COmmunity Mistrust and Measures of Institutional Trustworthiness (COMMIT)

项目总结/摘要 在美国，服务不足和社会弱势群体的死亡率更高， 以及COVID-19感染、发病率和死亡率的差异。这种不成比例的负担 揭示了COVID-19差异的根本原因，例如长期存在的系统性 卫生保健提供方面的种族偏见、歧视和健康的不良社会决定因素， 导致哮喘、糖尿病、高血压等疾病的健康差异， 肥胖，所有这些都会增加对COVID-19及其后遗症的风险和易感性。解决 这些根本原因，学术和其他研究机构和卫生保健系统必须改变 他们的透镜从一个只关注改变行为之间的服务不足， 弱势群体。卫生保健和研究机构之间的行为必须改变， 打破信任、检测、治疗和预防COVID-19的结构性障碍。之前 到要求患者和社区成员信任研究和研究人员， 应该进行彻底的制度改革，以提高可信度。 试图解决影响访问可接受性的社会，道德和行为问题（SEBI） 在大流行期间进行COVID-19检测极具挑战性，但可以实现 当存在现有的社区-学术伙伴关系时。信任与 可信赖性表明可信赖性是信任的前提。我们建议的研究将 采用持续参与的方法来提高机构的可信度， 提高现有社区参与研究（CEnR）伙伴关系的实力，以及 为建立类似的机构间伙伴关系提出建议， 社区组织服务不足的人群。 通过与社区和社区药房合作伙伴的合作，我们的目标是： 目标1：共同设计一个可持续的模式，建立值得信赖的CEnR伙伴关系， COVID-19检测 目标2：评估值得信赖的CEnR伙伴关系的最佳实践，以应对COVID-19检测 SEBI因素 目标3：共同制定符合道德标准的承诺备忘录模板， CEnR合作进行COVID-19检测，通过可信度提高信任， 透明度和尊重

PROJECT SUMMARY/ABSTRACT In the United States underserved and socially vulnerable populations have endured higher rates and disparities of COVID-19 infection, morbidity, and mortality. This disproportionate burden has shown the light on the root causes of COVID-19 disparities such as longstanding systemic racial bias in health care delivery, discrimination, and poor social determinants of health that lead to health disparities for medical conditions such as asthma, diabetes, hypertension, and obesity, all of which increase risk and susceptibility to COVID-19 and its sequalae. To address these root causes, academic and other research institutions and health care systems must shift their lens from one that focuses solely on changing behaviors among underserved and vulnerable populations. Behaviors among health care and research institutions must change to breakdown the structural barriers to trust, testing, treatment, and prevention of COVID-19. Prior to asking patients and community members to trust in research and researchers, the focus should be on radical institutional transformation to advance trustworthiness. Trying to address social, ethical, and behavioral issues (SEBI) influencing access acceptability and uptake of COVID-19 testing during a pandemic is extremely challenging, yet achievable when there are existing community-academic partnerships. The distinction between trust and trustworthiness suggests that trustworthiness is an antecedent to trust. Our proposed study will employ a continuous engagement approach to advance institutional trustworthiness and improve the strength of an existing community-engaged research (CEnR) partnership as well as develop recommendations for the formation of similar inter-institutional partnerships with community organizations in underserved populations. In collaboration with community and community-based pharmacy partners, our Aims are: Aim 1: Codesign a sustainable model for trustworthy CEnR partnerships to address SEBI of COVID-19 testing Aim 2: Assess best practices of trustworthy CEnR partnerships to address COVID-19 testing SEBI factors Aim 3: Codevelop an ethically-congruent memorandum of commitment (MOC) template for CEnR partnerships for COVID-19 testing to advance trust through trustworthiness, transparency, and respect