Pandemic preparedness for underserved persons in the US: Harnessing data from the RADx-UP consortium to assess public health tools for resource allocation

美国服务不足人群的流行病防范：利用 RADx-UP 联盟的数据评估用于资源分配的公共卫生工具

• 批准号: 10881319
• 负责人: Shuchi Anand
• 金额: $ 23.16万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-21 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10881319
• 关键词: 2019-nCoV; Acceleration; Age; American; American Indians; Area; Black race; COVID-19; COVID-19 pandemic; COVID-19 stress; COVID-19 test; COVID-19 testing; COVID-19 vaccine; Censuses; Centers for Disease Control and Prevention (U.S.); Cessation of life; Chronic Disease; Classification; Clinical Trials; Communicable Diseases; Communities; Community Surveys; County; Data; Diagnostic; Dialysis procedure; Disease; Disease Outbreaks; Disparity population; Ebola; Employment; Epidemiologist; Ethnic Origin; Evaluation; Face; Food; Funding; Future; Goals; Health; Health Insurance; Health Policy; Health system; Hispanic; Hospitalization; Household; Housing; Human; Incidence; Income; Infection; Influenza; Influenza A Virus, H1N1 Subtype; Infrastructure; Investments; Link; Literature; Location; Methods; Middle East Respiratory Syndrome; Monkeypox; Neighborhoods; Nephrology; Outcome; Participant; Patients; Perception; Performance; Persons; Phase; Population; Positive Test Result; Pragmatic clinical trial; Prevalence; Public Health; Public Health Practice; Race; Reduce health disparities; Resource Allocation; Resources; Sampling; Severe Acute Respiratory Syndrome; Severity of illness; Site; Speed; Standardization; Stress; System; Test Result; Testing; Time; Traction; Triage; Uncertainty; Underserved Population; United States National Institutes of Health; Vaccination; Vaccines; Virus; Vulnerable Populations; Work; ZIKA; data structure; disability; evidence base; experience; future pandemic; health care availability; health disparity; home test; hospitalization rates; improved; improved outcome; indexing; medical vulnerability; minority health; mortality; new pandemic; operation; pandemic disease; pandemic preparedness; pandemic stress; pathogen; performance tests; population survey; predictive test; public health emergency; recruit; response; screening; secondary analysis; sex; social; social vulnerability; socioeconomics; stressor; testing access; testing uptake; tool; uptake; vaccine access; vulnerable community; wastewater surveillance

PROJECT ABSTRACT Pandemic preparedness requires strengthening surveillance for emerging viruses, but also a plan for public health response when the next pathogen rapidly infects humans on a global scale. In order to ensure that the disproportionate disability and death experienced among disadvantaged populations in the US does not repeat in a future pandemic, public health agencies will need to validate resource allocation and surveillance tools within a health disparities framework. The RADx-UP Consortium enables such as an evaluation, since this NIH-funded Consortium of over 130 projects, with over 370,000 nationwide participants, focused on improving test access, and eliciting COVID19 stress and vaccine perception among underserved persons. Using RADx- UP data as the ground truth, we will test whether three area level vulnerability indices—the Social Vulnerability Index, the Minority Health Social Vulnerability Index, and the Community Vulnerability Index—identify persons experiencing food or housing insecurity, or gaps in healthcare access during the pandemic (Aim 1). We will leverage methods from clinical trial literature to assess RADx-UP data generalizability. We will link to American Community Survey, and generate county-standardized estimates of pandemic stress and vaccine concerns for the more than 900 US counties with participants in the RADx-UP consortium. We will then assess the association of these standardized estimates with the three area level vulnerability indices. A second aim of the proposed work will be to assess the predictive performance of the promising tool of wastewater surveillance among underserved populations. We will link RADx-UP data with the publicly available National Wastewater Surveillance System data, and compare wastewater infection prevalence metrics with the test positivity rate among RADx-UP performed tests, and county-level hospitalizations and deaths. We will evaluate changes in predictive performance over time (e.g., before versus after vaccine availability), and with integration of area- level vulnerability indices and other census demographic variables. With the ultimate aim of reducing health disparities in the future pandemic, our team of epidemiologists, statisticians, nephrology and infectious disease clinicians, and health policy experts will evaluate existing and emerging pandemic preparedness tools. In doing so, we hope to promote a public health infrastructure responsive to groups most vulnerable to the health and social turbulence inherent to a pandemic.

项目摘要