Leveraging Social Networks to Increase COVID-19 Testing Uptake: A Comparison of Credible Messenger and Chain Referral Recruitment Approaches

利用社交网络提高 COVID-19 检测的采用率：可信信使和连锁推荐招聘方法的比较

• 批准号: 10258730
• 负责人: KATHERINE S ELKINGTON
• 金额: $ 79.33万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-12-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10258730
• 关键词: AIDS prevention; Address; Affect; COVID-19; COVID-19 screening; COVID-19 test; COVID-19 testing; Caring; Communicable Diseases; Communities; Community Outreach; Contact Tracing; Crossover Design; Crowding; Data; Disasters; Education; Elements; Ensure; Environment; Epidemic; Future; HIV; Health; Health Personnel; Health Services Accessibility; Health behavior; Health system; Hepatitis C virus; Hospitalization; Human immunodeficiency virus test; Imprisonment; Individual; Infrastructure; Intervention; Investigation; Knowledge; Lung; Medical; Methamphetamine; Modeling; Neighborhoods; Network-based; New York City; Opioid; Outcome; Ownership; Participant; Pharmaceutical Preparations; Phase; Population; Poverty; Prevention program; Process; Program Sustainability; Protocols documentation; Public Health; Quarantine; Recording of previous events; Research; Risk; Risk Reduction; SARS-CoV-2 positive; Sampling; Services; Severities; Shelter facility; Site; Social Network; System; Target Populations; Technology; Testing; Time; Training; Underserved Population; Vaccines; Virus; Vulnerable Populations; Washington; Work; base; behavior test; community based participatory research; comparative efficacy; distrust; economic determinant; efficacy trial; experience; health care availability; health care model; high risk population; implementation evaluation; implementation strategy; improved; member; mortality; novel; novel strategies; opioid use; opioid user; outreach; pandemic disease; peer; peer support; prevent; psychosocial; rapid testing; recruit; residence; respiratory; respiratory health; response; scale up; screening; service delivery; social cognitive theory; social stigma; socioeconomics; substance use; testing uptake; transmission process; uptake

Until the advent of treatment or a vaccine, our ability to contain COVID-19 must rely on widespread identification of (asymptomatic) positive cases, their subsequent quarantine, and contact tracing of those potentially exposed. Therefore testing efforts must be targeted to those highly vulnerable yet unserved populations, including individuals who use opioids and other substances. These individuals may have poor respiratory or pulmonary health due to substance use (e.g. opioids, methamphetamine), which may make them more susceptible to the virus. Also, these individuals are also more likely to have been incarcerated, or reside on the street, in shelters or in crowded accommodation, further placing them at risk for transmission. We propose research to establish efficacy and sustainability of a community-social network outreach model that partners infectious disease health providers with community based organizations to successfully implement (reach, uptake, delivery and sustainment) COVID-19 point of service, rapid-testing among a highly vulnerable and often underserved population, those who use opioids and other substances. Two distinct social network recruitment strategies with demonstrated efficacy identifying hidden populations and increasing uptake of HIV testing will be adapted and compared. Guided by the EPIS framework, social cognitive theory, and Andersen’s model, this study comprises three phases. Phase 1: Adaptation of outreach recruitment strategies, we will work with our project community advisory board (CAB) to adapt chain-referral and credible messenger strategies for uptake of COVID-19 testing, to finalize recruitment and on-site testing protocols, and to train the CAB in the new protocols and in continuous quality improvement strategies (Aim 1). Phase 2: Strategy Efficacy Trial and Implementation Evaluation, we will compare the two strategies in a cross-over design at two community based organizations (CBOs) with long standing history of serving hard-to-reach populations in their communities. The comparison of strategies is not to identify the statistical superiority of one sampling strategy in providing population estimates over the other, but instead to identify the ability of each recruitment strategy to reach the target population and increase uptake of COVID-19 tests. We will examine the impact of each strategy on (i) reach (recruitment of target population), (ii) COVID-19 testing/repeat testing, and (iii) service delivery (i.e. quarantine, medical care and contact tracing) among those who test positive for COVID-19 (exploratory) (Aim 2). Phase 3: Sustainment, CBOs will implement the strategy proven efficacious based on outcomes, and we will examine their sustainment of the program (Aim 2). Implementation evaluation will identify participant-, staff-, and organizational-level factors that influence the feasibility, acceptability, and sustainability of each strategy in these CBOs. (Aim 3). This investigation will provide much needed information to improve health outcomes and to identify effective system-level responses to prevent or arrest the spread of COVID-19 among the social networks of those who use opioids and other substances, a highly vulnerable and often overlooked population.

在治疗方法或疫苗出现之前，我们控制COVID-19的能力必须依靠广泛传播