Addressing Vaccine AcceptaNce in Carceral Settings through Community Engagement (ADVANCE)

项目摘要 2019冠状病毒病大流行对那些被监禁和在我们的监狱工作的人产生了不成比例的影响。 国家的监狱和监狱。监狱人口的感染率是2000年的五倍。 普通民众和惩教工作人员的感染率是普通民众的三倍。 惩教系统的高COVID-19发病率与周边社区的高发病率有关，特别是 在人口流动率高的监狱和管教人员工作的社区。疫苗接种 惩教系统是一项重要的社区COVID-19缓解策略。但疫苗接种率 接受程度差异很大，部分原因是不信任问题和内部独特的社会规范和政策。 矫正系统。之前关于疫苗接受策略的工作，即使是在黑人和拉丁裔中， 不成比例地被监禁，很少关注在惩教工作中有效的战略。直到这 知识差距得到解决，将很难减少COVID-19对 惩教设施中的少数群体及其返回的社区。这是特别 重要的是不断出现新的变种。本提案的总体目标是， 通过社区参与（ADVANCE）在监狱环境中接受，是为了确定可行的， 采取有效干预措施，提高监狱中的疫苗接种率。我们将把成功的P3疫苗 由我们的团队开发的医疗保健实践的接受模型，以确定新的和替代旧的策略 这是一个适用于监狱的新框架，创建了一个新的病人、提供者、实践、监狱一级（P4）框架。中央 该提案的假设是，由人们直接合作开发和研究的战略 会增加疫苗的接受度。为了验证这一假设，我们将 三个目标：（1）确定有希望的基于矫正系统的战略，以提高疫苗的接受程度;（2） 采用基于社区的参与性研究方法，将这些战略纳入更新的P4框架; 和（3）通过快速循环，随机分组试验研究这些干预措施的有效性， 宾夕法尼亚州的惩教系统。在整个研究阶段，目前和以前被监禁的人， 惩教人员将提供投入，因此P4干预最有可能成功。ADVANCE代表一个 与以往关于疫苗接受性的工作有实质性的不同，侧重于提供证据基础 解决惩教系统接受疫苗的问题，这些系统可以扩大规模并适应其他司法- 涉及人口。

PROJECT SUMMARY The COVID-19 pandemic has had a disproportionate impact on those who are incarcerated and work in our nation's prisons and jails. The prison population has had an infection rate that is five times the rate in the general population and correctional staff have been infected at three times the rate of the general population. High rates of COVID-19 in correctional systems are linked to high rates in surrounding communities, especially in jails with high population turnover and in communities where correctional officers work. Vaccination in correctional systems is an important community-wide COVID-19 mitigation strategy. But rates of vaccine acceptance vary considerably, in part due to issues of distrust and unique social norms and policies within correctional systems. Prior work on vaccine acceptance strategies, even amongst Black and Latinx people who are disproportionately incarcerated, has rarely focused on strategies that work in corrections. Until this knowledge gap is addressed, it will be difficult to reduce the disproportionate impact of COVID-19 on minoritized populations in correctional facilities and the communities to which they return. This is especially important with ongoing new variants emerging. The overall objective of this proposal, ADdressing Vaccine AcceptaNce in Carceral Settings through Community Engagement (ADVANCE), is to identify feasible and effective interventions to improve vaccine uptake in prisons. We will adapt the successful P3 vaccine acceptance model for healthcare practices, developed by our team, to identify new and iterate on old strategies appropriate for prisons, creating a new Patient, Provider, Practice, Prison-level (P4) framework. The central hypothesis of the proposal is that strategies developed by and studied in partnership with people directly impacted by the correctional system will increase vaccine acceptance. To test this hypothesis, we will tackle three aims: (1) identify promising correctional system-based strategies to improve vaccine acceptance; (2) adapt these strategies into an updated P4 framework using community based participatory research approach; and (3) study the effectiveness of these interventions through rapid cycle, cluster-randomized trials in the Pennsylvania correctional system. Throughout study phases, currently and previously incarcerated people and correctional staff will provide input so P4 interventions are most likely to succeed. ADVANCE represents a substantial departure from previous work on vaccine acceptance by focusing on providing an evidence base for addressing vaccine acceptance in correctional systems that can be scaled and adapted for other justice- involved populations.