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，我们遏制 COVID-19 的能力必须依赖广泛的 识别（无症状）阳性病例，随后进行隔离，并对这些病例进行接触者追踪 潜在暴露。因此，测试工作必须针对那些高度脆弱但未得到服务的人 人群，包括使用阿片类药物和其他物质的个人。这些人可能有贫困 由于物质使用（例如阿片类药物、甲基苯丙胺）而导致呼吸或肺部健康，这可能使他们 更容易感染病毒。此外，这些人也更有可能被监禁或居住 在街上、避难所或拥挤的住处，进一步使他们面临传播风险。我们 提出研究以确定社区社交网络外展模型的有效性和可持续性，该模型 传染病卫生服务提供者与社区组织合作，成功实施 （覆盖、吸收、交付和维持）COVID-19 服务点，在高度弱势群体中进行快速检测 以及经常服务不足的人群，即使用阿片类药物和其他药物的人群。两个不同的社交网络 已证明有效识别隐藏人群和增加艾滋病毒感染率的招募策略 测试将被调整和比较。以EPIS框架、社会认知理论和安徒生理论为指导 模型中，本研究分为三个阶段。第一阶段：调整外展招聘策略，我们将 与我们的项目社区咨询委员会 (CAB) 合作，调整链推荐和可信信使策略 进行 COVID-19 检测、最终确定招募和现场检测方案以及对 CAB 进行培训 新协议和持续质量改进策略（目标 1）。第二阶段：策略成效试验及 实施评估，我们将在两个基于社区的交叉设计中比较两种策略 具有为其社区中难以接触到的人群提供服务的悠久历史的组织 (CBO)。这 策略比较并不是为了确定一种抽样策略在提供数据方面的统计优势 人口估计而不是其他，而是确定每种招募策略达到目标的能力 目标人群并增加 COVID-19 检测的采用率。我们将研究每个策略对 (i) 的影响 达到（招募目标人群），(ii) COVID-19 测试/重复测试，以及 (iii) 服务交付（即 隔离、医疗护理和接触者追踪）在那些 COVID-19 检测呈阳性的人中（探索性）（目标 2）。第 3 阶段：维持，CBO 将根据结果实施经证明有效的策略，我们 将检查他们对该计划的维持情况（目标 2）。实施评估将确定参与者、工作人员、 以及影响每项战略的可行性、可接受性和可持续性的组织层面因素 这些国会预算办公室。 （目标 3）。这项调查将提供急需的信息，以改善健康结果并 确定有效的系统级响应，以防止或阻止 COVID-19 在社交网络中的传播 在使用阿片类药物和其他药物的人群中，他们是一个高度脆弱且经常被忽视的人群。