Leveraging community health workers to improve SARS-CoV-2 testing and mitigation among criminal justice-involved individuals accessing a corrections-focused community-based organization

利用社区卫生工作者改善接触以惩教为重点的社区组织的刑事司法相关个人的 SARS-CoV-2 检测和缓解措施

• 批准号: 10491770
• 负责人: Matthew Akiyama
• 金额: $ 71.57万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-21 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10491770
• 关键词: 2019-nCoV; Accounting; Address; Adherence; Antigens; Behavior; COVID-19; COVID-19 point of care; COVID-19 testing; Cellular Phone; Cessation of life; Client; Communities; Community Health Aides; Contracts; Coronavirus; Cost Measures; Counseling; Coupled; Criminal Justice; Data Sources; Disease Outbreaks; Dose; Economics; Education; Educational Background; Educational Intervention; Effectiveness of Interventions; Endemic Diseases; Environment; Face; Fortune; General Population; Goals; HIV; Halfway Houses; Hand; Healthcare; Hepatitis C; Homelessness; Housing; Hygiene; Illinois; Immunocompromised Host; Imprisonment; Individual; Infection; Intervention; Jail; Justice; Lead; Low Prevalence; Masks; Medical; Modeling; Needle-Exchange Programs; Needs Assessment; New York City; Online Systems; Outcome; Participant; Persons; Play; Prisons; Public Health; Questionnaires; Randomized; Records; Risk; Risk Factors; Role; SARS-CoV-2 infection; SARS-CoV-2 transmission; Services; Shelter facility; Site; Social Distance; Societies; Surveys; Test Result; Testing; United States; Vaccination; Vulnerable Populations; barrier to care; base; community transmission; comorbidity; compare effectiveness; comparison intervention; cost; cost effective; cost effectiveness; effectiveness evaluation; effectiveness testing; experience; high risk; high risk population; homeless shelters; improved; low socioeconomic status; markov model; mortality; novel; pandemic disease; people of color; point of care; point of care testing; primary outcome; programs; randomized trial; secondary outcome; social cognitive theory; standard of care; stem; supported housing; testing uptake; transmission process; vaccine acceptance; ventilation

Abstract. The United States (U.S.) has experienced higher mortality than any other nation due to COVID-19 with nearly 13.5 million cases and over 268,103 deaths. Due to the limited ability to socially distance, poor ventilation, and limited hygiene supplies, U.S. prisons and jails have observed explosive transmission of SARS-CoV-2 accounting for the 10 largest U.S. outbreaks. Because 95% of criminal justice-involved individuals reenter society COVID-19 transmission extends beyond those who are currently incarcerated. As justice-involved individuals reenter the community, they face high rates of homelessness, and many others live in other congregate settings such as converted hotels and halfway houses. The increased risk of SARS-CoV-2 while incarcerated coupled with the likelihood of living in congregate settings after incarceration, create conditions ripe for rapid COVID-19 transmission that will be critical to address in order to gain control of COVID-19 in the U.S. The goal of this study is to test the impact and cost-effectiveness of an intervention to mitigate SARS-CoV-2 transmission among justice-involved individuals recently released from incarceration. We will conduct a randomized trial to compare the effectiveness of an onsite Point-of-Care SARS-CoV-2 testing and education intervention with community health workers (CHWs) as a central component compared to the standard of care at a community-based organization (CBO) that provides services to justice-involved individuals in New York City. We will measure costs of testing, education, and navigation, and explore the cost-effectiveness of the onsite Point-of-Care intervention compared to the standard of care. Our specific aims are to: 1) Test the effectiveness of an onsite PoC SARS- CoV-2 intervention in a corrections-focused CBO; 2) Model the cost-effectiveness of an onsite PoC SARS-CoV- 2 intervention among CJIs compared to SoC. Because testing, education, and navigation will be provided by CHWs in a culturally-sensitive environment and test results will be received in minutes (rather than days), we hypothesize that O-PoC will be associated with improved testing uptake and receipt of test results, mitigation behaviors (mask wearing, hand hygiene, social distancing), and those who attend more O-PoC sessions will have better adherence to mitigation behaviors.

抽象的。 美国（US）由于COVID-19，中国的死亡率比任何其他国家都高， 13.5 268，103多人死亡。由于社交能力有限，通风不良， 由于卫生用品有限，美国监狱和看守所已经观察到SARS-CoV-2的爆炸性传播 导致了美国10次最大的疫情爆发因为95%涉及刑事司法的人会重返社会 COVID-19的传播范围超出了目前被监禁的人。作为公正的个人 重新进入社区后，他们面临着很高的无家可归率，还有许多人生活在其他聚集的环境中。 比如改建的旅馆和中途之家在监禁期间增加SARS-CoV-2的风险 在监禁后可能生活在聚集环境中，为快速COVID-19创造条件 为了在美国控制COVID-19，必须解决的传播问题。 是为了测试干预措施的影响和成本效益，以减轻SARS-CoV-2传播， 最近从监狱释放的涉及司法的个人。我们将进行随机试验， 现场护理点SARS-CoV-2检测和社区教育干预的有效性 卫生工作者（CHW）作为一个核心组成部分相比，在以社区为基础的护理标准， 在纽约市为涉及司法的个人提供服务的CBO组织。我们将衡量成本 测试、教育和导航，并探索现场护理点干预的成本效益 与护理标准相比。我们的具体目标是：1）测试现场预防SARS的有效性- 在以矫正为重点的CBO中进行CoV-2干预; 2）模拟现场SARS-CoV的成本效益， 与SoC相比，CJI之间的干预2。因为测试，教育和导航将由 在一个文化敏感的环境和测试结果将在几分钟内（而不是几天），我们 假设O-干扰将与改善测试吸收和接收测试结果、缓解 行为（戴口罩，手部卫生，社交距离），而那些参加更多O-Bounces课程的人将 更好地坚持缓解行为。