Evaluation of Smoke-Free Housing Policy Impacts on Tobacco Smoke Exposure and Health Outcomes

抽象的。到2020年12月，新冠肺炎将拉美裔/拉丁裔和 美国的非裔美国人/黑人是非西班牙裔白人的两倍。新的 纽约市(纽约市)在新冠肺炎流行和令人不安的模式早期成为新冠肺炎的震中- 相关的差距迅速出现。在2020年10月，我们启动了快速诊断加速 针对纽约市公共住房居民的服务不足人群(RADx-UP)，利用长期存在的 与纽约市住房管理局(NYCHA)、纽约市卫生局、纽约市公立医院 负责追踪接触者的系统(NYC Health+医院)和一组强大的社区合作伙伴 执行了解数据、参与社区的研究项目，以制定和测试战略以提高 在纽约市公共住房居民中采用新冠肺炎测试。NYCHA是世界上最大的公共住房 北美当局，40多万官方居民居住在全国15%的公共住房中 单位。家庭收入中位数为2万美元，大约90%的NYCHA居民要么是黑人，要么是 西班牙裔。通过RADx-第一阶段项目，我们开发了一个强大的社区参与结构，以 指导我们的工作，设计并推出了新冠肺炎感染和检测率的每周监测 在纽约市各地开发了374个项目，为公共住房场地上的新冠肺炎试验场提供了便利，并启动了 使用NYCHA居民社区卫生工作者的干预试验。现在，为了解决传输的事实 主要发生在较年轻的人群中，我们正在引入接触点唾液检测和 现场疫苗调度，以及延伸覆盖范围的检测方法。我们的新目标是：1)扩张 并维持我们的社区参与基础设施；2)将近乎实时的监控应用于直接移动 测试和弹出疫苗接种诊所到全市公共住房开发项目；3)发现促进者和 在两个新的优先群体(青少年/年轻人和待在家里的老年人)的检测和接种方面存在障碍 成人)；以及4)测试监督的护理点唾液测试和疫苗调度模式。通过在基础上构建 我们的早期成功、强大的合作伙伴关系、强大的市政数据来源以及快速扩展的 通过测试计划，此实施研究提供了调整战略以解决以下方面实际障碍的机会 将检测和疫苗接种服务扩展到大量高需求人群。调查结果将被用来开发 关于在全国多单元和公共住房环境中实施测试战略的指导。

ABSTRACT. By December, 2020, COVID-19 associated hospitalization rates among Hispanic/Latino and African-American/Black persons in the United States were twice as large as non-Hispanic White persons. New York City (NYC) became the epicenter of COVID-19 early in the epidemic and disturbing patterns of COVID- related disparities rapidly emerged. In October 2020, we launched a Rapid Acceleration of Diagnostics for Underserved Populations (RADx-UP) targeting NYC public housing residents, leveraging longstanding partnerships with the NYC Housing Authority (NYCHA), the NYC Health Department, the NYC public hospital system responsible for contact tracing (NYC Health +Hospitals) and a robust set of community partners to execute a data-informed, community-engaged research project to develop and test strategies to increase adoption of COVID-19 testing among NYC public housing residents. NYCHA is the largest public housing authority in North America, with more than 400,000 official residents living in 15% of the nation’s public housing units. Median family income is $20,000, and approximately 90% of NYCHA residents are either black or Hispanic. Through the RADx-Phase I project, we developed a strong community engagement structure to guide our work, designed and launched weekly surveillance of COVID -19 infections and testing rates at all 374 developments across NYC, facilitated COVID-19 testing sites on public housing grounds, and launched an intervention trial using NYCHA resident community health workers. Now, to address the facts that transmission is predominantly occurring among younger age groups, we are introducing point-of-contact saliva testing and on-the-spot vaccine scheduling, as well as testing methods to extend reach. Our new aims are to: 1) Expand and sustain our community engagement infrastructure; 2) Apply near-real time surveillance to direct mobile testing and popup vaccination clinics to public housing developments citywide; 3) Discover facilitators and barriers to testing and vaccination in two new priority groups (teens/young adults and homebound older adults); and 4) Test supervised point-of-care saliva testing and vaccine scheduling modalities. By building on our early successes, strong partnerships, robust municipal data sources, and a rapidly expanding array of testing initiatives, this implementation study offers the opportunity to tailor strategies to address real barriers in extending testing and vaccination services to a large, high-need population. Findings will be used to develop guidance for implementing testing strategies in multi-unit and public housing settings nationally.