Motivational enhancement to augment contingency management for SARS-CoV-2 testing and vaccination utilization among syringe exchange clients

增强动机，以加强注射器交换客户中 SARS-CoV-2 检测和疫苗接种利用的应急管理

• 批准号: 10447247
• 负责人: Camille C Cioffi
• 金额: $ 109.52万
• 依托单位: UNIVERSITY OF OREGON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-15 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10447247
• 关键词: 2019-nCoV; Address; American; Behavioral; CLIA certified; COVID-19; COVID-19 health disparity; COVID-19 morbidity; COVID-19 mortality; COVID-19 risk; COVID-19 testing; COVID-19 vaccination; COVID-19 vaccine; Caring; Cessation of life; Client; Collaborations; Communicable Diseases; Contracts; Cost Effectiveness Analysis; Data Collection; Discrimination; Disease; Effectiveness; Evaluation; Exposure to; General Population; Goals; HIV; HIV/HCV; Health behavior outcomes; Healthcare Systems; Hepatitis B; Herd Immunity; Human immunodeficiency virus test; Hygiene; Immunization; Immunization Programs; Immunocompromised Host; Infrastructure; Injecting drug user; Intervention; Laboratories; Link; Long-Term Effects; Medical; Misinformation; Motivation; Needle-Exchange Programs; Oregon; Outcome; Penetration; Phase; Population Decreases; Preventive; Probability; Procedures; Process; RADx; RADx Underserved Populations; Randomized Controlled Trials; Recording of previous events; Reporting; Research; Risk; SARS-CoV-2 infection; SARS-CoV-2 transmission; Sampling; Services; Site; Specimen; Stigmatization; Testing; Time; Trust; Tuberculosis; Universities; Vaccination; Vaccines; Viral hepatitis; Vulnerable Populations; arm; base; behavior change; community based participatory research; comparative effectiveness; contingency management; effective intervention; experience; extrinsic motivation; follow-up; health care availability; health care service; high risk; housing instability; implementation evaluation; improved; phase 1 study; prevent; programs; sample collection; service intervention; success; testing uptake; transmission process; treatment arm; vaccine acceptance; vaccine access; vaccine hesitancy

PROJECT SUMMARY People who inject drugs (PWIDs) are highly vulnerable to contracting SARS-CoV-2 and to the effects of the disease caused by SARS-CoV-2, coronavirus disease 2019 (COVID-19). PWIDs experience underlying medical conditions and unstable housing that put them at increased risk for COVID-19 morbidity and mortality. PWIDs also experience barriers such as a history of stigmatization and discrimination by health care systems and exposure to misinformation that reduces access to health care services, such as SARS-CoV-2 testing and vaccination. The proposed project builds on our Phase I Rapid Acceleration of Diagnostics project (#67; PI: Stormshak) that successfully embedded SARS-CoV-2 testing into syringe exchange programs (SEPs) across the state of Oregon, in collaboration with HIV Alliance (HIVA). The testing program’s success is linked to a contingency management (CM) intervention that increased the rates of testing utilization from 4% to 24% (d = 1.36), even as nationwide testing utilization was decreasing. The first aim of the proposed project is to test the sustained effectiveness of CM on testing outcomes, given the current context of increasing COVID-19 vaccine accessibility. Testing remains critical to prevent the transmission of SARS-CoV-2 among PWIDs who continue to be at high exposure risk, and for whom vaccine hesitancy is high. We will also leverage our partnership with HIVA to establish a COVID-19 vaccine program at HIVA’s SEPs. The second aim is to conduct a randomized control trial (RCT) to examine whether a brief motivational enhancement (ME) intervention (i.e., Connect2Test) augments the effects of CM on SARS-CoV-2 testing and vaccination uptake. Our Phase I study demonstrates that CM improves SARS-CoV-2 testing utilization. CM is also known to increase immunization rates against other infectious diseases, such as Hepatitis B. Additionally, consistent with research showing that ME enhances the effects of CM on health behavior outcomes, we anticipate that Connect2Test will augment CM’s effects on testing and vaccination among PWIDs. Moreover, because ME elicits and strengthens motivation for long-term behavior change, whereas CM prompts immediate and short-term behavior change, we anticipate that CM + ME, versus CM alone, will have long-term effects on SARS-CoV-2 testing, evidenced by participation in repeated testing over time. The third aim of the proposed project is to assess CM and Connect2Test implementation, including a cost-effectiveness analysis of CM alone versus CM plus Connect2Test, to improve long-term sustainability of testing, vaccination, and intervention approaches to mitigate the spread of SARS-CoV-2.

项目总结