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来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: 10310923
• 负责人: Matthew Akiyama
• 金额: $ 75.16万
• 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/10310923
• 关键词: 2019-nCoV; Accounting; Address; Adherence; Antigens; Behavior; COVID-19; COVID-19 testing; Cellular Phone; Cessation of life; Client; Color; 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; 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; 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（美国）的死亡率比19.19的任何其他国家都高，几乎 1,350万例，死亡268,103例。由于社交距离的能力有限，通风不良和 有限的卫生用品，美国监狱和监狱已经观察到SARS-COV-2的爆炸性传播 占美国10个最大爆发的情况。因为有95％的刑事司法人员重新进入社会 COVID-19传输范围超出了目前被监禁的传播。作为司法人员的个人 重新进入社区，他们面临高度无家可归的率，许多其他人生活在其他聚集环境中 例如转换的酒店和中途房屋。被监禁耦合时SARS-COV-2的风险增加 在被监禁后生活在聚集环境中 要解决至关重要的传播，以便在美国获得对Covid-19的控制权 是测试干预措施减轻SARS-COV-2传输的影响和成本效益 与正义的人最近从监禁中释放。我们将进行随机试验以比较 现场护理点SARS-COV-2测试和与社区的教育干预的有效性 与社区基于社区的护理标准相比，卫生工作者（CHW）是核心组成部分 组织（CBO），为纽约市的司法人员提供服务。我们将衡量成本 测试，教育和导航，并探索现场护理干预的成本效益 与护理标准相比。我们的具体目的是：1）测试现场POC SARS-的有效性 COV-2干预以矫正为中心的CBO； 2）建模现场POC SARS-COV的成本效益 2与SOC相比，CJIS之间的干预。因为测试，教育和导航将由 在文化敏感的环境中的CHW和测试结果将在几分钟内（而不是几天）收到，我们 假设O-POC将与改进的测试摄取和测试结果接收，缓解措施有关 行为（戴口罩，卫生，社交距离），参加更多O-Poc会议的人将 对缓解行为有更好的遵守。