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)因新冠肺炎而经历了比其他任何国家更高的死亡率，几乎 1350万例，超过268,103人死亡。由于社交距离有限，通风不良，以及 卫生用品有限，美国监狱和监狱观察到SARS-CoV-2的爆炸性传播 占了美国十大疫情的主因。因为95%涉及刑事司法的个人重新进入社会 新冠肺炎传播的范围超出了那些目前被监禁的人。作为涉及正义的个人 重新进入社区，他们面临着高流浪率，许多其他人生活在其他会众环境中 例如改建的酒店和中途之家。囚禁期间感染SARS-CoV-2的风险增加 由于监禁后可能生活在聚集环境中，为快速建设新冠肺炎创造了成熟的条件 为了在美国获得新冠肺炎的控制权，解决这一问题至关重要。这项研究的目标是 是为了测试干预措施的影响和成本效益，以减少SARS-CoV-2在 最近从监禁中获释的涉及正义的个人。我们将进行一项随机试验来比较 SARS-CoV-2现场检测及社区教育干预效果评价 与社区护理标准相比，卫生工作者(CHW)是一个核心组成部分 向纽约市的司法人员提供服务的组织(CBO)。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PoC SARS的有效性- 以矫正为重点的CBO中的CoV-2干预；2)现场PoC SARS-CoV的成本效益模型- 2 CJIS与SOC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，我们将在几分钟(而不是几天)内收到检测结果 假设O-PoC将与改进的测试吸收和测试结果的接收、缓解 行为(戴口罩、手卫生、社交距离)，以及那些参加更多O-PoC会议的人将 更好地坚持缓解行为。