Using the multiphase optimization strategy (MOST) to optimize an intervention to increase COVID-19 testing for Black and Latino/Hispanic frontline essential workers

使用多阶段优化策略 (MOST) 优化干预措施，以增加对黑人和拉丁裔/西班牙裔一线基本工作人员的 COVID-19 检测

• 批准号: 10447429
• 负责人: Marya Gwadz
• 金额: $ 120.03万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10447429
• 关键词: Address; Age; Altruism; Appointment; Behavior Therapy; Black race; COVID-19; COVID-19 diagnosis; COVID-19 disparity; COVID-19 pandemic; COVID-19 screening; COVID-19 severity; COVID-19 testing; COVID-19 vaccination; Centers for Disease Control and Prevention (U.S.); Characteristics; Cognitive; Communities; Counseling; Data; Diagnostic Reagent Kits; Diagnostic tests; Education; Emotions; Essential worker; Experimental Designs; Exposure to; Fright; Future; Goals; Guidelines; Health; Health education; Hispanic; Hispanic Populations; Home; Home Care Services; Individual; Intervention; Interview; Joints; Knowledge; Language; Latino; Maintenance; Mediator of activation protein; Medical; Methods; New York; New York City; Occupations; Participant; Persons; Population; Qualitative Research; Race; Randomized; Readiness; Research; Research Design; SARS-CoV-2 exposure; Services; Sick Leave; Site; Specific qualifier value; Symptoms; Testing; Text Messaging; Time; Triad Acrylic Resin; Underserved Population; Universities; Vaccinated; Vulnerable Populations; base; behavioral economics; community setting; community transmission; coronavirus disease; distrust; experience; food preparation; health belief; high risk; implementation barriers; implementation intervention; improved; motivational enhancement therapy; multi-component intervention; multiphase optimization strategy; pandemic disease; peer; primary outcome; public health relevance; racial and ethnic disparities; scale up; screening; self testing; social; social norm; sociodemographics; standard of care; text messaging intervention; theories; transmission process; unvaccinated; uptake

PROJECT SUMMARY. The proposed study responds to RFA-OD-21-008 which calls for community-engaged interventions to support COVID-19 testing in underserved and vulnerable populations. Among those at highest risk for exposure to COVID-19 is the large population of frontline essential workers (FEW) in lower status occupations (e.g., retail, in-home health care), among whom Black and Latino/Hispanic (BLH) persons are over-represented. The CDC recommends testing for all those experiencing symptoms of COVID-19. For those not vaccinated, testing is recommended after exposure to individuals with a COVID-19 diagnosis, and regular COVID-19 screening testing is recommended even when asymptomatic for those with frequent close contact with others in indoor settings such as FEW. However, BLH-FEW experience serious impediments to COVID-19 testing at individual/attitudinal- (e.g., lack of knowledge of guidelines, distrust), social- (e.g., social norms), and structural-levels of influence (e.g., poor access to testing). Indeed, testing rates are lower among BLH than White populations and only 25-50% of BLH-FEW are currently vaccinated. The proposed community-engaged study is led by a collaborative team at New York University and the Northern Manhattan Improvement Corporation (NMIC). Its main goal is to optimize a behavioral intervention to boost COVID-19 testing rates for BLH-FEW. Consistent with RFA-OD-21-008, the proposed study uses the multiphase optimization strategy (MOST) framework to test four candidate intervention components grounded in our past research. The candidate components are informed by critical race theory and guided by the theory of triadic influence, are brief or do not require substantial staff time, and will be tested in a highly efficient factorial experimental design. They are A) motivational interview counseling, B) a text message component grounded in behavioral economics, C) peer education, and D) access to testing (via navigation to a test appointment vs. a self-test kit). All participants receive the standard of care, namely, health education on COVID-19 testing, and referrals. The specific aims of the study are to: identify which of four candidate components contribute meaningfully to improvement in the primary outcome, COVID-19 testing with medical confirmation; the most effective combination of components will comprise the “optimized” intervention (Aim 1), identify mediators (e.g., distrust, access) and moderators (e.g., sociodemographic characteristics) of the effects of each component (Aim 2), and use a mixed-methods approach to explore relationships among barriers to, facilitators of, and uptake of COVID-19 testing and COVID-19 vaccination (Aim 3). Participants will be N=448 BLH-FEW who have not been tested for COVID-19 in the past six months and who are not vaccinated for COVID-19, randomly assigned to an intervention condition, and assessed at 6- and 12-weeks post-baseline; N=50 participants will engage in qualitative in-depth interviews. We will also uncover, describe, and plan for implementation issues so the optimized intervention can be rapidly scaled up by NMIC and other community-based organizations.

项目总结。拟议的研究回应了RFA-OD-21-008，该报告呼吁社区参与