CO-CREATE-Ex: Community-engaged Optimization of COVID-19 Rapid Evaluation And TEsting Experiences

项目总结/摘要 圣地亚哥的COVID-19感染病例在该县中部和南部一直居高不下 美国/墨西哥边境附近的社区，主要是拉丁裔居民的家园， 受COVID-19影响最大的少数族裔社区。为了解决这个问题，我们的第一阶段RADx-UP项目与 与圣伊西德罗健康（SYH），一个联邦合格的健康中心，和全球行动研究中心（全球 ARC），一个社会变革组织，共同创建和展示基于PCR的COVID-19检测的影响 圣伊西德罗的一个项目。到目前为止，我们已经为超过10，000个社区进行了大约15，000次PCR检测， 成员（92%拉丁裔），并收到SYH的请求，将测试计划扩展到更多的小学 护理诊所响应RFA-OD-22-006，我们将继续与我们的社区（全球ARC）合作， 临床（SYH）合作伙伴，以完善，指定，实施和评估实施策略包， 优化COVID-19检测，超越目前的PCR检测，专注于FDA授权的COVID-19快速 抗原检测使用自我管理的快速抗原检测将使参与者建立自我检测的能力 并利用卫生信息技术获得额外的诊所服务。根据初步执行情况 与该项目成立的社区和科学咨询委员会，三个实施 优先制定战略，以加速持续采用快速COVID-19检测。这三大战略 包括：（1）目前，步行现场免费检测;（2）促销主导的COVID-19检测咨询和预防 护理提醒;（3）自动售货机，分发FDA授权的自我检测试剂盒。我们的主要目标是 （1）完善和实施我们的多组成部分执行战略包和一套相关的 快速FDA授权的COVID-19检测的成功措施，2）实施和评估我们的 创新、多层次和多组件实施策略组合，以优化COVID-19快速检测 在服务不足的拉丁裔社区中，使用跨四个社区的推出实施优化研究设计， 18个月以上的诊所2019冠状病毒病大流行凸显了参与的紧迫性和必要性 * 不断对社区各方进行有意义的公共卫生研究投资，以减少健康差距。 这一建议很适合提供一套成功的战略和衡量标准，可用于 为服务不足的社区提供服务，同时保持灵活性，以适应不断变化的COVID-19 景观

PROJECT SUMMARY/ABSTRACT Cases of COVID-19 infection in San Diego have persistently remained high in the county’s central and southern communities near the US/Mexico border, home to primarily Latino residents who have been one of the ethnic minority communities most impacted by COVID-19. To address this, our Phase I RADx-UP project partnered with San Ysidro Health (SYH), a federally qualified health center, and the Global Action Research Center (Global ARC), a social change organization, to co-create and demonstrate the impact of a PCR-based COVID-19 testing program in San Ysidro. To date, we have administered approximately 15,000 PCR tests for >10,000 community members (92% Latino) and received requests from SYH to scale-out the testing program to additional primary care clinic sites. Responsive to RFA-OD-22-006, we will continue working with our community (Global ARC) and clinical (SYH) partners to refine, specify, implement, and evaluate an implementation strategy bundle that optimizes COVID-19 testing, expanding beyond current PCR testing to focus on FDA-authorized COVID-19 rapid antigen testing. Use of self-administered rapid antigen tests will allow participants to build capacity to self-test and use health information technology to access additional clinic services. Based on initial implementation mapping with the project’s established Community and Scientific Advisory Board, three implementation strategies were prioritized to accelerate sustained uptake of rapid COVID-19 testing. These three strategies include: (1) current, walk-up onsite free testing; (2) promotores-led COVID-19 test counseling and preventive care reminders; (3) vending machines that dispense FDA-authorized self-testing kits. Our primary objectives are to: 1) refine and operationalize our multi-component implementation strategy bundle and a related set of measures of success for rapid FDA- authorized COVID-19 testing and 2) implement and evaluate impact of our innovative, multilevel, and multicomponent implementation strategy bundle to optimize COVID-19 rapid testing among underserved, Latino communities using a roll-out implementation optimization study design across four clinics over 18 months. The COVID-19 pandemic has underscored the urgent and essential need to engage invested community parties continuously and meaningfully in public health research to reduce health disparities. This proposal is well-positioned to provide a set of strategies and measures of success that can be used in settings serving underserved communities while maintaining flexibility to adjust to the changing COVID-19 landscape.