Core C Clinical Core

核心 C 临床核心

• 批准号: 10267800
• 负责人: MICHAEL J MUGAVERO
• 金额: $ 332.36万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-23 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10267800
• 关键词: 2019-nCoV; AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Advocate; African American; Alabama; Algorithms; Americas; Area; Asians; Behavioral; COVID-19; COVID-19 pandemic; Centers for Disease Control and Prevention (U.S.); Clinical; Collaborations; Communities; Community Health; Community Health Aides; Contact Tracing; Country; County; Data; Deep South; Disease; Effectiveness; Epidemic; Epidemiology; Ethics; Ethnic Origin; European; Evaluation; Foundations; Future; Geography; HIV; Health; Health education; Human immunodeficiency virus test; Individual; Infrastructure; Interview; Knowledge; Location; Medical; Methods; Modeling; Morbidity - disease rate; Persons; Phase; Population; Positioning Attribute; Preparation; Process; Public Health; Race; Research; Research Design; Research Personnel; Research Support; Resources; Risk Factors; Rural; Rural Community; Scientist; Series; System; Test Result; Testing; Time; Training; United States; Universities; Update; Vulnerable Populations; Work; base; combat; community partnership; comparative; coronavirus disease; design; evidence base; experience; experimental study; indexing; infection rate; innovation; meetings; metropolitan; mortality; novel virus; pandemic disease; peer; primary outcome; programs; public health intervention; racism; response; rural counties; rural underserved; scale up; secondary outcome; social; social stigma; socioeconomic disadvantage; socioeconomics; success; uptake; vaccination strategy

Alabama is ranked as the state most vulnerable to COVID-19 by the community vulnerability index, and among the bottom 5 states in meeting SARS-CoV-2 testing targets. COVID-19 case rates are 3-fold higher in several rural counties in Alabama relative to metropolitan areas like Birmingham, with SARS-CoV-2 testing percent positivity approaching or exceeding 20% in a majority of rural counties. Meaningful community engagement in developing and implementing SARS-CoV-2 testing programs is vital to proactively address social, ethical and behavioral considerations germane to underserved communities. University of Alabama at Birmingham (UAB) Center for AIDS Research (CFAR) investigators have long-standing relationships working with clinical, community, and public health agencies to conduct innovative HIV testing and prevention studies, and are poised to act swiftly in response to the COVID-19 pandemic. A Dynamic COVID-19 Community-Engaged Testing Strategy in Alabama (COVID COMET AL) will transfer vast community-informed HIV testing knowledge to address the urgent need for rapid scale-up of SARS-CoV-2 testing among underserved rural, socio-economically disadvantaged, and Black/African American populations. COVID COMET AL is grounded in the ADAPT framework for tailoring evidence-based public health interventions for new settings and populations, and includes Assessment, Preparation, and Implementation phases. In collaboration with well-established clinical and community testing partners, regional health education centers, and additional community-based organizations, CFAR investigators will work together with interdisciplinary scientists from across campus at UAB to conduct the following specific aims: Aim 1 (Assessment): Refine a data-driven, time-updated algorithm to identify the underserved rural counties most impacted by COVID-19 in Alabama, Aim 2 (Preparation): Use a communityengaged sequential mixed-methods approach to inform tailored adaptation and implementation of the COVID COMET AL strategy in highly impacted rural counties selected for implementation, Aim 3 (Implementation): Deploy the iteratively adapted COVID COMET AL strategy, which includes peer health advocates, community health workers, and venue based testing, in 3 highly impacted rural Alabama counties at a time, in two sequential waves, each lasting 6-months, and Aim 4: Evaluate the implementation process of COVID COMET AL in partnering with community stakeholders to maximize program reach, effectiveness, and sustainability. Using a quasi-experimental, paired, comparative time series study design, temporal change in SARS-CoV-2 testing percent positivity will be compared in the 6 implementation counties relative to 6 matched control counties as the primary outcome, with testing reach, time to return test results, and time to contact tracing as secondary outcomes. Evaluation of COVID COMET AL implementation grounded in the Interactive Systems Framework will inform dissemination of this dynamic, data-driven public health testing strategy to maximize impact in addressing disparities in underserved rural communities, and will also guide COVID-19 vaccination strategies

阿拉巴马州被社区脆弱性指数评为最容易受到新冠肺炎攻击的州， 在达到SARS-CoV-2检测目标方面排名垫底的5个州。在几个案例中，新冠肺炎的发病率高出3倍 阿拉巴马州的农村县相对于伯明翰等大都市地区，SARS-CoV-2检测的百分比 在大多数农村县，积极性接近或超过20%。有意义的社区参与 开发和实施SARS-CoV-2检测计划对于积极解决社会、伦理和 行为考虑与服务不足的社区密切相关。阿拉巴马大学伯明翰分校(UAB) 艾滋病研究中心(CFAR)的调查人员与临床、 社区和公共卫生机构进行创新的艾滋病毒检测和预防研究，并做好准备 迅速采取行动应对新冠肺炎疫情。一种动态的新冠肺炎社区参与测试 阿拉巴马州的战略(COVID彗星AL)将把大量社区了解的艾滋病毒检测知识转移到 解决在服务不足的农村、社会经济领域迅速扩大SARS-CoV-2检测的迫切需要 弱势群体和黑人/非裔美国人。COVID彗星AL在适配器中停飞 为新环境和新人群量身定做循证公共卫生干预措施的框架，包括 评估、准备和实施阶段。与久负盛名的临床和 社区检测合作伙伴、区域健康教育中心和其他社区组织， CFAR调查人员将与UAB校园内的跨学科科学家合作，进行 以下具体目标：目标1(评估)：改进数据驱动、及时更新的算法，以确定 阿拉巴马州受新冠肺炎影响最严重的未得到充分服务的农村县，目标2(筹备)：使用社区参与的顺序混合方法，为COVID的量身定制的适应和实施提供信息 在受影响较大的农村县选择实施的彗星AL战略，目标3(实施)： 部署反复调整的COVID comet AL战略，其中包括同行健康倡导者、社区 卫生工作者和基于场地的测试，一次在阿拉巴马州3个受影响严重的农村县，分两次进行 WAVE，每次为期6个月，目标4：评估COVID彗星AL#年的实施进程 与社区利益相关者合作，最大限度地提高计划的覆盖面、有效性和可持续性。使用 准实验、配对、比较时间序列研究设计：SARS-CoV-2检测的时间变化 将6个实施县与6个匹配的对照县的阳性百分率进行比较，如下 主要结果，测试范围、返回测试结果的时间和联系跟踪的时间是次要的 结果。基于交互系统框架的COVID彗星AL实施评估 将为这一动态、数据驱动的公共卫生检测战略的传播提供信息，以最大限度地提高 解决服务不足农村社区的差距，还将指导新冠肺炎疫苗接种战略