Community Activation to TrAnsform Local sYSTems (CATALYST)

项目摘要 社区卫生工作者(CHW)在解决多层次、社区问题方面发挥了重要作用 获取新冠肺炎信息、测试、风险缓解和疫苗接种的障碍；然而， 鉴于巨大的社会、社区和社会环境，人们对社区卫生工作者如何管理他们的角色知之甚少 政治挑战。2020年5月，奥兰治县健康股权新冠肺炎社区- 与社区卫生公平领袖和卫生公平建立学术伙伴关系 学术合作伙伴提升对当地新冠肺炎股权反应的需求和指导 恢复计划。公平的复苏必须满足更大的公民参与需求，以及社区卫生组织 对于驾驭日益高涨的反移民态度和促进公民参与 人口普查完成统计和选举投票率除新冠肺炎教育和慢性病外 疾病管理。在这项研究中，我们的目标是：(1)从CHW和CHW的角度来考察 社区成员共建新冠肺炎的促进者、障碍和变革过程 新冠肺炎大流行期间的应对和慢性病管理CHW干预。 我们将与五个以社区为基础的组织合作，在这些领域开展重点小组活动 加利福尼亚州奥兰治县对新冠肺炎的社会脆弱性最高；(2)评估系统性 加剧奥兰治县新冠肺炎检测、病例和疫苗不平等的因素 对新冠肺炎的社会脆弱性最高的人。通过采访社区领导人和 对于政策利益相关者，我们将确定有助于成功的多层次背景因素 社区卫生组织和社区成员在接受新冠肺炎教育、检测和培训方面的挑战 疫苗接种；以及(3)分析卫生福利院和社区开展的宣传工作如何 组织塑造了新冠肺炎的回应。我们将从各地招募和面试CHW 加州将确定奥兰治县社区反应和弹性的程度 可以推广到全州不同的人群。这项研究的优势包括我们的 对社区驱动的新冠肺炎干预措施的响应性；慢性病的整合 将管理纳入新冠肺炎回应的研究；重点关注CHW确保获得 新冠肺炎资源，在社区成员中建立意识，改造当地 新冠肺炎响应；强有力的社区和大学领导；多层次评估 新冠肺炎干预的重要性。我们将增进对新冠肺炎变化过程的了解 对新冠肺炎社会易感性最高的社区进行CHW干预。结果是 这项研究将为加强公平共建新冠肺炎和 为未来的公共卫生危机做好准备，并在全国范围内成为CBPR的典范。

Project Abstract Community health workers (CHWs) played an essential role in addressing multi-level, community barriers to accessing COVID-19 information, testing, risk mitigation, and vaccination; however, little is known about how CHWs managed their roles in light of enormous social, community, and political challenges. In May 2020 the Orange County Health Equity COVID-19 Community- Academic Partnership formed with community-based health equity leaders and health equity academic partners to elevate the need for and guide local COVID-19 equity response and recovery initiatives. Equitable recovery must address larger civic engagement needs, and CHWs were essential to navigating rising anti-immigrant attitudes, and promoting civic engagement for census complete count and elections turnout in addition to COVID-19 education and chronic disease management. In this study, we aim to: (1) Examine from the perspective of CHWs and community members the facilitators, barriers, and processes of change of delivering COVID-19 response and chronic disease management CHW intervention during the COVID-19 pandemic. In partnership with five community-based organizations, we will conduct focus groups in the areas with the highest social vulnerability to COVID-19 in Orange County, CA; (2) Assess the systemic factors that enhance inequities in COVID-19 testing, cases, and vaccines in Orange County areas with the highest social vulnerability to COVID-19. Through interviews with community leaders and policy stakeholders, we will identify the multilevel contextual factors that contribute to successes and challenges of CHWs and community members to access COVID-19 education, testing, and vaccinations; and (3) analyze how advocacy efforts implemented by CHWs and community-based organizations shape the COVID-19 response. We will recruit and interview CHWs from across California to identify the degree to which Orange County’s community responses and resiliencies are generalizable to diverse populations across the state. Strengths of this study include our responsiveness to community-driven COVID-19 interventions; the integration of chronic disease management into the study of COVID-19 responses; a focus on CHW efforts to ensure access to COVID-19 resources and to build consciousness among community members and transform local COVID-19 responses; strong community and university leadership; and multilevel assessments of COVID-19 interventions. We will advance knowledge about processes of change in COVID-19 CHW interventions in communities with highest social vulnerability to COVID-19. The results of this study will inform policy recommendations to strengthen equitable COVID-19 recovery and prepare for future public health crises and serve as a model of CBPR nationwide.