A Multi-site Investigation of Social Determinants of Health and SARS-CoV-2 Testing and Vaccination Outcomes among Diverse US Latinx Adults

对美国不同拉丁裔成年人的健康社会决定因素以及 SARS-CoV-2 检测和疫苗接种结果进行多地点调查

• 批准号: 10881574
• 负责人: Elizabeth L Budd
• 金额: $ 18.44万
• 依托单位: UNIVERSITY OF OREGON
• 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/10881574
• 关键词: Address; Adult; Age; Behavior; COVID-19; COVID-19 pandemic; COVID-19 testing; Common Data Element; Communities; Country; Data; Discrimination; Disease; Economics; Education; Equation; Ethnic Origin; Ethnic Population; Gender; Geography; Heterogeneity; Hispanic; Hospitalization; Household; Housing; Immigration; Income; Individual; Inequity; Influenza vaccination; Investigation; Knowledge; Language; Latina; Latino; Latinx; Latinx population; Lead; Literature; Measures; Medicaid; Meta-Analysis; Metadata; Methods; Mexico; Modeling; Non-Insulin-Dependent Diabetes Mellitus; Oregon; Outcome; Participant; Persons; Phase; Population; Prevention; Preventive; Preventive service; RADx Underserved Populations; Race; Reporting; Research; Research Personnel; SARS-CoV-2 positive; Sampling; Sampling Studies; Sexism; Site; Standardization; Subgroup; Techniques; Testing; United States National Institutes of Health; Vaccinated; Vaccination; barrier to testing; burden of illness; data harmonization; design; disorder control; disorder prevention; experience; food insecurity; health care availability; health disparity; health equity promotion; health inequalities; inequitable distribution; innovation; knowledge base; mortality; pandemic disease; public health research; racial discrimination; racial population; racism; residence; sex; social; social health determinants; systemic barrier; testing access; theories; uptake; vaccination outcome

7. Project Summary Latinxs comprise a large and growing population in the US, but are typically underrepresented in study samples, limiting statistical comparisons to only other racial or ethnic groups.1 Inadequate access to large, diverse samples of Latinxs in public health research has led to treating Latinxs as a monolith, despite known and important within-group differences.1–5 These conditions have led to inadequately tailored disease prevention and control strategies1 and allowed for the persistence of health inequities such as those experienced among Latinxs before and throughout the COVID-19 pandemic compared to non-Latinx Whites8– 12,14 and even to all other racial-ethnic-sex groups.13,92 Yearby's revised Social Determinants of Health (SDOH) Framework explains that structural discrimination (e.g., racism, ethnocentrism, and sexism) is the underlying cause of the inequitable distributions of economic, healthcare access, educational, social, and environmental SDOH across populations, which ultimately results in disproportionate disease burden.19 Individuals hold multiple identities (e.g., ethnic, racial, country of origin, gender, age, language) that interact with structural discrimination in distinct ways,22–24 but how these identities interact with SDOH and SARS-CoV-2 testing and vaccination outcomes within Latinxs is unknown. The present proposal harnesses Latinx-identifying participant data (N = 31,372) from 10 purposively selected, geographically diverse Rapid Acceleration of Diagnostics for Underserved Populations (RADx-UP) projects to overcome the limitations in prior research. Specifically, using pooled Tier 1 common data elements for Aim 1, we will identify the relative importance of economic, healthcare access, educational, and environmental SDOH on SARS-CoV-2 testing (e.g., engagement in testing, testing access) and vaccination (e.g., vaccination status, reasons to/to not get vaccinated) outcomes within a large, robust individual person data meta-analysis of Latinx US adults. Using the same Tier 1 data for Aim 2, we will investigate how the Aim 1 model varies by race, country of origin, gender, age, and language. Finally, for Aim 3, we will use Tier 2 data and employ scale equating data harmonization techniques to examine additional identity-related moderators (e.g., immigration status), SDOH (e.g., racial discrimination, food insecurity), and more robust measures of testing and vaccination outcomes that advance the Aim 1 and 2 models; and evaluate the degree to which the findings generalize to the national Latinx population. Study findings will advance the empirical knowledge base necessary to design precise, culturally tailored prevention and control strategies within Latinxs to reduce health inequities in COVID-19 and beyond.

7.项目摘要 拉丁裔在美国人口众多且不断增长，但在研究中通常代表性不足。 样本，仅限于其他种族或族裔群体的统计比较。 公共卫生研究中拉丁裔的不同样本导致将拉丁裔视为一个整体，尽管已知 和重要的组内差异。1 -5这些条件导致了不适当的定制疾病 预防和控制战略1，并允许持续存在的卫生不公平现象， 与非拉丁裔白人相比，拉丁裔白人在2019冠状病毒病大流行之前和整个疫情期间的经历8- 12，14甚至所有其他种族-民族-性别群体。13，92 Yearby修订的健康社会决定因素（SDOH） 该框架解释说，结构性歧视（例如，种族主义，种族中心主义和性别歧视）是潜在的 经济、医疗保健、教育、社会和环境分配不公平的原因 SDOH在整个人群中，最终导致不成比例的疾病负担。 多个身份（例如，族裔、种族、原籍国、性别、年龄、语言），这些因素与结构性 但这些身份如何与SDOH和SARS-CoV-2检测相互作用， 拉丁美洲人的疫苗接种结果尚不清楚。本提案利用拉丁美洲身份识别参与者 数据（N = 31，372）来自10个有目的地选择的，地理上不同的快速诊断加速， 服务不足人口（RADx-UP）项目，以克服在以前的研究的局限性。具体而言，使用 汇总目标1的第1级通用数据元素，我们将确定经济， SARS-CoV-2检测的医疗保健获取、教育和环境SDOH（例如，参与 测试，测试访问）和疫苗接种（例如，疫苗接种状况、接种/未接种的原因）结果 在拉丁美洲美国成年人的大型，强大的个人数据荟萃分析中。将相同的第1层数据用于 目标2，我们将研究目标1模型如何因种族，原籍国，性别，年龄和语言而变化。 最后，对于目标3，我们将使用第2层数据，并采用规模等同数据协调技术， 检查附加的身份相关的主持人（例如，移民身份），SDOH（例如，种族歧视， 粮食不安全），以及更强有力的检测和疫苗接种结果措施，以推进目标1和目标2 模型;并评估研究结果推广到全国拉丁裔人口的程度。研究 研究结果将推进必要的经验知识基础，以设计精确的、针对不同文化的预防措施 和控制战略，以减少COVID-19及以后的卫生不公平现象。