FIU-RCMI ADMINISTRATIVE CORE

总结 背景：美国仍然是全球COVID-19公共卫生的中心之一 紧急情况，导致政府实施缓解政策，以遏制和控制病毒。 尽管采取了这些措施，有色人种（POC -黑人、拉丁裔和美洲印第安人/阿拉斯加原住民） 在美国，艾滋病患者在这一流行病中所占比例不成比例。目标：总体目标 本研究旨在通过以下方式评估宏观和生态政策的影响：（a）使用州和县一级的数据， 关于有色人种社区经历的COVID-19健康结果的报告，以及（B）进行深入的 与社区成员和提供者进行访谈，了解他们对获得和 提供医疗保健服务。设计：首先，在美国的州和县进行生态研究 研究种族/民族密度与COVID-19结果之间关系的水平，考虑到选定的 COVID-19风险因素（拥挤、贫困水平、基本工作人员的百分比）作为调节因素， 关系第二，将对时间、解释和执行方面的分歧进行政策研究 联邦和州一级关于COVID-19后果的缓解政策。最后，将进行面试， 了解提供者和患者对如何实施宏观层面的社会和卫生政策的观点， 联邦和地方政府影响提供者对护理服务的看法和社区成员对护理服务的看法。 关于获得COVID-19医疗保健服务的看法。分析：描述性统计量将用于 按种族/民族密度描述各州和县的COVID-19患病率，然后用双变量 相关性双变量相关性中的任何统计学显著相关性（<0.10）将被纳入 以COVID-19发病率、患病率和死亡率为结果的回归模型。回归模型 将用于确定COVID-19结果与州和县一级之间的关系 人口数据和COVID-19政策数据。对于访谈，将采用内容分析法来分析 关于获得和提供护理的感知障碍和促进者的定性数据。Significance：The 这项研究的结果将有助于理解社会机制和差异的基础， 在COVID-19公共卫生危机中，少数民族人口的代表性不足。的 研究目标与最近NIMHD发布的COVID-19应对支持研究的优先事项一致 调查“州和地方缓解政策对卫生服务利用差异的影响”， 社区一级的保护因素和干预措施在减轻 疫情造成的行业中断的后果，与COVID-19相关的种族主义的影响， 其他类型的歧视，以及健康的社会决定因素在影响预防性健康方面的作用 行为”。

SUMMARY Background: The United States (US) remains one of the epicenters of the global COVID-19 public health emergency, resulting in the government’s implementation of mitigation policies to stem and contain the virus. Despite these measures, people of color (POC - Blacks, Latinx and American Indian/Alaska Native populations) in the US are disproportionately represented in the epidemic. Objectives: The overall objective of this study is to evaluate the impact of macro and ecological policies by (a) using state and county level data to report on COVID-19 health outcomes experienced by communities of color and (b) conducting in-depth interviews among community members and providers to understand their perceptions about accessing and providing healthcare services. Design: Firstly, there will be an ecological study at the US state and county levels examining the relationship between racial/ethnic density and COVID-19 outcomes, considering selected COVID-19 risk factors (crowding, poverty level, percentage of essential workers) as moderators in that relationship. Secondly, there will be a policy study of differences on timing, interpretation and implementation of federal and state level mitigation policies on COVID-19 outcomes. Finally, interviews will be conducted to understand provider and patient viewpoints about how macro level social and health policies implemented by federal and local governments influence providers’ perception about delivery of care and community members’ perception about accessing COVID-19 healthcare services. Analysis: Descriptive statistics will be used to describe COVID-19 prevalence by racial/ethnic density in states and counties, followed by bivariate correlations. Any statistically significant correlation (<0.10) in the bivariate correlations will be incorporated into the regression models with COVID-19 incidence, prevalence and death rate as outcomes. Regression models will be used to determine the relationship between COVID-19 outcomes and state and county level demographic data and COVID-19 policy data. For the interviews, content analysis will be used to analyze qualitative data about perceived barriers and facilitators accessing and providing care. Significance: The results of this study will help to understand the underpinnings of social mechanisms and disparities contributing to the overrepresentation of underrepresented minority populations in the COVID-19 public health crisis. The study objectives are in line with recent NIMHD priorities issued for the COVID-19 response to support studies that investigate the “influence of state and local mitigation policies on differences in health services utilization and health outcomes, the role of community-level protective factors and interventions in mitigating the adverse consequences of the sector disruptions caused by the outbreak, the influence of COVID-19–related racism and other types of discrimination, and the role of social determinants of health in influencing preventive health behaviors”.