Improving COVID-19 Vaccine Uptake Among Racial and Ethnic Minority Groupswith Rheumatic Diseases

提高患有风湿病的种族和族裔群体对 COVID-19 疫苗的使用

• 批准号: 10585759
• 负责人: Maria Ioana Danila
• 金额: $ 65.85万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-17 至 2028-02-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10585759
• 关键词: Address; Adult; Advisory Committees; Alabama; American; Area; Awareness; Behavior; Black Populations; Black race; COVID-19; COVID-19 booster; COVID-19 vaccination; COVID-19 vaccine; Caring; Cessation of life; Clinic; Clinic Visits; Communication; Communities; Complex; Confusion; Disparity; Dose; Education; Effectiveness; Ethnic Origin; Ethnic Population; Exposure to; Fostering; Fright; Funding; Future; General Population; Geographic Locations; Geography; Health; Health Status; Hospitalization; Immunosuppressive Agents; Individual; Inequity; Insurance Coverage; Intervention; Interview; Latinx; Latinx population; Logistics; Massachusetts; Measures; Medicaid; Methods; Mind; Minority Groups; Misinformation; Modeling; Narration; National Center for Advancing Translational Sciences; Outcome; Participant; Patient Self-Report; Patients; Persons; Pharmaceutical Preparations; Population; Population Heterogeneity; Privatization; Proxy; Randomized; Recommendation; Records; Research; Resources; Rheumatism; Rheumatoid Arthritis; Rheumatology; Risk; Safety; Self Efficacy; Series; Structure; Surveys; Systemic Lupus Erythematosus; Tablet Computer; Telephone; Testing; Training; Uninsured; United States National Institutes of Health; Vaccinated; Vaccination; Vaccinee; Vaccines; Work; attentional control; autoimmune rheumatologic disease; behavior change; booster vaccine; college; community engagement; diet and exercise; effectiveness testing; ethnic minority; ethnic minority population; experience; flexibility; good diet; group intervention; health equity; health inequalities; high risk; improved; influenza virus vaccine; innovation; intervention effect; marginalized population; member; minority patient; multi-component intervention; multidisciplinary; novel; patient navigation; patient navigator; people of color; post SARS-CoV-2 infection; primary endpoint; racial diversity; racial minority; racial population; recruit; scale up; severe COVID-19; side effect; simulation; social; treatment as usual; uptake; vaccine acceptance; vaccine efficacy; video chat; virtual

PROJECT SUMMARY Black and Latinx individuals are at higher risk for certain autoimmune rheumatic diseases (AIRDs) and have experienced worse COVID-19 outcomes compared to their white counterparts. The American College of Rheumatology recommends beyond the initial COVID-19 vaccination, subsequent COVID-19 vaccine doses to complete the primary vaccination series and a booster dose in people with AIRD. Yet, historically, overall vaccine uptake among people with AIRDs has been low, and this vaccine reluctance has extended to COVID- 19 vaccination. This proposal will harness community-engaged methods to develop and test the effectiveness of a multi-modal intervention that combines “storytelling” videos and patient navigation to increase uptake of recommended COVID-19 vaccination among Black and Latinx AIRD patients in two distinct US geographic regions. Aim 1 will develop a multi-modal intervention that includes a) “storytelling” videos we will produce with vaccinated Black or Latinx patients with AIRDs narrating their COVID-19 vaccination experiences, and b) a patient navigation approach to encourage recommended COVID-19 vaccination. Navigators will be trained using virtual case simulation to discuss up-to-date guidance and provide logistical support for vaccination. In Aim 2a we will recruit 1,170 racial and ethnic minority patients from 4 rheumatology clinics in the Southern and Northeastern U.S. to participate in this patient-level, randomized, controlled, parallel group trial. Participants will be randomized to receive at the routine clinic visit either “storytelling” OR an “attention-control” plus usual care. At the clinic visit, coordinators will invite participants to view “storytelling” videos on tablet computers deployed in a private clinic area. At 2 days after the clinic visit, the navigators will contact each participant remotely (phone/video calls) to provide customized assistance for vaccination. A second contact will occur ~2 weeks later. We will examine the differences in rates of COVID-19 vaccine receipt between racial/ethnic minority participants with AIRD exposed to our multi-modal intervention versus an “attention-control” video (focused on the merits of a balanced diet/exercise on health status) plus usual care. We will measure rates of receipt of subsequent COVID-19 vaccination at 3 months after the clinic visit using extant linkages to state vaccination records (primary endpoint). We will measure via surveys COVID-19 vaccine confidence, influenza vaccine uptake (self-report) as a proxy for intervention effect on vaccination behavior for other vaccines, self- efficacy, and social health. We will explore whether insurance status and education moderate COVID-19 vaccine uptake. In Aim 2b, using surveys and semi-structured interviews, we will assess how intervention components achieved their effects to inform future scale-up of our intervention. Beyond our innovative approach and experienced team, a key strength of our study is its generalizability since we are including two geographically distinct regions with substantial ethnic/racial diversity in their populations that deliver care to many uninsured, Medicaid, and other historically marginalized groups.

