Building Resilience and Vital Equity (BRAVE) - Increasing COVID-19 Testing in American Indians

摘要 COVID19大流行继续对包括美国印第安人在内的服务不足的社区造成最严重的打击 (AI)/阿拉斯加原住民(AN)。具有显著健康差距和健康的社会决定因素的疾病有 主要风险因素，并界定人工/AN之间与COVID19相关的差异。增加的测试和即将推出的 遵守疫苗接种建议是管理COVID19和缓解 病毒对边缘化社区的影响。越来越多的证据表明，服务不足的社区 由于贫困，不太可能积极参与大规模检测和免疫接种建议， 获取渠道、信息不足、后勤以及围绕恐惧、耻辱和信任的问题。北卡罗来纳州(北卡罗来纳州) 拥有密西西比河以东最大的人工智能人口和全国第六大人工智能人口 超过一半的人生活在苏格兰罗伯逊、霍克和坎伯兰等服务不足的农村县。这 建议是两个社区参与的学术机构(北卡罗来纳州中部)之间的伙伴关系 大学-NCCU和北卡罗来纳大学彭布罗克-UNCP)和主要的社区合作伙伴 北卡罗来纳州的伦比部落(LTNC)，有62,500名成员。我们假设一个双向社区- 采用参与式方法了解社会伦理和行为影响(SEBI)，并与Focus相结合 解决障碍的干预措施将增加测试并缓解新冠肺炎在人工智能领域的后果 北卡罗来纳州的社区。该提案的具体目的是(1)了解障碍和社会 通过设计和实施文化敏感度在美洲印第安人中进行柯萨奇病毒19检测的意义 调查工具和干预材料。(2)实施勇敢外展和检测干预，增加 在美国印第安人社区进行测试；(3)数据分析、评估和数据共享。勇敢是一种大胆的行为 社区参与的计划，通过解决差距和建立弹性来增加测试，以改变 在我们与这一不幸的公共卫生紧急情况作斗争的过程中，人工智能社区的叙事从挣扎到强大。

Abstract The COVID19 pandemic continues to hit hardest on underserved communities including American Indians (AI)/Alaska Natives (AN). Diseases with significant health disparities and social determinants of health are major risk factors and define COVID19 related disparities among AI/AN. Increased testing and upcoming adherence to vaccination recommendations are two important strategies to manage COVID19 and mitigate the impact of the virus on marginalized communities. Mounting evidence indicates that underserved communities are less likely to actively participate in mass testing and immunization recommendations due to poverty, access, inadequate information, logistics and issues surrounding fear, stigma and trust. North Carolina (NC) has the largest AI population east of the Mississippi River and the sixth largest AI population in the nation with more than half living in rural underserved counties of Robeson, Scotland, Hoke and Cumberland. This proposal is a partnership between two community engaged academic institutions (North Carolina Central University - NCCU and University of North Carolina at Pembroke-UNCP) and a major community partner – The Lumbee Tribe of North Carolina (LTNC) with 62,500 members. We hypothesize that a bidirectional community- engaged approach to understand the social ethical and behavioral implications (SEBI) combined with focused interventions to address the barriers will increase testing and mitigate the consequences of COVID-19 in AI communities of NC. The specific aims of the proposal are (1) To understand the barriers and social implications of COVID19 testing among American Indians by designing and implementing culturally sensitive survey tools and intervention materials. (2) Implement BRAVE outreach and testing interventions to increase testing in American Indian community and (3) Data analysis, evaluation and data sharing. BRAVE is a bold community-engaged initiative to increase testing by addressing disparities and building resiliency to change the narrative from struggle to strength in AI community as we fight this unfortunate public health emergency.