Puipuia le Ola: Increasing reach and uptake of COVID-19 testing among Pacific Islanders in Hawaii and Guam

摘要 非土著夏威夷太平洋岛民被界定为原籍关岛的土著人民， 北方马里亚纳群岛联邦、美属萨摩亚、密克罗尼西亚联邦、 马歇尔群岛和帕劳共和国是COVID-19相关发病率最高的国家， 在美国，PI的死亡率也受到已知会增加其严重并发症风险的医学共病的影响。 新冠肺炎。此外，PI难以获得医疗保健，医疗保险不足或没有，居住在 多代人或多个家庭过度拥挤的住房，并有低收入的服务工作，使他们面临 受感染的公众夏威夷正在经历COVID-19的急剧激增，每天的数量达到三位数，甚至更多 超过10，000个案例。PI仅占该州人口的4%，占COVID-19病例的32%。 我们的长期目标是减少PI之间的COVID-19差异。拟议研究的总体目标 是使用文化共鸣的社区参与战略，以增加COVID-19的影响和吸收 检测以更好地了解夏威夷和关岛PI中的SARS-CoV-2感染模式。我们的中央 假设文化上适当和语言上正确的策略将增加COVID-19的吸收 在PI中进行检测，从而获得更精确的SARS-CoV-2感染率和血清阳性率。我们 多学科调查小组由医生和社区卫生工作者组成， 研究人员和基础及应用科学家。将通过以下具体目标实现这一目标。 具体目标1。制定和评估适合不同文化的社区参与战略， 在夏威夷和关岛的PI中进行COVID-19检测。 方法：让PI社区参与，共同设计一项在文化和语言上适当的战略， 推广COVID-19检测，实施策略并评估其有效性。 具体目标2：确定夏威夷和关岛无症状PI的SARS-CoV-2感染模式。 方法：对无症状成人PI进行COVID-19 RT-PCR和SARS-CoV-2特异性IgG和IgM检测 在夏威夷和关岛，以确定感染率和血清阳性率。 一个高度承诺的社区和科学咨询委员会，由PI社区的杰出领导人组成 致力于改善知识产权健康的学者将提供指导， 缓解PI之间COVID-19差异的策略。社会各界、学术界及 政府证明了这个社区测试研究项目的紧迫性。

Abstract Non-Native Hawaiian Pacific Islanders (PI), defined as indigenous people having origins in Guam, the Commonwealth of the Northern Mariana Islands, American Samoa, Federated States of Micronesia, Republic of the Marshall Islands and Republic of Palau, have among the highest COVID-19-associated morbidity and mortality rates in the U.S. PI also suffer from medical co-morbidities known to increase their risk of severe COVID-19. In addition, PI have poor access to health care, inadequate or no health insurance, live in multi-generational or multi-family overcrowded housing, and have low-paying service jobs that expose them to the infected public. Hawaii is experiencing a dramatic surge in COVID-19, with triple-digit daily counts and more than 10,000 cases. PI, who comprise only 4% of the State’s population, account for 32% of COVID-19 cases. Our long-term goal is to reduce COVID-19 disparities among PI. The overall objective of the proposed research is to use culturally resonant community-engagement strategies to increase the reach and uptake of COVID-19 testing to better understand SARS-CoV-2 infection patterns among PI in Hawaii and on Guam. Our central hypothesis is that culturally appropriate and linguistically correct strategies will increase uptake of COVID-19 testing among PI, resulting in more precise SARS-CoV-2 infection and seroprevalence rates. Our multi-disciplinary investigative team comprises physicians and community health workers, community-engaged researchers and basic and applied scientists. The objective will be achieved by the following specific aims. Specific Aim 1. Develop and evaluate culturally tailored community-engaged strategies to increase COVID-19 testing among PI in Hawaii and Guam. Approach: Engage PI communities to jointly design a strategy with culturally and linguistically appropriate content to promote COVID-19 testing and mplement the strategy and evaluate its effectiveness. Specific Aim 2: Determine SARS-CoV-2 infection patterns in asymptomatic PI in Hawaii and Guam. Approach: Perform COVID-19 RT-PCR and SARS-CoV-2-specific IgG and IgM testing of asymptomatic adult PI in Hawaii and Guam to ascertain infection rates and seroprevalence. A highly committed Community and Scientific Advisory Board, comprising prominent leaders in the PI community and academicians who are dedicated to improving IP health, will provide guidance to design culturally relevant strategies to mitigate COVID-19 disparities among PI. Strong support from the community, academia and government attest to the to the urgency of this Community-Engaged Testing Research Project.