项目摘要 黑人和拉丁裔个体患某些自身免疫性风湿性疾病（AIRD）的风险较高， 经历了比他们的白色同行更糟糕的COVID-19结果。The American College of 流变学建议，除了最初的COVID-19疫苗接种外，随后的COVID-19疫苗剂量应 在AIRD患者中完成初级疫苗接种系列和加强剂量。然而，从历史上看， AIRD患者的疫苗接种率一直很低，这种疫苗不情愿已经延伸到COVID-1， 19接种疫苗该提案将利用社区参与的方法来开发和测试有效性， 一种多模式干预，结合“讲故事”视频和患者导航， 在美国两个不同地区的黑人和拉丁裔AIRD患者中推荐COVID-19疫苗接种 地区Aim 1将开发多模式干预，包括a）我们将制作的“讲故事”视频， 接种了AIRD的黑人或拉丁裔患者讲述了他们的COVID-19疫苗接种经历，以及B）a 患者导航方法，以鼓励推荐的COVID-19疫苗接种。导航员将接受培训 利用虚拟病例模拟讨论最新指导，并为疫苗接种提供后勤支持。在 目标2a：我们将从南部和南部的4个风湿病诊所招募1,170名少数民族患者， 参与这项患者水平、随机、对照、平行组试验。参与者 将在常规门诊访视时随机接受“讲故事”或“注意力控制”加常规 在乎在诊所访问中，协调员将邀请参与者在平板电脑上观看“讲故事”视频 部署在私人诊所区域。在诊所访视后2天，导航员将联系每名受试者 远程（电话/视频通话）提供定制的疫苗接种援助。将发生第二次接触~2 周后我们将研究种族/民族之间COVID-19疫苗接种率的差异 少数AIRD参与者接受我们的多模式干预与“注意力控制”视频 （重点是均衡饮食/运动对健康状况的好处）加上日常护理。我们将测量 在诊所就诊后3个月接受后续COVID-19疫苗接种，使用与国家的现有联系 疫苗接种记录（主要终点）。我们将通过调查COVID-19疫苗信心，流感 疫苗接种（自我报告）作为对其他疫苗接种行为干预效果的替代，自我报告 效率和社会健康。我们将探讨保险状况和教育是否会缓和COVID-19 疫苗摄取。在目标2b中，我们将使用调查和半结构化访谈，评估干预如何 这些措施取得了成效，为今后扩大我们的干预行动提供了信息。超越我们的创新 方法和经验丰富的团队，我们的研究的一个关键优势是它的普遍性，因为我们包括两个 地理上不同的地区，其人口具有很大的族裔/种族多样性， 许多没有保险的人，医疗补助和其他历史上被边缘化的群体。