Supporting COVID-19 prevention and testing for marginalized and minoritized youth and young adults

项目总结 冠状病毒(新冠肺炎)的大流行具有广泛的社会、心理和经济影响 对美国的影响，以及毁灭性的发病率和死亡率。然而，这些影响 对所有人口的影响并不是平等的。监控数据显示，包括黑人在内的少数族裔， 拉美裔人和土著居民对这种疾病和它的 金融和社会后果。同样，性少数群体和性别少数群体(SGM)，虽然不包括在 国家监控数据，经历了高度的脆弱性，这表明他们可能也经历了 更高的感染率和新冠肺炎的相关后果。至关重要的是，随着大流行继续 随着在美国的发展，在年轻人和青壮年(YYA)中发现了更多的病例 14-24岁，这是一个以前被认为处于低风险的人群。考虑到高流动性和较低的感知风险 在这些人群中，这可能不仅在YYA内部导致更大的疫情，而且还会导致整体和额外的 弱势群体。因此，了解和增加YYA人群的检测和预防行为， 特别脆弱的SGM YYA(SGMY)和种族/少数民族YYA(Remy)，有必要进一步阻止 新冠肺炎传播开来。不幸的是，新冠肺炎在这一人群中的影响、测试和预防行为 仍然明显得不到研究。关键的是，检测和预防行为的差异很大。 受外界因素影响。例如，在个人、人际关系和 在结构层面，这可能会影响边缘人群的护理参与和预防。此外， 政策层面的因素，包括测试的可用性、医疗保健、政府消息传递和重新开放 模式，也可能影响检测率和感染率。因此，考虑到缺乏 在SGMY和Remy中关于新冠肺炎的信息，以及这些群体中感染率的上升， 该项目将使用地理上不同的定量调查来评估COVID的模式和差异- 19个月的纵向检测和预防行为，以及多层次因素的影响， 包括污名和政策。以本次调查的结果为依据，以信息、动机、 和行为技能(IMB)模型，我们将使用混合方法迭代地开发社区 针对SGMY和Remy量身定做的参与式健康信息干预措施，以增加检测和预防 行为，暂定名为PRIV_CVD。这一短信干预将由100 Remy进行试点验证 和SGMY来提炼内容，并确定可行性和可接受性。鉴于缺乏消息传递指导方针 对于这一人群，这将是首个针对新冠肺炎预防的循证信息干预 在YYA中。在社区的积极投入下开发和试行这样的干预将允许 如果有效，将迅速扩大干预范围并广泛实施，以解决 新冠肺炎跻身雅雅之列，整体传播减少。

PROJECT SUMMARY The coronavirus (COVID-19) pandemic has had widespread social, psychological, and economic repercussions in the United States, along with devastating morbidity and mortality. However, these effects have not impacted all populations equally. Surveillance data show that racial/ethnic minorities, including Black, Latinx, and Indigenous populations, have been disproportionately burdened by both the disease and its financial and social consequences. Similarly, sexual and gender minority (SGM) groups, while not captured in national surveillance data, experience high levels of vulnerability, suggesting that they too may be experiencing higher rates of infection and related ramifications of COVID-19. Crucially, as the pandemic has continued to develop in the US, a greater number of cases have been identified among youth and young adults (YYA) aged 14-24 years, a population previously thought to be at low risk. Given the high mobility and lower perceived risk of this population, this may result in larger outbreaks not only within YYA, but also overall and in additional vulnerable groups. Therefore, understanding and increasing testing and preventive behaviors among YYA, especially vulnerable SGM YYA (SGMY) and racial/ethnic minority YYA (REMY), is necessary to stop further COVID-19 spread. Unfortunately, COVID-19 impacts, testing, and preventive behaviors in this population have remained markedly understudied. Critically, disparities in testing and preventive behaviors are highly influenced by outside factors. For example, experiences of stigma, at the individual, interpersonal, and structural level, may impact care engagement and prevention among marginalized populations. Furthermore, policy-level factors, including availability of tests, healthcare, governmental messaging, and re-opening patterns, are also likely to influence rates of testing and rates of infection. As such, given the dearth of information surrounding COVID-19 among SGMY and REMY, and the rising rates of infection in these groups, this project will use a geographically diverse quantitative survey to assess patterns and disparities in COVID- 19 testing and preventive behaviors longitudinally across 6 months, as well as the impact of multilevel factors, including stigma and policy. Informed by the results of this survey, and guided by the Information, Motivation, and Behavioral Skills (IMB) Model, we will use a mixed-methods approach to iteratively develop a community engaged, health messaging intervention tailored towards SGMY and REMY to increase testing and preventive behaviors, provisionally titled Prev_Cvd. This text messaging intervention will be pilot testied by 100 REMY and SGMY to refine content and determine feasibility and acceptability. Given the lack of messaging guidelines for this population, this will be the first evidence-based messaging intervention for COVID-19 prevention among YYA. Developing and pilot testing such an intervention with active input from the community will allow for the intervention, if effective, to be rapidly scaled up and widely implemented to address disparities in COVID-19 among YYA and reduce overall transmission.