Localized mHealth approach to boosting COVID-19 testing and vaccine literacy, access, and uptake among women with criminal legal system involvement

摘要 有刑事法律系统参与的人经历的新冠肺炎数量是中国的五倍 感染和死亡风险是美国普通人群的三倍。 根据新冠肺炎和美国国立卫生研究院的健康差距人群，患有慢性萎缩性胃炎的人通常是贫穷的和 不成比例地来自种族和少数民族群体。尽管新冠肺炎的风险增加，但我们预计 只有一半的CLSI患者会接种疫苗。正在社区和社区中进行新冠肺炎测试 没有接种疫苗的群体将是控制疫情的关键。新冠肺炎测试的消息 仍然很重要的是，可能无法接触到处于危险之中的人--这是造成差异的关键驱动因素。 我们的团队有一个独特的机会，可以利用移动医疗提高测试的识字能力、访问能力和接受能力 (MHealth)技术(文本和网络)在社区环境中接触患有CLSI的女性，她们是 现有的三个城市队列来自地理和社会政治上不同的城市：亚利桑那州伯明翰、堪萨斯州 密苏里州/肯塔基州城市和加利福尼亚州奥克兰该应用程序高度响应RADx-UP阶段II研究的号召 这是对旨在缩小服务不足人群中新冠肺炎差距的干预措施的考验。我们的队伍已经准备好了 将建议的研究嵌入现有的基于网络的妇女健康素养干预平台 (www.sheemen.org，2R01CA181047)。我们还能够立即推送 MHealth新冠肺炎对508名我们已经招募到的女性进行扫盲干预测试 CLSI妇女的健康研究(R01CA226838)，并迅速使这一可扩展的干预措施广泛开展 适用于慢性萎缩性胃炎患者。 我们将让女性作为利益相关者，研究新冠肺炎测试的地区和个体差异 以及疫苗知识、可获得性和接受度。我们将利用研究结果快速开发以移动健康为重点的干预措施 关于新冠肺炎素养，然后推动对三个城市的CLSI女性的干预，以推动新冠肺炎 识字、测试、获取和吸收，以及接种疫苗。调查结果将被用于制定传播策略。 与利益攸关方共同推动对200万女性和1100万男性的mHealth干预 美国每年都有刑事法律制度。

ABSTRACT People with criminal legal system involvement (CLSI) have experienced five times as many COVID-19 infections and have three times the risk of death compared to general population in the U.S. Heavily impacted by COVID-19 and squarely within NIH health disparities populations, people with CLSI are often poor and disproportionately from racial and ethnic minority groups. Despite the increased risk of COVID-19, we expect that only one-half of people with CLSI will get vaccinated. Ongoing COVID-19 testing in communities and among groups that are not vaccinated will be key to containing the pandemic. The messaging that COVID-19 testing will still be important may not be getting through to people who are at risk – a critical driver of disparities. Our team has a unique opportunity to boost testing literacy, access, and uptake using mobile health (mHealth) technologies (text and Web) to reach women with CLSI in community settings who are part of the existing Tri-City Cohort drawn from geographically and socio-politically diverse cities: Birmingham, AL, Kansas City, MO/KS, and Oakland, CA. This application is highly responsive to the RADx-UP Phase II call for research that tests interventions to reduce COVID-19 disparities among underserved populations. Our team is positioned to embed the proposed study into an existing Web-based women’s health literacy intervention platform (www.shewomen.org, 2R01CA181047) for women leaving jail. We are also able to immediately push the mHealth COVID-19 testing literacy intervention to 508 women we have already recruited to a three-city cervical health study of women with CLSI (R01CA226838), and to promptly make this scalable intervention widely available to people with CLSI. We will engage the women as stakeholders to study regional and individual differences in COVID-19 testing and vaccine literacy, access, and uptake. We will use findings to rapidly develop an mHealth intervention focused on COVID-19 literacy, and then push the intervention to CLSI women in the three cities to boost COVID-19 literacy, testing, access, and uptake, and vaccination. Findings will be used to develop dissemination strategies with stakeholders to push the mHealth intervention to the two million women and 11 million men who interface with the criminal legal system annually in the U.S.