 批准号: 10413438
• 负责人: CLIFFORD JAMES ROSEN
• 金额: $ 94.09万
• 依托单位: MAINEHEALTH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-07 至 2022-08-04
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10413438
• 关键词: Address; Affect; Africa South of the Sahara; Area; Attitude; Belief; COVID-19; COVID-19 diagnosis; COVID-19 pandemic; COVID-19 testing; COVID-19 vaccination; COVID-19 vaccine; Caring; Central America; Clinic; Communication; Communities; Contact Tracing; County; Data; Decision Making; Disadvantaged; Drops; Economic Factors; Economics; Education; Exposure to; Family; Feedback; Foundations; Fright; Health; Health Care Research; Health care facility; Homelessness; Household; Immigrant; Imprisonment; Individual; Intervention; Interview; Justice; Knowledge; Learning; Longitudinal Studies; Low Income Population; Low income; Maine; Measures; Mental disorders; Middle East; Modeling; Needle-Exchange Programs; Patients; Perception; Persons; Population; Public Health; Qualitative Methods; Quarantine; Research; SARS-CoV-2 infection; Secondary Immunization; Sexually Transmitted Diseases; Site; Social Environment; Structure; Suggestion; Surveys; Testing; Time; United States; Vaccinated; Vaccination; Vaccines; Vulnerable Populations; Work; base; behavioral economics; cohort; expectation; experience; health disparity; high risk; insight; interest; marginalized population; member; outreach; pandemic disease; preference; programs; public health intervention; rapid testing; social; social stigma; testing uptake; vaccine acceptance; vaccine hesitancy

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.

2019冠状病毒病大流行对弱势群体的影响尤为严重