Community-Engaged Research on COVID-19 Testing Among Underserved and/or Vulnerable Populations Phase II

项目总结 新冠肺炎疫情在全球范围内造成了前所未有的公共卫生和经济后果 在美国。长期存在的社会不平等被放大，弱势社区 不成比例地背负着大流行的负担。在佛罗里达州的迈阿密-戴德县，那里的少数民族人口 经历了高度的社会脆弱性，黑人和拉美裔在新冠肺炎中的比例过高 住院率和死亡率与全国比率的比较。此外，迈阿密-戴德县继续经历 新冠肺炎的排名远远高于全国和州的水平。现在已经有了有效的疫苗，但接种疫苗 美国少数族裔的这一比例一直较低，拉大了新冠肺炎结果的差距。AS 这种扩大的SARS-CoV-2检测和疫苗接受度对于缓解社区传播至关重要 服务不足和脆弱的社区。在这份RADx-UP项目第二阶段的申请中，我们将申请 在扩大社区推广以增加检测和疫苗接种率的第一阶段期间获得的知识 少数族裔社区缩小造成服务不足和贫困人口新冠肺炎负担的差距 弱势群体。我们建议继续我们的RADx-UP社区参与研究，通过聘请 与四个社区合作伙伴共同制定新的招聘战略，以扩大测试的覆盖面，其中包括 让信仰领袖和少数族裔医疗保健提供者参与进来，并将我们的流动检测(和疫苗接种)单位 在教堂的停车区。我们还将在完成第一阶段的参与者中进行纵向研究 评估(A)感染和接种状况的变化，(B)疫苗的可获得性如何 影响与测试相关的态度、信念和行为，(C)SDoH的变化及其对新冠肺炎的影响 测试和疫苗接种/犹豫，以及(D)心理复原力、心理健康和 测试和疫苗摄取/迟疑，以及(E)其他RADX-UP公共数据元素。我们还将进行 感染后和疫苗接种后关于抗体产生和后续感染的研究。对于 建议的第二阶段申请，我们已与新的社区组织合作，包括保留 信仰与新冠肺炎战斗，这是一个由少数族裔医疗保健提供者与黑人和黑人合作的组织 拉美裔教堂，并与社区参与联盟(CEAL)合作，反对新冠肺炎差异 主动权。我们目前正在利用已建立的基础设施和社区进行RADx-UP第一阶段 伙伴关系，以实现这些目标，并在获取和传播SARS方面产生迅速和可衡量的影响-- 对服务不足和弱势人群进行的CoV-2检测。我们的社区合作伙伴拥有以下资源 为检测呈阳性的病例提供社区参与、公共卫生缓解和后续护理。我们的 战略包括科学和社区咨询委员会；一个流动测试单位；一个CLIA许可的实验室 由该应用程序的PI领导；数据挖掘和数据分析的纵向方法；以及 研究团队在招募和留住本提案所针对的社区成员方面经验丰富。

PROJECT SUMMARY The COVID-19 pandemic has caused unprecedented public health and economic consequences globally and in the United States. Long-standing social inequities have been magnified and vulnerable communities have been disproportionately burdened by the pandemic. In Miami-Dade County, Florida, where minority populations experience a high level of social vulnerability, Blacks and Hispanics are overrepresented in COVID-19 related hospitalizations and deaths compared to national rates. Further, Miami-Dade County continues to experience COVID-19 rates well above the state and national levels. Effective vaccines are now available, yet vaccination rates have been persistently lower among U.S. minorities, broadening disparities in COVID-19 outcomes. As such, expanded SARS-CoV-2 testing and vaccine acceptance is critical to mitigating community spread in underserved and vulnerable communities. In this application for Phase II of the RADx-UP project, we will apply the knowledge gained during Phase I to expand community outreach to increase testing and vaccine uptake in minority communities to decrease disparities that contribute to burden of COVID-19 in underserved and vulnerable populations. We propose to continue our RADx-UP community-engaged research by employing new recruitment strategies in conjunction with four community partners to increase reach of testing that include engaging faith leaders and minority health care providers, and placing our mobile testing (and vaccination) unit in church parking areas. We will also conduct a longitudinal study among participants who completed Phase I of the study to assess (a) changes in infection and vaccination status, (b) how the availability of vaccines affects attitudes, beliefs, and behaviors related to testing, (c) changes in SDoH and their impact on COVID-19 testing and vaccine uptake/hesitancy, and (d) the relationship between mental resilience, mental health, and testing and vaccine uptake/hesitancy, and (e) other RADx-UP common data elements. We will also conduct post-infection and post-vaccination studies on antibody production and subsequent infections. For the proposed Phase II application, we have partnered with new community organizations, including Keeping the Faith to Fight COVID-19, an organization of minority health care providers working with Black and Black Hispanic churches, and with the Community Engagement Alliance (CEAL) Against COVID-19 Disparities initiative. We are currently conducting RADx-UP Phase I with established infrastructure and community partnerships to accomplish the aims and enable rapid and measurable impact in access and uptake of SARS- CoV-2 testing by underserved and vulnerable populations. Our community partners have the resources to provide community engagement, public health mitigation, and follow-up care for cases who test positive. Our strategy includes Scientific and Community Advisory Boards; a mobile testing unit; a CLIA-licensed laboratory headed by the PI of this application; data mining and longitudinal approaches for data analyses; and a research team experienced in recruiting and retaining members of the communities targeted in this proposal.