Scaling and Sustaining COVID-19 Vaccination through Meaningful Community Engagement and Care Coordination for Underserved Communities

项目摘要/摘要 新冠肺炎疫苗分配不均，疫苗接种量滞后，尤其是在 移民、难民、拉丁裔和黑人、土著、有色人种(BIPOC)社区。潜在原因 对于缓慢和可变的对新冠肺炎疫苗的接受包括个人(例如健康素养、信任)、文化 (例如，语言需要)和结构性障碍，例如技术和系统因素(例如，复杂和 安排和参加疫苗预约的繁琐过程)。没有一刀切的方法来解决 疫苗实施。这一点在数据中得到了证实，这些数据表明，新冠肺炎测试存在巨大差异。 发病率、死亡率和接种率。具有文化相关性和语言适当性、动态化和 可扩展的战略对于立即和长期成功采用新冠肺炎疫苗和 大流行缓解。改变新冠肺炎疫苗接种行为提供了同时 改善对其他预防健康行为的参与度，这些行为是重要的公共卫生优先事项(例如， 糖尿病管理、癌症筛查、推荐的成人疫苗接种)。我们建议共同提炼、测试、 并扩大多成分健康计划，以解决疫苗接种的多层次障碍和 在圣地亚哥的移民、难民、拉丁裔和BIPOC社区参与预防性医疗。 驾驭逆向创新思维，我们将应用务实的稳健实施和可持续 模型(PRISM)与我们的社区合作伙伴Global ARC和San Ysidro Health共同创建 结合mHealth推广的健康计划的要素(社区驱动的文本和语音消息) 以及加强护理协调。响应NOSI NOT-MD-22-006，这款R01将建立在我们目前的基础上 CEAL和RADx-UP实施研究，以扩展和维持多组件健康计划，以 在以下人群中提高对新冠肺炎疫苗接种和预防性护理参与度的接受度、可及性和接受度 服务不足的社区。我们组建了一支经验丰富的社区实施团队 科学家、卫生公平、公共卫生和传染病研究人员要实现以下目标：1) 优化多成分健康计划，促进新冠肺炎疫苗的采用和参与 预防性医疗保健使用我们已建立的共同创建方法来解决多层次(个人、 社区、系统)疫苗接种和预防护理参与的障碍；2)评估 多组分新冠肺炎疫苗和预防保健的实施、有效性和可持续性 使用混合类型3实施-有效性顺序多重分配的接洽计划 在旧金山中部和东部的移民、难民、拉丁裔和BIPOC社区中进行随机试验设计 迭戈。

PROJECT SUMMARY/ABSTRACT COVID-19 vaccines have been inequitably distributed and vaccine uptake has lagged, particularly for immigrant, refugee, Latino, and Black, Indigenous, People of Color (BIPOC) communities. Underlying reasons for the slow and variable uptake of COVID-19 vaccines include individual (e.g., health literacy, trust), cultural (e.g., linguistic needs), and structural barriers, such as technological and systemic factors (e.g., complex and onerous processes to schedule and attend vaccine appointments). There is no one-size-fits-all approach to vaccine implementation. This is borne out in the data indicating enormous disparities in COVID-19 testing, morbidity, mortality, and inoculation rates. Culturally relevant and linguistically appropriate, dynamic, and scalable strategies are essential to the immediate and long-term success of COVID-19 vaccine uptake and pandemic mitigation. Changing COVID-19 vaccine uptake behaviors offers an opportunity to concurrently improve engagement in other preventive health behaviors that are important public health priorities (e.g., diabetes management, cancer screenings, recommended adult vaccinations). We propose to co-refine, test, and scale a multicomponent health program to address the multi-level barriers to vaccine uptake and engagement in preventative healthcare in immigrant, refugee, Latino, and BIPOC communities in San Diego. Harnessing reverse innovation thinking, we will apply the Practical Robust Implementation and Sustainability Model (PRISM) to co-create with our community partners, the Global ARC, and San Ysidro Health, the elements of a health program that combines mHealth outreach (community-driven text and voice messages) and enhanced care coordination. Responsive to NOSI NOT-MD-22-006, this R01 will build on our current CEAL and RADx-UP implementation research to scale and sustain a multicomponent health program to increase acceptance, access, and uptake of COVID-19 vaccination and preventive care engagement among underserved communities. We assembled an experienced team of community-engaged implementation scientists, health equity, public health, and infectious disease researchers to accomplish the following aims: 1) Optimize a multicomponent health program to promote COVID-19 vaccine uptake and engagement in preventive healthcare using our established co-creation approach to address multi-level (individual, community, systemic) barriers to vaccine uptake and preventive care engagement; 2) Evaluate the implementation, effectiveness, and sustainment of the multicomponent COVID-19 vaccine and preventive care engagement program using a hybrid type 3 implementation-effectiveness sequential multiple assignment randomized trial design across immigrant, refugee, Latino, and BIPOC communities in Central and East San Diego.