Increasing representation of Black communities in COVID-19 home testing and surveillance data

增加黑人社区在 COVID-19 家庭测试和监测数据中的代表性

• 批准号: 10617065
• 负责人: Heather Bradley
• 金额: $ 57.02万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-11-01 至 2024-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10617065
• 关键词: 2019-nCoV; Address; Adverse event; Age; Agreement; Anterior nares; Antibodies; Attitude; Behavior; Biological; Black Populations; Black race; Blood specimen; COVID-19; COVID-19 mortality; COVID-19 pandemic; COVID-19 prevention; COVID-19 test; COVID-19 testing; Cessation of life; Characteristics; Clinic; Collaborations; Collection; Communication; Communities; Data Collection; Decision Making; Diagnostic Reagent Kits; Disease; Effectiveness of Interventions; Ensure; Focus Groups; Genetic; Health; Health Knowledge Attitudes Practice; Home; Individual; Intervention Studies; Interview; Knowledge; Laboratories; Medical; Methods; Modality; Morehouse School of Medicine; Motivation; Nose; Oral; Participant; Persons; Phase; Polymerase Chain Reaction; Population; Population Surveillance; Prevention strategy; Privacy; Public Health; RADx Underserved Populations; Reporting; Research; SARS-CoV-2 infection; SARS-CoV-2 transmission; SARS-CoV-2 variant; Sampling; Specimen; Structural Racism; Surveys; System; Test Result; Testing; Trust; United States; Variant; Visual; Work; Writing; adverse outcome; aged; antigen test; burden of illness; community based participatory research; cultural competence; empowerment; graduate student; health care availability; health knowledge; high risk; home test; improved; member; novel; outcome disparities; pandemic disease; point of care testing; post intervention; preventive intervention; racial disparity; rapid testing; research study; serosurvey; severe COVID-19; sociodemographics; surveillance data; variant detection; vigilance; willingness

Abstract Black communities in the U.S. have disproportionately experienced adverse outcomes attributable to the COVID-19 pandemic. While COVID-19 cases and deaths have declined in recent months, emergent variants continue to pose threats to the health of Black communities and others. COVID-19 testing has recently shifted from primarily point-of-care testing to widespread use of rapid home antigen tests. Home testing may be preferable to clinic-based testing for Black persons, many of whom have a high degree of well-founded, historically based mistrust of the medical system, but very little is currently known about knowledge, attitudes, and behaviors surrounding COVID-19 home testing among Black people. In addition to challenges related to affordability and accessibility of home testing, the privacy afforded by home testing comes at the expense of surveillance information. Home tests are rarely reported to public health surveillance, and specimens are unavailable for genetic sequencing and variant detection. This results in a substantial gap in public health knowledge about COVID-19 burden of disease and circulating variants, which may be particularly problematic for Black communities with higher risk for adverse outcomes. We propose a pre-post intervention study based in Black communities in Atlanta, GA to assess willingness of research participants to use a COVID-19 rapid home test and to simultaneously mail a self-collected anterior nares sample to a commercial laboratory for confirmatory PCR testing. We will provide culturally competent oral and illustrated written communication messages encouraging continued COVID-19 vigilance and home testing alongside self-collection of a specimen for mail-off testing. These messages will be packaged with a home test kit for rapid testing and self- collecting and mailing a second specimen to a laboratory. If a subset of home testers were willing to self-collect and mail a specimen for confirmatory testing, multiplier methods could be used to estimate burden of disease and circulating variants among home testers. However, people with medical mistrust may not elect to share biological specimens for surveillance purposes. We aim to understand motivations and barriers for using this type of testing modality in Black communities while also assessing general knowledge, attitudes, and behaviors related to home testing. Specific aims are to: (1) Develop culturally appropriate, empowering communications strategies underscoring the importance of home COVID-19 testing for individual and public health; (2) Assess knowledge, attitudes, and behaviors regarding COVID-19 rapid home testing among socio- demographically diverse Black communities; (3) Assess willingness to provide, in conjunction with a rapid home test, a self-collected specimen to a laboratory for confirmatory COVID-19 testing; (4) Conduct in-depth interviews with persons completing (N=10) and not completing (N=10) the study-provided home test to further improve communications strategies using participants’ open-ended reflections on intervention effectiveness.

抽象的 美国的黑人社区不成比例地经历了由于以下原因造成的不利后果： 2019冠状病毒病大流行。尽管近几个月来 COVID-19 病例和死亡人数有所下降，但新出现的变种 继续对黑人社区和其他人的健康构成威胁。 COVID-19 测试最近发生了变化 从主要的现场护理检测到广泛使用快速家庭抗原检测。家庭测试可能是 比对黑人进行基于临床的测试更可取，其中许多人都有充分的依据， 历史上对医疗系统的不信任，但目前对知识、态度、 以及黑人中围绕 COVID-19 家庭检测的行为。除了相关的挑战 家庭测试的可负担性和可及性，家庭测试提供的隐私是以牺牲 监视信息。家庭检测很少报告给公共卫生监测部门，样本也很少被报告给公共卫生监督部门。 无法用于基因测序和变异检测。这导致公共卫生方面存在巨大差距 有关 COVID-19 疾病负担和循环变异的知识，这可能特别成问题 对于出现不良后果的风险较高的黑人社区。我们提出了一项基于前后干预研究 在佐治亚州亚特兰大的黑人社区中评估研究参与者使用 COVID-19 快速检测的意愿 家庭测试，同时将自己收集的前鼻孔样本邮寄到商业实验室 确证性 PCR 检测。我们将提供具有文化能力的口头和插图书面交流 鼓励人们继续对 COVID-19 保持警惕并进行家庭检测以及自我收集的信息 用于邮寄测试的样本。这些消息将与家庭测试套件打包在一起，用于快速测试和自我检测 收集第二个样本并将其邮寄到实验室。如果一部分家庭测试者愿意自行收集 并邮寄样本进行验证性检测，乘数法可用于估计疾病负担 以及在家庭测试人员中流传的变种。然而，对医疗不信任的人可能不会选择分享 用于监测目的的生物样本。我们的目标是了解使用此功能的动机和障碍 黑人社区的测试方式类型，同时还评估一般知识、态度和 与家庭测试相关的行为。具体目标是： (1) 开发适合文化的、赋权的 沟通策略强调家庭 COVID-19 检测对个人和公众的重要性 健康; (2) 评估社会群体中有关 COVID-19 快速家庭检测的知识、态度和行为 人口结构多样化的黑人社区； (3) 结合快速评估提供意愿 家庭检测，自行采集样本到实验室进行 COVID-19 确认检测； （四）深入开展 对完成（N = 10）和未完成（N = 10）研究提供的家庭测试的人进行访谈，以进一步 利用参与者对干预有效性的开放式反思来改进沟通策略。