REACH-OUT (Research, Engagement and Action on COVID-19 Health Outcomes via Testing)

项目摘要 随着2019冠状病毒病（COVID-19）大流行的演变，公平获得SARS-CoV检测和 追踪接触者对目前的大流行监测至关重要。即使COVID-19感染率， 住院率和死亡率总体上都在下降，因此有必要进行检测，以确定可能受益的人。 从COVID-19治疗，鼓励隔离和检疫密切接触者，以防止传播， 监测真实世界的疫苗有效性，并了解病毒如何在内部传播， 社区.对于那些受COVID-19影响不成比例的社区，检测可能同时进行， 更重要，但更具挑战性，因为社会，道德和行为的影响（SEBI）， 阳性试验对阳性测试导致工资损失、就业中断、隐私泄露或 住房的不稳定性会阻碍检测和接触者追踪。在一些社区，结构性障碍、不信任或 其他因素也可能导致疫苗犹豫或接种率较低-这种情况 为未来COVID-19疫情蔓延的社区带来更大的偏见、歧视和污名化的可能性 爆发或可能发生。REACH-OUT（关于COVID-19健康的研究、参与和行动）的目标 通过检测取得成果）的目的是提高COVID-19检测的覆盖面、接受率和可持续性， 通过以社区为基础的参与性行动， 研究方法我们的项目建立在强大的社区参与网络基础设施的基础上， 科罗拉多社区参与联盟（CO-CEAL）和现有的 第一阶段SEBI补助金（音乐会;社区组织的土著：COVID-19流行病学，研究， 测试和服务）。它扩大和深化了这些努力，以应对这一大流行病的下一阶段。 社区和多学科学术研究人员之间的这种独特的伙伴关系， 生物伦理学、混合方法研究、干预设计和公共卫生评估将：（1）参与 社区快速了解关键的文化信仰，沟通偏好，和社区层面 可以利用的资源，以克服COVID-19检测的社会，道德和行为障碍， 混合方法;（2）共同创造和实施一个菜单的文化和谐的战略在个人， 人际、卫生系统和/或社区层面，以提高检测率、接触者追踪和获得 使用干预映射方法的COVID-19支持服务;以及（3）评估流程， 测试REACH-OUT的结果，为应对COVID-19和未来大流行病提供信息 （包括对参与过程本身的评价）。我们将重点关注5个人群（美国 印第安人/阿拉斯加原住民;城市拉丁裔;农村拉丁裔;城市黑人或非裔美国人;和黑人/难民）， 使我们能够得出关于共同和独特的障碍的比较见解， 与其他SEBI项目的协调-将我们的发现推广到美国其他社区。

PROJECT ABSTRACT As the coronavirus disease 2019 (COVID-19) pandemic evolves, equitable access to SARS-CoV testing and contact tracing will be critical to ongoing pandemic surveillance. Even as COVID-19 infection rates, hospitalizations, and deaths are declining overall, testing will be necessary to identify people who may benefit from COVID-19 therapies, to encourage isolation and quarantine of close contacts to prevent spread, to monitor for real-world vaccine effectiveness, and to learn about how the virus may be spreading within communities. For those communities disproportionately affected by COVID-19, testing may be simultaneously more important and yet more challenging because of the social, ethical, and behavioral implications (SEBI) of a positive test. Fears of positive tests leading to lost wages, employment disruption, privacy breaches, or housing instability can deter testing and contact tracing. In some communities, structural barriers, mistrust, or other factors may have contributed to vaccine hesitancy or lower rates of vaccination – circumstances that create greater potential for bias, discrimination, and stigmatization of communities where future COVID-19 outbreaks or may occur. The goal of REACH-OUT (Research, Engagement and Action on COVID-19 Health Outcomes via Testing) is to improve the reach, uptake and sustainability of COVID-19 testing among 5 underserved and socially- or medically-vulnerable populations via a community-based, participatory action research approach. Our project builds upon the strong community engagement network infrastructure built by the Colorado Community Engagement Alliance Against COVID-19 Disparities (CO-CEAL) and an existing Phase I SEBI grant (CONCERTS; Community Organizations for Natives: COVID-19 Epidemiology, Research, Testing, and Services). It broadens and deepens these efforts to address the next phase of the pandemic. This unique partnership between communities and multidisciplinary academic researchers with expertise in bioethics, mixed methods research, intervention design, and public health evaluation will: (1) engage communities to rapidly understand key cultural beliefs, communication preferences, and community-level resources that can be leveraged to overcome social, ethical, and behavioral barrier to COVID-19 testing using mixed methods; (2) co-create and implement a menu of culturally-concordant strategies at the individual, interpersonal, health system, and/or community levels to increase testing rates, contact tracing, and access to COVID-19 support services using an Intervention Mapping approach; and (3) evaluate the processes and testing outcomes from REACH-OUT to inform the COVID-19 response and responses to future pandemics (including evaluation of the engagement process itself). We will focus on 5 populations (American Indian/Alaska Native; Urban LatinX; Rural LatinX; Urban Black or African American; and Black/Refugee), enabling us to draw comparative insights about the barriers in common and unique to each and – in coordination with other SEBI projects – to generalize our findings to other communities throughout the US.