Supported employment to create a community culture of SARS-CoV-2 rapid testing among people who inject drugs: PeerConnect2Test

项目摘要 这个第三阶段项目建立在我们第一阶段和第二阶段项目成功的基础上，但使用了一种新的方法 适应不断变化的大流行环境；促进注射吸毒者的快速检测(PWID)通过 支持就业计划，将PWID培训为同行卫生工作者(PHW)。PWID容易受到 感染SARS冠状病毒2(SARS-CoV-2)及其对疾病的影响 由SARS-CoV-2引起的冠状病毒病2019(新冠肺炎)因结构劣势，健康 脆弱性，以及妨碍充分获得医疗服务的污名化。虽然我们的项目已经 之前处理了6,000多个针对PWID的自收集聚合酶链式反应(PCR)检测 俄勒冈州，大流行的不断变化的性质，包括新的变种和可获得的 SARS-CoV-2疫苗需要更多的战略，以增加对 PWID。对于遇到结构漏洞的PWID，快速测试可能比PCR测试更具优势 例如没有住房和无法获得技术，以便他们可以实时接收结果并 快速连接到所需的资源。PWID快速检测的可及性以前受到以下方面的限制 劳动力短缺，无法联系到需要检测的PWID。我们提出了一个新的社区-- 实施战略，通过支持的就业方案改善快速检测的可及性 PWID，Peer Connect2Test(PeerC2T)，将成为公共卫生部门向其他国家分发SARS-CoV-2快速检测试剂盒 PWID。我们预计PeerC2T将提高PHW(AIM)的知识、自我效能和健康行为 1)。我们将使用AIMS 2和3中的RE-AIM框架来评估PeerC2T是否改善了SARS-CoV-2 在其他PWID中测试摄取(RE；目标2)并确定干预考虑因素(AIM；目标3)。这个 该项目的总体目标是在我们与Hiva的伙伴关系的基础上发展一个变革性的社区- 推动干预措施，以促进在PWID中广泛获得快速检测。我们将继续 与RADx-UP协调和数据收集中心协作。调查结果将澄清以下问题的含义 支持针对SARS-CoV-2检测的PWID就业计划在PWID和其他公众中的接受情况 为改善残疾人的健康状况而作出的卫生努力。因此，这项研究的结果可能会引起广泛的公众 利用PWID支持的就业计划预防艾滋病传播的健康影响 其他传染病。

Project Summary This Phase III project builds on the successes of our Phase I and Phase II projects but uses a novel approach to adapt to the changing pandemic context; facilitation of rapid testing by people who inject drugs (PWID) via a supported employment program that trains PWID as peer health workers (PHW). PWID are vulnerable to contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and to the effects of the disease caused by SARS-CoV-2, coronavirus disease 2019 (COVID-19) due to structural disadvantage, health vulnerabilities, and stigmatization that prevents adequate access to medical care. While our project has previously processed more than 6,000 self-collected polymerase chain reaction (PCR) tests for PWID across the state of Oregon, the ever-changing nature of the pandemic, including new variants and the availability of SARS-CoV-2 vaccines, calls for additional strategies that can increase access to and uptake of testing among PWID. Rapid tests may offer an advantage over PCR tests for PWID experiencing structural vulnerabilities such as houselessness and lack of access to technology so that they can receive results in real-time and be quickly connected to needed resources. Accessibility of rapid testing for PWID has been previously limited by workforce shortages and the inability to reach PWID who need testing. We propose a novel community- engaged strategy to improve the accessibility of rapid tests through a supported employment program for PWID, Peer Connect2Test (PeerC2T), to become PHW to distribute SARS-CoV-2 rapid test kits to other PWID. We expect that PeerC2T will improve knowledge, self-efficacy, and health behaviors among PHW (Aim 1). We will use the RE-AIM framework in Aims 2 and 3 to evaluate whether PeerC2T improves SARS-CoV-2 testing uptake among other PWID (RE; Aim 2) and identify intervention considerations (AIM; Aim 3). The overall goal of this project is to build on our partnership with HIVA to develop a transformative community- driven intervention to promote widespread access to rapid testing among PWID. We will continue to collaborate with the RADx-UP Coordination and Data Collection Center. Findings will clarify the implications of supported employment programs for PWID for SARS-CoV-2 testing uptake among PWID and other public health efforts to improve health outcomes among PWID. Thus, findings from this study may have broad public health implications for leveraging supported employment programs for PWID to prevent the transmission of other infectious diseases.