REDES: a peer network and mobile health (mHealth) enhanced CHW model to maximize COVID-19 vaccination among low income Latinos

项目摘要 新冠肺炎疫情对美国拉丁裔的影响不成比例。未能提供公平的机会 疫苗将加剧拉美裔在新冠肺炎和其他健康状况方面的巨大差异 社区。我们的团队已经建立了一个社区联盟，并确定了有效的干预措施来减少 低收入有限英语水平(LEP)拉丁裔社区之间的差异使用定性、调查、 和实施科学方法论。我们将测试联合干预Redes的效果 (“网络”)-一个社交网络和移动健康(MHealth)增强型社区卫生工作者(CHW) 干预-解决拉美裔和他们的一群人对新冠肺炎疫苗的犹豫不决和接受情况 马里兰州的网络。招募接种过新冠肺炎疫苗的指数参与者300人。一半的人 指标参与者将被随机分为试验组(n=150)。CHW将训练他们成为同龄人 导师面对面和通过短信进行同伴外联，并促进疫苗接受度和 利用他们的网络。对照组(n=150)的索引参与者将得到同等的关注 干预。此外，我们将招募未接种疫苗的主要和次要网络成员的指数 学习参与和新冠肺炎接种。我们将招收大约1,590名小学和 次要网络成员。所有参与者将在3、6、12和18个月后进行前瞻性跟踪 基线摄入量。具体目的是：1)评估一种联合干预措施的效果 促进拉美裔接受新冠肺炎疫苗；2)检查疫苗的持续障碍和促进者 吸收拉美裔及其网络，以量身定制我们的干预措施并应对新的挑战，以及3) 评估REDES的实施决定因素和结果，为未来的大范围 实施。我们的多学科研究团队将拉丁裔健康、社交网络、mHealth 干预措施，疫苗迟疑专业知识；社区与合作伙伴长期接触的历史 马里兰州的组织；以及现有的双语/双文化CHW能力和丰富的当地基础设施 新冠肺炎回应。如果这种联合干预显示了效果，我们将开发一种 为社区合作伙伴和卫生部门提供英文和西班牙文的实施战略工具包 有兴趣复制这种方法。这项提案主要关注新冠肺炎疫苗接种，但 所获得的知识将与未来的疫苗公平倡议相关，例如新冠肺炎助推器(如果需要) 和季节性流感疫苗接种。

Project Summary The COVID-19 pandemic disproportionately impacts Latinos in the US. Failing to provide equitable access to vaccines will exacerbate the profound disparities in COVID-19 and other health conditions among Latinos communities. Our team has established a community coalition and identified effective interventions to reduce disparities among low-income limited English proficiency (LEP) Latino communities using qualitative, survey, and implementation science methodologies. We will test the efficacy of a combination intervention REDES (“Networks”) - a social network and mobile health (mHealth) enhanced community health worker (CHW) intervention - to address COVID-19 vaccine hesitancy and uptake among a cohort of Latinos and their networks in Maryland. We will recruit 300 index participants who have taken the COVID-19 vaccine. Half of the index participants will be randomized to the experimental group (n=150). CHWs will train them to be peer mentors to conduct peer outreach in-person and by text messages and to promote vaccine acceptance and uptake with their networks. Index participants in the control group (n=150) will receive an equal attention intervention. In addition, we will recruit unvaccinated primary and secondary network members of indexes for study participation and COVID-19 vaccination. We will enroll an estimated total of 1,590 primary and secondary network members. All participants will be followed prospectively at 3, 6, 12, and 18 months after baseline intake. The specific aims are: 1) Evaluate the efficacy of a combination intervention REDES to promote COVID-19 vaccine uptake among Latinos; 2) Examine ongoing barriers and facilitators of vaccine uptake among Latinos and their networks to tailor our intervention and address new challenges, and 3) Evaluate the implementation determinants and outcomes of REDES to inform future broad-scale implementation. Our multi-disciplinary research team brings together Latino health, social network, mHealth interventions, vaccine hesitancy expertise; a long-term history of community engagement with partner organizations in Maryland; and existing bilingual/bicultural CHW capacity and a rich local infrastructure for COVID-19 response. If this combination intervention demonstrates the efficacy, we will develop an implementation strategy toolkit, both in English and Spanish, for community partners and health departments interested in replicating the approach. This proposal primarily focuses on COVID-19 vaccination, but knowledge gained will be relevant to future vaccine equity initiatives, such as COVID-19 boosters (if needed) and seasonal influenza vaccination.