Chronic health conditions and uptake of COVID-19 testing and vaccination among Native Americans in the RADx-UP Consortium

项目摘要/摘要 美国印第安人/阿拉斯加原住民(AI/AN)人口受到新冠肺炎的影响不成比例 与其他种族/民族人口相比，这是一种流行病。AI/AN个人经历了更高的患病率 增加新冠肺炎并发症风险的慢性病，包括癌症、糖尿病、慢性肝病 疾病、慢性肺部疾病、心血管疾病、哮喘和肥胖，并有较高的 吸烟与其他种族/民族相比。新冠肺炎大流行开创史无前例 因社会疏远任务而中断必要的服务，包括医疗保健 实施了减少病毒传播的措施。医疗服务进一步中断，原因是 临床和医院资源向新冠肺炎患者的必要转移。目前尚不清楚是否会发生变化 在人工智能/人工智能人群的医疗保健获取方面或慢性健康状况影响对新冠肺炎测试和 以及这些变化是否因地理和社会人口因素而不同(例如，乡村和 区域剥夺)。因此，迫切需要了解大流行的影响程度。 获得医疗保健的机会以及患有慢性病的个人在接受COVID方面是否存在障碍- 19检测和接种疫苗。我们的长期目标是改善获得新冠肺炎检测和疫苗接种的机会 在人工智能/AN人群中，特别是在有慢性健康状况的人群中。我们的总体目标是 应用程序是分析RADX-UP财团数据，以评估新冠肺炎大流行对 AI/AN RADX-UP参与者患有慢性健康状况，获得医疗保健的机会发生变化，以及 社会人口学因素对新冠肺炎检测和疫苗接种率的影响我们的目标是确定慢性 健康状况、医疗保健可获得性和社会人口因素影响了新冠肺炎检测的可及性 (2)AI/AN人群获得新冠肺炎疫苗接种情况。在这项工程顺利完成后， 预期结果是，我们将在以下人群中确定新冠肺炎测试和疫苗接种的障碍 AI/AN RADX-UP参与者患有慢性健康状况、难以获得医疗保健和贫困 社会人口因素。这些结果预计将产生积极影响，因为经验证据表明 新冠肺炎检测的障碍和高危人群之间的协调将有助于发展 采取干预战略，以改善这一服务不足人群的健康结果。

Project Summary/Abstract American Indian/Alaska Native (AI/AN) populations were disproportionately affected by the COVID-19 pandemic compared to other racial/ethnic populations. AI/AN individuals experience a higher prevalence of chronic diseases that increase risk of COVID-19 complications including cancer, diabetes, chronic liver disease, chronic lung diseases, cardiovascular diseases, asthma, and obesity, and have higher rates of smoking compared to other racial/ethnic groups. The COVID-19 pandemic created unprecedented interruptions in necessary services, including healthcare, in response to social distancing mandates implemented to reduce the transmission of the virus. Health care services were further disrupted due to the necessary shift of clinical and hospital resources to COVID-19 patients. It remains unknown whether changes in healthcare access for AI/AN people or chronic health conditions impacted uptake of COVID-19 testing and vaccination and whether these changes differed by geography and sociodemographic factors (e.g., rurality and area deprivation). There is, therefore, a critical need to understand the extent to which the pandemic influenced access to healthcare and whether individuals with chronic health conditions had barriers to receiving COVID- 19 testing and vaccination. Our long-term goal is to improve access to COVID-19 testing and vaccination among AI/AN people, particularly among those with chronic health conditions. Our overall objective of this application is to analyze RADx-UP consortium data to evaluate the impact of the COVID-19 pandemic on AI/AN RADx-UP participants with chronic health conditions, changes in access to healthcare, and sociodemographic factors on COVID-19 testing and vaccination uptake. We aim to identify whether chronic health conditions, healthcare access, and sociodemographic factors impacted 1) access to COVID-19 testing and 2) access to COVID-19 vaccination among AI/AN persons. Upon successful completion of this project, the expected outcomes are that we will have identified barriers to COVID-19 testing and vaccination uptake among AI/AN RADx-UP participants with chronic health conditions, challenged healthcare access, and poor sociodemographic factors. These results are expected to have a positive impact because empirical evidence of barriers to COVID-19 testing and harmonization among high-risk populations will allow for development of intervention strategies to improve health outcomes in this underserved population.