Investigating the effectiveness of COVID-19 testing choices, community engagement, and culturally-embedded mHealth literacy delivery in a medically-underserved, community-based sample

在医疗服务不足、基于社区的样本中调查 COVID-19 检测选择、社区参与和嵌入文化的移动医疗素养传播的有效性

• 批准号: 10258548
• 负责人: Ayman Al-Hendy
• 金额: $ 160.98万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-11-11 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10258548
• 关键词: Adherence; Adult; Advertisements; African American; Agreement; Ambulatory Care; Ambulatory Care Facilities; Anxiety; Behavior; Behavior Control; Behavioral; Biometry; COVID-19; COVID-19 morbidity; COVID-19 testing; Caring; Case Study; Catchment Area; Cessation of life; Chicago; Child; Clinic; Clinical Microbiology; Collaborations; Collection; Common Data Element; Communities; County; Coupled; Data; Data Analyses; Data Collection; Development; Diagnosis; Diagnostic Reagent Kits; Disclosure; Early Diagnosis; Economics; Effectiveness; Epidemiologic Monitoring; Epidemiology; Ethics; Exposure to; FDA approved; Food; Frequencies; Future; Glass; Health; Healthcare; Healthcare Systems; Home; Hospitals; Hour; Illinois; Individual; Infection; Infection Control; Informed Consent; Infrastructure; Intensive Care Units; Intervention; Knowledge; Laboratories; Latinx; Low income; Measures; Mediator of activation protein; Medical; Mental Health; Methods; Microbiology; Molecular; Monitor; Multilingualism; Neighborhoods; Nose; Participant; Patient Self-Report; Patients; Perception; Persons; PhenX Toolkit; Preparation; Quarantine; Radio; Recording of previous events; Research Methodology; Respiratory Tract Infections; Risk; Sampling; Schools; Secure; Sentinel; Site; Specimen; Stress; Swab; Test Result; Testing; Time; United States National Institutes of Health; Universities; Viral; Viral Load result; Washington; base; community engagement; community partnership; comparative effectiveness analysis; cooking; data acquisition; disparities in morbidity; empowerment; follow-up; health care availability; health disparity; high risk; intervention effect; literacy; mHealth; medically underserved; mortality; mortality disparity; multi-racial; nasal swab; novel; outreach; person centered; point of care testing; posters; prevent; racial and ethnic; racial and ethnic disparities; satisfaction; social; social capital; social determinants; social media; social stigma; testing uptake; theories; underserved community; uptake; willingness

Since the first U.S. cases were identified in Washington on January 20th and soon thereafter in Chicago on January 24th, COVID-19 has rapidly emerged as the most prevalent and deadly respiratory infection within the State of Illinois, with 220,178 total confirmed cases and 7,880 (3.6%) deaths. The UIC Hospital and Health Care System (UI Health), in collaboration with its 14 partnering Federally Qualified Mile Square Heath Center practice sites (FQHCs) (where this project will be implemented), saw over 4,000 of these cases between March and June, 2020 (6), noting the disproportionately higher rates if COVID-19 in Latinx people (47.1% with 32.7% of deaths) and in people identifying as African American or Black (28.9% with 43.1% of deaths). Of 48,111 cases reported in Cook County alone, 7,231 (15.0%) were hospitalized with 2,234 (4.6%) in an intensive care unit. These COVID-19-related morbidity and mortality disparities are accompanied by numerous other health disparities. Many of our FQHCs lack the staffing and revenue to test on-site and provide extensive follow-up outpatient care for the large influxes of symptomatic patients concerned about COVID-19. These challenges have likely resulted in increased COVID-19-related complications and deaths that might have been prevented with clearer and more accurate public messaging about COVID-19, wider access to testing, earlier diagnosis, and an increased perception that care is confidential, accessible, and self-driven. This project will employ sentinel and community-based epidemiological surveillance and participatory research methods to evaluate whether a person-centered, rapid COVID-19 testing intervention (at-home swab and send, or on-site point of care testing), coupled with a novel mHealth COVID-19 Literacy and Outreach Suite of apps and videos, will serve to increase the acceptance, access, reach, uptake, and impact of COVID-19 testing at UI Health and in the 14 FQHC practice sites and their corresponding catchment areas. We will also analyze the social, ethical, economic, and behavioral drivers and consequences of our outreach and testing approaches according to the degree to which participants contribute to the co-creation of study-related messaging. Finally, we will leverage our existing infrastructures to expand testing uptake and analyze (by PCR) viral load at infection onset/exposure and following onset/exposure to determine viral dynamics and identify individuals at early and late stages of infection. PhenX measures will be used to test intervention effects on testing and retesting uptake, time-to-diagnosis, COVID-19 knowledge, healthcare access and seeking, disclosure, medical adherence, and practice of home self-isolation, quarantine, and other infection control behaviors. All data acquisition, collection and curation approaches will be informed by the CDCC, including AboutML-informed consent approaches and with the other RADxUP studies and relevant federal agencies.

自从1月20日在华盛顿发现第一例美国病例以来，芝加哥很快就发现了病例 1月24日，COVID-19迅速成为美国最流行和最致命的呼吸道感染， 伊利诺伊州，共确诊220,178例，死亡7,880例（3.6%）。UIC医院和健康 护理系统（UI健康），与其14个合作伙伴联邦合格英里广场健康中心合作 实践地点（将实施该项目的地方），在3月12日至14日期间， 和2020年6月（6），注意到如果COVID-19在拉丁美洲人中的发病率不成比例地高（47.1%和32.7%）， 非裔美国人或黑人（28.9%，43.1%）。在48 111个案件中， 仅库克县就报告了7，231例（15.0%）住院，其中2，234例（4.6%）在重症监护室。 这些与COVID-19相关的发病率和死亡率差异伴随着许多其他健康问题， 差距。我们的许多公司缺乏人员和收入来进行现场测试和提供广泛的后续行动 为大量涌入的有症状的COVID-19患者提供门诊护理。这些挑战 可能导致本可预防的COVID-19相关并发症和死亡增加 通过更清晰、更准确的COVID-19公共信息，更广泛的检测渠道，更早的诊断， 以及越来越多的人认为护理是保密的、可获得的和自我驱动的。该项目将采用 以哨点和社区为基础的流行病监测和参与性研究方法， 无论是以人为中心的快速COVID-19检测干预（在家拭子和发送，还是现场点检测）， 护理测试），再加上一个新的mHealth COVID-19扫盲和推广套件的应用程序和视频，将 有助于提高接受，访问，覆盖面，吸收，和在UI健康的COVID-19测试的影响， 14个国家人权委员会的实践地点及其相应的集水区。我们还将分析社会，道德， 经济和行为驱动因素以及我们的推广和测试方法的后果， 参与者对共同创建研究相关消息的贡献程度。最后，我们将利用 我们现有的基础设施，以扩大测试吸收和分析（通过PCR）病毒载量的感染 发病/暴露和发病/暴露后，以确定病毒动态，并在早期和 感染晚期。PhenX措施将用于测试干预效果测试和复检 接受率、诊断时间、COVID-19知识、医疗服务获取和寻求、披露、医疗依从性， 以及居家自我隔离、隔离和其他感染控制行为的实践。所有数据采集， 收集和管理方法将由CDCC告知，包括关于ML的知情同意 方法，并与其他RADxUP研究和相关的联邦机构。