An Adaptive Intervention Trial of Home Testing with Behavioral Nudges for Improving COVID-19 Testing and Prevention among People Affected by Diabetes

摘要 这个多机构团队(埃默里大学、莫尔豪斯医学院、佐治亚理工学院)、 基于佐治亚州糖尿病翻译研究中心(P30DK111024)的合作伙伴关系，建议 利用并扩展正在进行的RADx-UP资助项目PEACH(P30DK111024)，以设计和 评估基于家庭的新冠肺炎测试计划，并通过手机提供行为提示 增加对新冠肺炎预防活动(检测、接种疫苗、预防行为)的认识 行为轻推家庭测验对新冠肺炎测验的适应性干预试验 并对糖尿病患者进行预防。“新冠肺炎测试仍然是 认识和管理新冠肺炎大流行。乔治亚州面临着几个挑战 新冠肺炎管理包括低接种率，过度扩张的社区卫生合作伙伴难以 同时管理新冠肺炎检测和疫苗接种，减少新冠肺炎检测数量和大量人口 高危人群，包括糖尿病患者或糖尿病高危人群，社会经济水平较低的人，以及 非裔美国人/黑人和拉丁裔社区。在PEACH2项目中，我们建议利用社区 在桃子项目的一部分发展和扩大了合作伙伴关系，以收集有关新冠肺炎的更多信息 测试，特别关注家庭测试解决方案(目标1)，使用定量(扩展 已经作为桃子项目的一部分进行的后续调查)和定性调查(深入访谈 有100名社区成员、关键利益攸关方和社区合作伙伴)方法。这些数据，以及 桃子项目和乔治亚·赛尔项目的调查结果(1OT2HL156812-01/16-312-0217571-66105L)，将用于 开发文本消息、行为提示以促进持续的新冠肺炎检测、报告和预防 行为包括针对参与者的种族/民族、性别、年龄、接种状况和检测 历史。然后，我们将评估(目标2a)家庭测试平台的吸收、使用和观点(提供a 单个家庭新冠肺炎检测试剂盒适用于每个家庭成员，通过在线收集检测结果 报告系统，以及通过短信传递的有针对性的行为提示)- 基于适应性的干预试验(n=600)，通过与 社区合作伙伴网站(信仰和社区组织、格雷迪糖尿病诊所、新冠肺炎 社区测试和疫苗分发站点)。我们还将评估(目标2b)家庭测试平台如何 影响研究参与者和家庭成员的疫苗接种和犹豫不决。这项研究将建立在 通过桃子计划建立的成功的社区和学术合作伙伴关系，以进一步促进COVID- 19在格鲁吉亚最脆弱的社区中进行测试。吸取的经验教训可以传播给其他人 高危社区，并可调整，以促进其他条件下的家庭检测。

ABSTRACT This multi-institution team (Emory University, Morehouse School of Medicine, Georgia Institute of Technology), anchored by the Georgia Center for Diabetes Translation Research (P30DK111024) partnership, proposes to leverage and expand on the on-going, RADx-UP funded Project PEACH (P30DK111024), to design and evaluate a home-based COVID-19 testing program with behavioral nudges delivered via mobile phone texts to increase uptake of COVID-19 prevention activities (testing, vaccination, preventive behaviors) in “An Adaptive Intervention Trial of Home Testing with Behavioral Nudges for Improving COVID-19 Testing and Prevention among People Affected by Diabetes.” COVID-19 testing remains a cornerstone in understanding and managing the COVID-19 pandemic. The state of Georgia faces several challenges to COVID-19 management including low vaccine rates, over-extended community health partners struggling to manage both COVID-19 testing and vaccination, decreasing COVID-19 testing numbers, and large populations at elevated risk, including those with or at risk for diabetes, individuals at lower socioeconomic levels, and African American/Black and LatinX communities. In Project PEACH2, we propose to leverage the community partnerships developed and expanded at part of Project PEACH to gather additional information on COVID-19 testing, with a particular focus on at-home testing solutions (Aim 1), using both quantitative (an expansion of the follow-up surveys already being conducted as part of Project PEACH) and qualitative (in-depth interviews with 100 community members, key stakeholders, and community partners) methods. This data, along with the findings of Project PEACH and Georgia CEAL (1OT2HL156812-01/16-312-0217571-66105L), will be used to develop text message, behavioral nudges to promote continued COVID-19 testing, reporting and preventive behaviors including vaccination targeted to participants’ race/ethnicity, sex, age, vaccination status, and testing history. We will then evaluate (Aim 2a) the uptake, usage, and views of a home testing platform (provision a single home COVID-19 test kit for each household family member, collection of test results via an online reporting system, and targeted behavioral nudges delivered via text messages) in a randomized community- based, adaptive intervention trial (n=600) targeting individuals affected by diabetes through collaborations with community partner sites (faith- and community-based organization, the Grady Diabetes Clinic, COVID-19 community testing and vaccine distribution sites). We will also assess (Aim 2b) how the home testing platform affects vaccine uptake and hesitancy among study participants and family members. This study will build on the successful community-academic partnerships created through Project PEACH to further promote COVID- 19 testing among the most vulnerable communities in Georgia. Lessons learned can be disseminated to other at-risk communities and can be adapted to promote home-based testing for other conditions.