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

项目摘要 随着冠状病毒病2019年(新冠肺炎)大流行的演变，公平获得SARS冠状病毒检测和 接触者追踪将对持续的大流行监测至关重要。尽管新冠肺炎感染率很高， 住院人数和死亡人数总体上正在下降，有必要进行测试以确定可能受益的人 从新冠肺炎疗法，到鼓励对密切接触者进行隔离隔离，以防止传播，到 监测真实世界的疫苗有效性，并了解病毒可能如何在 社区。对于那些受新冠肺炎影响不成比例的社区，测试可能会同时进行 更重要，也更具挑战性，因为 测试呈阳性。担心阳性检测会导致工资损失、就业中断、侵犯隐私或 住房不稳定可能会阻碍测试和接触者追踪。在一些社区，结构性障碍、不信任或 其他因素可能导致疫苗接种犹豫不决或疫苗接种率较低--这些情况 对未来新冠肺炎所在社区造成更大的偏见、歧视和污名化 暴发或可能发生。接触的目标(新冠肺炎健康的研究、参与和行动 通过测试的结果)是在5个国家中提高新冠肺炎测试的覆盖面、接受度和可持续性 通过以社区为基础的参与性行动，服务不足和社会或医疗弱势群体 研究方法。我们的项目建立在由构建的强大的社区参与网络基础设施之上 科罗拉多州反对新冠肺炎差异的社区参与联盟(CO-CEL)和现有的 第一阶段SEBI赠款(音乐会；原住民社区组织：新冠肺炎流行病学、研究、 测试和服务)。它扩大和深化了这些努力，以应对下一阶段的大流行。 这是社区和多学科学术研究人员之间的独特伙伴关系，他们在 生物伦理学、混合方法研究、干预设计和公共健康评估将：(1) 社区以快速了解关键的文化信仰、沟通偏好和社区级别 可以利用的资源，以克服新冠肺炎测试的社会、道德和行为障碍 混合方法；(2)在个人上共同创建和实施文化一致性策略菜单， 人际、卫生系统和/或社区层面，以提高检测率、接触者追踪和获取 使用干预地图方法的新冠肺炎支持服务；以及(3)评估流程和 外联活动的测试结果，为新冠肺炎应对和应对未来大流行病提供信息 (包括对参与进程本身的评价)。我们将重点关注5个群体(美国人 印度/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；以及黑人/难民)， 使我们能够对每个和-in共同和独特的障碍进行比较 与其他SEBI项目的协调-将我们的发现推广到美国各地的其他社区。

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.