Comprehensive Long COVID Care for Underserved Communities: Innovative Delivery and Dissemination Models (Comunidad)

为服务不足的社区提供全面的长期新冠护理：创新的交付和传播模式 (Comunidad)

• 批准号: 10866175
• 负责人: Lisa Kilpela
• 金额: $ 99.91万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2028-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10866175
• 关键词: Comprehensive; Long; COVID; Care; Underserved

ABSTRACT Long COVID specialty clinics, some with a multidisciplinary staff, have emerged in various locations, but comprehensive, coordinated care is not readily accessible to many with Long COVID. The Post-COVID-19 Recovery Clinic at UT Health San Antonio serves not only San Antonio, the seventh largest city in the US, but also the largely rural and Hispanic/Latino population of South Texas, a population beset by health disparities. And yet, a major challenge in our current model is the 5-month wait for a new patient appointment and the additional delay to see medical specialists and mental health providers. Further, given our patient population’s many adverse social determinants of health and limited access to care, ready availability of social workers is critical but currently limited. Within our patients’ local communities, there is also a shortage of primary care providers available and knowledgeable about diagnosing, evaluating, and managing people with Long COVID. Moreover, there is a lack of awareness about Long COVID and rife misinformation and disinformation among community members in our vast South Texas catchment area. To improve and expand Long COVID care in San Antonio and South Texas, and to test new, sustainable models of care, we propose to conduct the Comprehensive Long COVID Care for Underserved Communities: Innovative Delivery and Dissemination Models (COMUNIDAD) project, a 5-year program with 3 aims: Aim 1: To expand holistic, multidisciplinary care at UT Health San Antonio. Together with patient and community representatives, we will develop evidence-based, symptom-specific best practices for evaluation, treatment, and self-care. Clinical services and, as appropriate, research study referrals, will be coordinated by a full-time nurse clinical coordinator and care will be provided by a multidisciplinary team. To expand the workforce, we will offer clinical rotations for health professional trainees. Aim 2: To collaborate with community providers on best practices for basic Long COVID evaluation and management. Utilizing Project ECHO and other telementoring modalities, we will disseminate information among clinicians in South Texas rural clinics on conducting a 15-minute, low-tech evaluation of patients presenting with Long COVID symptoms. Care can then be managed locally or referred to the UT Health Long COVID clinic. Aim 3: To partner with the community to disseminate up-to-date information about Long COVID among the largely Hispanic/Latino, rural South Texas communities. Based on community preferences, we will utilize community health workers, mobile apps, social media platforms, and other communication avenues in English and Spanish to increase health literacy and teach the community about Long COVID and accessing care. We anticipate participating actively in the AHRQ learning community to incorporate up-to-date evidence- based care and share information on models of care with other Long COVID centers. If adopted nationally, models such as COMUNIDAD will greatly improve care for persons with Long COVID.

摘要 在各地出现了长期的COVID专科诊所，其中一些拥有多学科工作人员，但 许多Long COVID患者并不容易获得全面、协调的护理。后COVID-19 UT Health圣安东尼奥的康复诊所不仅服务于美国第七大城市圣安东尼奥， 还有德克萨斯州南部的大部分农村人口和西班牙裔/拉丁裔人口，这些人口受到健康差距的困扰。 然而，在我们目前的模式中，一个主要的挑战是等待新病人预约的5个月时间， 更多的延迟看医疗专家和心理健康提供者。此外，考虑到我们的患者群体 许多不利的健康社会决定因素和有限的获得保健的机会，社会工作者的现成可用性， 关键，但目前有限。在我们病人所在的当地社区， 在诊断、评估和管理长期COVID患者方面提供专业知识的医疗服务提供者。 此外，人们对长期的COVID缺乏认识， 在我们广阔的南德克萨斯集水区的社区成员。 改善和扩大圣安东尼奥和南得克萨斯州的长期COVID护理，并测试新的可持续的 护理模式，我们建议为服务不足的社区开展全面的长期COVID护理： 创新交付和传播模式项目，一个五年期方案，有三个目标： 目标1：扩大UT Health圣安东尼奥的整体，多学科护理。与患者和 社区代表，我们将制定以证据为基础的、针对具体社区的最佳评价做法， 治疗和自我护理。临床服务和研究转诊（如适用）将由 一个多学科小组将提供全职护士临床协调员和护理。为了扩大劳动力， 我们会为医疗专业见习生提供临床轮值服务。 目标2：与社区提供者合作，制定基本的长期COVID评估的最佳做法， 管理我们将利用ECHO项目和其他远程监测方式，在下列机构之间传播信息： 南德克萨斯州农村诊所的临床医生对出现以下症状的患者进行15分钟的低技术评估 长期的COVID症状。然后，护理可以在当地管理或转介到UT Health Long COVID诊所。 目标3：与社区合作，向市民发放有关朗新冠肺炎的最新资料， 主要是西班牙裔/拉丁裔，德克萨斯州南部的农村社区。根据社区的偏好，我们将利用 社区卫生工作者、移动的应用程序、社交媒体平台和其他英语沟通渠道 和西班牙语，以提高健康素养，并向社区传授有关长期COVID和获得护理的知识。 我们期望积极参与AHRQ学习社区，以纳入最新的证据- 与其他Long COVID中心分享护理模式的信息。如果在全国采用， COMUNIDAD等模式将大大改善对长期COVID患者的护理。