Cherokee Nation Native AmericanResearch Center for Health

项目总结 通过RADx-UP计划，切诺基民族社区驱动的测试和联系计划 Tracing(Cherokee Protected)将部落、学术和社区合作伙伴团结在 切罗基民族(CN)解决对新冠肺炎测试、联系人追踪和文化知识的迫切需求 在服务不足和弱势的农村人口中开展教育。截至8月4日，切罗基国家医疗服务 (CNHS)已在主要服务于农村的部落人口中确认了850例新冠肺炎病例 俄克拉荷马州东北部。新冠肺炎的社区传播遍及中原地区所有14个县 保留，但由于CN在社区测试、筛选和联系人跟踪方面的能力有限，真正的 新冠肺炎的影响尚不清楚。大约34%的18岁美国印第安人/阿拉斯加原住民(AI/AN)成年人- 几年来，由于并存疾病，人们面临着严重新冠肺炎的风险，比美国其他任何种族/民族都要高。 CN的五个县在美国严重新冠肺炎风险成年人患病率排名前20%的县中 由于潜在的医疗条件；高贫困率和地理位置加剧了这一脆弱性 障碍。居住在CN农村地区的人可能需要往返60英里才能进行病毒检测。 到目前为止，CN的大多数新冠肺炎测试都是通过CNHS进行的，CNHS是最大的部落压缩健康 美国的系统，为生活在CN保留区内的所有AI/AN人提供服务。尽管CNHS占了 约8.5%的IHS活跃用户群体和38%的俄克拉荷马州服务活跃用户群体 区域，并不是所有居住在保留地的部落成员都能进入CNHS，因此，不能通过 CNHS。除CNHS诊所外，该地区14个县中有7个县只有一个公共检测点，结果可能 在2-3周内不会退货。CNHS及其紧密结合的CN公共卫生计划具有典范作用 20年来提供公共卫生干预的记录，包括突破性的丙型肝炎病毒 与俄克拉荷马大学健康科学中心的消除计划，以及与&gt；40正在进行的项目 农村K-12学校。通过合作的临床研究和分子研究，CN和俄克拉何马州 医学研究基金会在部落人口中发现了新的免疫生物标记物。在这些基础上绘制 现有的优势和基础设施，切诺基保护将(1)建设基础设施并增加FDA-EUA (2)启用社区新冠肺炎检测， 接触者追踪，并与CN公共卫生一起进行教育；(3)确定新冠肺炎检测的障碍和促进者 在CN保留地为增加检测和接触者追踪的量身定做的教育活动提供信息，以及 减少扩散；以及(4)实施严格的评估，以确保质量改进和可持续性。

PROJECT SUMMARY Through the RADx-UP program, the Cherokee Nation Community-Driven Program for Testing and Contact Tracing (Cherokee PROTECT) unites tribal, academic, and community partners under the leadership of Cherokee Nation (CN) to solve a dire need for COVID-19 testing, contact tracing, and culturally informed education in underserved and vulnerable rural populations. As of August 4, Cherokee Nation Health Services (CNHS) has confirmed >850 cases of COVID-19 in the tribal populations served across mainly rural northeastern Oklahoma. Community spread of COVID-19 exists throughout all 14 counties in the CN reservation, but with CN’s limited capacity for community testing, screening, and contact tracing, the true impact of COVID-19 is unknown. Roughly 34% of American Indian/Alaska Native (AI/AN) adults aged 18-64 years are at risk of severe COVID-19 due to comorbidities, more than any other racial/ethnic group in the US. Five counties in CN are in the top 20% of US counties for the prevalence of adults at risk of severe COVID-19 due to underlying medical conditions; this vulnerability is compounded by high poverty rates and geographic barriers. People living in rural areas of CN may have to travel as many as 60 miles round-trip for viral testing. Most COVID-19 testing in CN to date has been conducted through CNHS, the largest tribally compacted health system in the US that serves all AI/AN people living within the CN reservation. Although CNHS accounts for approximately 8.5% of all IHS active user population and 38% of active user population of Oklahoma service area, not all tribal members residing in the reservation access CNHS, and therefore, may not be tested by CNHS. Other than CNHS clinics, 7 of 14 counties in this area have only one public testing site, and results may not be returned for 2-3 weeks. CNHS and its closely integrated CN Public Health program have an exemplary 20-year record of delivering public health interventions, including a groundbreaking Hepatitis C Virus elimination program with the University of Oklahoma Health Sciences Center, and ongoing projects with >40 rural K-12 schools. Through collaborative clinical research and molecular studies, CN and the Oklahoma Medical Research Foundation have identified new immune biomarkers in tribal populations. Drawing on these existing strengths and infrastructure, Cherokee PROTECT will (1) Build infrastructure and increase FDA-EUA COVID-19 viral and antibody testing for clinical care in CNHS; (2) Enable community-based COVID-19 testing, contact tracing, and education with CN Public Health; (3) Identify barriers and facilitators to COVID-19 testing in the CN reservation to inform a tailored educational campaign to increase testing and contact tracing, and decrease spread; and (4) Implement a rigorous evaluation to ensure quality improvement and sustainability.