COVID-19 testing and vaccination social network diffusion for diverse criminal legal involved communities

摘要：本次RADX-UP第二期提案，《社交网络扩散为多元预防新冠肺炎》 刑事法律介入社区“，将实施适当的新冠肺炎测试和情况 疫苗接种社会网络传播干预-C3-建立在RADx-UP第一阶段课程和 研究小组先前开发的成功的社会网络预防干预措施。C3罪犯 涉案法律(CLI)人群包括那些最近经历过逮捕的未被监禁的人， 监禁、缓刑、假释或毒品法庭等分流方案。而新冠肺炎的涨幅 在这组人中观察到了测试，仍有成员的测试历史以及 接种疫苗的人对此犹豫不决。新冠肺炎预防信息不能再简化为 “人人检测和/或人人接种”作为社区成员的检测和疫苗接种决策 对个人病史(即先前感染)、当地感染率(即低感染率)和 检测/疫苗接种的可用性。随着新冠肺炎预防工作变得更加复杂(即，测试是否 暴露)，人们倾向于关注信使，特别是那些与他们关系密切的人。个人 现有个人网络结构内的连接和通信，如家庭、朋友和 其他值得信赖的熟人是增加适当情况测试和 克服新冠肺炎疫苗的犹豫。C3通过使用网络扩散方法在RADx-UP I的基础上构建 通过激励性采访促进，目的是动员自己的有机社交网络 增加适合环境的检测和疫苗接种量。通过这一过程，我们将最大限度地提高初级 这类干预的好处和影响也具有增加以下可能性的预期效果 信使本身将经历他们所接受的培训所促进的相同的行为变化。 我们将利用在RADx-UP第一阶段开发的基础设施，该阶段包括全球4个高影响站点 美国中部：巴吞鲁日洛杉矶、小石城、印第安纳波利斯和伊利诺伊州芝加哥。我们将利用 既定的参与努力已经到位，并继续将社区完全整合到战略 干预措施的应用。我们将使用RE-AIM(REACH、有效性、采用、实施和 维护)指导实施的框架。C3的目标是：目标1a。测试疗效(3个月情况 适当的测试或接种)网络扩散干预(C3)与现有的新冠肺炎测试 以及疫苗与护理干预之间的联系：1)主要研究参与者(主要结果)；以及2) 二次研究参与者使用随机对照试验设计连接到主要参与者(二次结果)。目标 1B.探索在个人和网络层面产生不同干预效果的机制，可能 增加适合情况的检测和/或疫苗接种。目标2.检查中的关键RE-AIM组件 实时捆绑实施网络扩散干预(C3)。

Abstract: This RADx-UP Phase II proposal, “Social network diffusion of COVID-19 prevention for diverse Criminal Legal Involved Communities”, will implement a situation appropriate COVID-19 testing and vaccination social network diffusion intervention – C3 – building upon RADx-UP Phase I lessons and successful social network prevention interventions developed previously by the research team. C3 Criminal Legal Involved (CLI) populations encompass those non-incarcerated who have experienced recent arrest, incarceration, probation, parole or diversion programs such as drug courts. While increases in COVID-19 testing have been observed among this group, there remain members with limited testing history as well as individuals who are vaccine hesitant. COVID-19 prevention messaging can no longer be simplified to “everyone test and/or everyone vaccinate” as testing and vaccination decisions among community members are sensitive to personal histories (i.e., prior infection), local infection rates (i.e., low rates) and testing/vaccination availability. As COVID-19 prevention efforts have become more complicated (i.e., test if exposed), people tend to focus on the messenger, and particularly those that are close to them. Personal connections and communications within existing personal network structures, such as families, friends and other trusted acquaintances represent the cornerstone to increase situation appropriate testing and overcoming COVID-19 vaccine hesitancy. C3 builds upon RADx-UP I, by using a network diffusion approach facilitated through motivational interviewing purposefully geared to mobilize one’s own organic social network to increase context appropriate testing and vaccine uptake. Through this process we will maximize the primary benefit and impact of this type of intervention which also has the intended effect of increasing likelihood that the messenger themselves will undergo the same behavior change that they have been trained to promote. We will leverage infrastructure developed in RADx-UP Phase I, which includes 4 high-impact sites across the Central US from Phase I: Baton Rouge LA, Little Rock AR, Indianapolis IN, and Chicago IL. We will utilize established engagement efforts already in place and continue to fully integrate communities in the strategic application of the intervention. We will use the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to guide implementation. C3 aims to: Aim 1a. Test the efficacy (3-month situation appropriate testing or vaccination) of a network diffusion intervention (C3) versus an existing COVID-19 testing and vaccine linkage to care intervention among: 1) primary study participants (primary outcome); and 2) secondary study participants connected to primary participants (secondary outcome) using a RCT design. Aim 1b. Explore the mechanisms for differential intervention effects at the individual and network-level that may increase situation appropriate testing and/or vaccination uptake. Aim 2. Examine key RE-AIM components in real time tied to the implementation of the network diffusion intervention (C3).