Utah Center for Clinical and Translational Science

项目总结/摘要 种族/少数民族、社会经济地位低和农村人口的健康状况严重恶化 各种疾病和病症之间的不平等，以及不成比例的负面负担 2019冠状病毒病大流行对健康的影响。拉丁美洲人占犹他州人口的14%， 犹他州的COVID-19病例，在高与低特征的社区，病例率高出3倍以上 剥夺犹他州每10万人中有665人是白人，3,503人是拉丁裔，3,470人是白人。 太平洋岛民中有1，727人是非洲裔美国人，1，569人是美洲原住民。社区卫生 中心（CHC）是解决筛查和接受COVID-19检测的最佳环境， 服务不足的人群。12个犹他州CHC系统正在参与SCALE-UP犹他州。第39集Primary 护理诊所每年为超过115，000名独特的患者提供服务（37%拉丁裔，11%美洲原住民，61% <100% 51%没有保险，49%的诊所在农村/边境地区）。扩展犹他州是一个全州范围的， 多层次干预研究。长期目标是扩大覆盖面，吸收， 在得不到充分服务的人群中进行COVID-19筛查和检测的可持续性。该团队现有 基础设施和“准备就绪”的诊所和人口健康管理干预措施， 实施. SCALE-UP犹他州建立在长期的资助伙伴关系基础上，并将实施和 评估三种实用、可行、可扩展的多层次干预措施，以增加COVID-19筛查和吸收 在犹他州社区卫生中心。干预措施利用广泛采用的卫生信息技术， 护理、短信和患者导航。SCALE-UP犹他州将协调和协同现有的 基础设施和资源，以及加强基础设施和数据网络，以快速 部署新的筛查和检测方案，疫苗接种计划等。该项目将采用快速 周期研究方法，在短时间内小规模测试干预措施（例如，小于1个 月）和周期性评估周期。这些快速研究周期的一个关键方面是， 在小范围内进行快速测试，然后传播到其他诊所/患者。干预措施将是 可随时供其他低资源医疗保健环境采用;并且，数据将促进人口 健康和实施科学。 具体目标是： 1.实施和评估诊所和PHM干预措施，以提高COVID-19检测的接受率 在犹他州的CHC患者中。 2.检查实施效果结果，以及诊所和患者的特征， 可能影响干预效果和实施结果。

PROJECT SUMMARY/ABSTRACT Racial/ethnic minority, low socioeconomic status (SES), and rural populations suffer profound health inequities across a wide variety of diseases and conditions, as well as a disproportionate burden of the negative health consequences of the COVID-19 pandemic. Latinos make up ~14% of the Utah population vs. ~40% of Utah's COVID-19 cases, and the case rate is over 3-fold higher in neighborhoods characterized by high vs. low deprivation. The case rate in Utah per 100,000 is 665 among Whites vs. 3,503 among Latinos, 3,470 among Pacific Islanders, 1,727 among African Americans, and 1,569 among Native Americans. Community Health Centers (CHCs) are optimal settings for addressing the screening and uptake of COVID-19 testing among underserved populations. Twelve Utah CHC systems are participating in SCALE-UP Utah. Their 39 primary care clinics serve over 115,000 unique patients annually (37% Latino, 11% Native American, 61% <100% poverty level, 51% uninsured, and 49% of clinics are in rural/frontier areas). SCALE-UP Utah is a state-wide, pragmatic, multilevel intervention study. The long-term objective is to increase the reach, uptake, and sustainability of COVID-19 screening and testing among underserved populations. The team has existing infrastructure and “shovel ready” clinic and population health management (PHM) interventions ready for implementation. SCALE-UP Utah builds on long standing, funded partnerships, and will implement and evaluate three practical, feasible, scalable multi-level interventions to increase COVID-19 screening and uptake in Utah CHCs. Interventions leverage widely adopted Health Information Technology (HIT) at the point of care, text messaging, and patient navigation. SCALE-UP Utah will coordinate and synergize existing infrastructure and resources across the state, as well as strengthen infrastructure and data networks for rapid deployment of new screening and testing protocols, vaccination programs, etc. The project will employ a rapid cycle research approach in which interventions are tested on a small scale, using short time frames (e.g., <1 month) and cyclical evaluation cycles. A critical aspect of these rapid-research cycles is that change can be quickly tested on a small scale, and then disseminated to other clinics/patients. The interventions will be readily available for adoption by other low-resource healthcare settings; and, the data will advance population health and implementation science. The specific aims are to: 1. Implement and evaluate clinic and PHM interventions for increasing the uptake of COVID-19 testing among CHC patients across Utah. 2. Examine implementation effectiveness outcomes, as well as characteristics of both clinics and patients that may influence intervention effects and implementation outcomes.