Reducing Ethical and Social Prejudicial Effects of COVID-19 Testing in Underserved Populations (RESPECT-UP)

减少 COVID-19 检测对服务不足人群的道德和社会偏见影响 (RESPECT-UP)

基本信息

批准号：
10545071
负责人：
Raegan Winston Durant
金额：
$ 59.4万
依托单位：
UNIVERSITY OF ALABAMA AT BIRMINGHAM
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-01-01 至 2024-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10545071
关键词：
Address Adult African American population Alabama Attitude Authorization documentation Behavior Behavior Control Behavioral COVID-19 COVID-19 disparity COVID-19 impact COVID-19 pandemic COVID-19 testing COVID-19 vaccination COVID-19 vaccine Caring Church Collaborations Communities Contact Tracing Country County Crowding Data Development Discrimination Disease Outbreaks Disparity Education Effectiveness Employment Equity Ethics Ethnic Population Focus Groups Food Future General Population Geographic Locations Geography Goals Health Personnel Health Policy Hour Housing Improve Access Inequity Institution Institutional Practice Interview Knowledge Location Logistics Maps Methodology Methods Misinformation Mississippi Neighborhoods Occupations Phase Planning Theory Policies Policy Maker Politics Population Population Heterogeneity Prevalence Printing Public Health RADx Underserved Populations Recommendation Recording of previous events Religion Research Resources Rural SARS-CoV-2 infection Schedule Site Social Work Stigmatization Surveys Testing Training Transportation Trust Underserved Population Vaccinated Vaccination Viral Virus Vulnerable Populations asymptomatic COVID-19 authority community engagement community partnership coronavirus disease cost current pandemic design education resources epidemiology study experience follow-up future outbreak future pandemic high risk human centered design implementation evaluation implementation outcomes implementation science improved indexing informant marginalized community operation pandemic response perceived discrimination prevent primary care setting racial disparity racial diversity racial population rural African American service organization social social health determinants social stigma social vulnerability socioeconomic disparity stem symptomatic COVID-19 underserved community uptake vaccine access viral outbreak

项目摘要

Prior epidemiologic research by our team documented stark racial and socioeconomic disparities in COVID-19 case prevalence, testing rates, and test positivity in Alabama. COVID-19 testing in vulnerable populations is paramount for current and future pandemic control and critical for reducing COVID-19 disparities. Reducing Ethical and Social Prejudicial Effects of COVID-19 Testing in Underserved Populations (RESPECT-UP) aims to understand and address the social, ethical, and behavioral factors surrounding COVID-19 testing in highly vulnerable urban and rural African American communities in Alabama, in the top quintile of the Social Vulnerability Index. The targeted geographic areas in Jefferson County (urban) and Dallas County (rural) have some of the lowest vaccination rates in the country, making their population a very high risk for future disease outbreaks. In Aim 1, we employ a sequential explanatory mixed methods design to assess social and structural barriers to COVID-19 testing while exploring stigma, discrimination, and behavioral factors that impact COVID- 19 testing intentions in the context of vaccine availability. In Aim 2, we develop actionable strategies to reduce inequities in COVID-19 testing and produce RESPECT-UP Toolkits tailored to various organizational and community contexts. In Aim 3, we deploy the toolkits and evaluate their effectiveness in urban and rural primary care settings; implementation in other settings will be evaluated in future efforts. Informed by a Social Determinants of Health framework and the Theory of Planned Behavior, this systematic approach to understanding the full continuum of structural, social, ethical, and behavioral determinants of COVID-19 testing generates important new scientific knowledge. Furthermore, working together with community stakeholders in a participatory way, the project produces concrete multi-level solutions – RESPECT-UP Toolkits – that can be used by organizations, communities, and policy makers to improve the equity, access, and uptake of current COVID-19 testing and be ready to deliver equitable, non-stigmatizing, and non-discriminatory testing in future outbreaks. The Toolkits can be adapted to a variety of populations and settings, which further increases their value, generalizability, sustainability, and potential impact. RESPECT-UP is supported by a community coalition of partners with a long-standing history of collaboration, and coordinates efforts with other COVID-19 research initiatives to maximize resources, community partnerships, and collected data.

我们的团队的先前流行病学研究记录了Covid-19的Stark种族和社会经济差异案例患病率，测试率和阿拉巴马州的测试潜力。脆弱人群中的Covid-19测试是当前和未来的大流行控制的最重要因素，对于降低共同19的差异至关重要。减少 COVID-19测试在服务不足的人群中的道德和社会偏见作用（尊重）目的了解和解决高度围绕Covid-19的社会，道德和行为因素阿拉巴马州的脆弱的城市和粗糙的非洲裔美国社区，在社会的顶级五分之列漏洞指数。杰斐逊县（Urban）和达拉斯县（农村）的目标地理区域该国的一些疫苗率是一些最低的疫苗，使他们的人口成为未来疾病的很高风险爆发。在AIM 1中，我们采用顺序利用混合方法设计来评估社会和结构在探索影响共同的污名，歧视和行为因素时，COVID-19测试的障碍 19在疫苗可用性的背景下进行测试意图。在AIM 2中，我们制定了可行的策略来减少 COVID-19测试的不平等现象，并生产针对各种组织和的尊重工具包社区环境。在AIM 3中，我们部署工具包并评估其在城市和农村中的有效性初级保健设置；将来的努力将评估其他设置中的实施。由社会告知健康框架的决定因素和计划行为理论，这种系统的方法了解COVID-19测试的结构，社会，道德和行为决定者的完整连续性产生重要的新科学知识。此外，与社区利益相关者合作参与方式是，该项目生成具体的多层解决方案 - 尊重工具包 - 可以是由组织，社区和政策制定者使用，以改善当前的股权，获取和吸收 COVID-19测试，并准备在将来提供公平，非耻辱和非歧视性测试爆发。工具包可以适应各种人群和设置，这进一步增加了他们的价值，概括性，可持续性和潜在影响。尊重得到社区的支持合作伙伴的联盟具有长期的合作历史，并与其他Covid-19进行协调努力研究计划，以最大化资源，社区伙伴关系和收集的数据。