Frontiers: University of Kansas Clinical and Translational Science Institute

项目摘要 地方卫生部门正在采用各种各样的方法来解决严重的卫生不平等问题 与COVID-19大流行相关。学习协作在其他环境中也很有效， 将各实体聚集在一起，以支持联合解决问题并减少方法上的差异。这些 协作者建立在共享经验的基础上，帮助他们的成员不仅了解要做什么，而且了解如何 这样做，提供对成功实施干预措施至关重要的知识和技能。本研究 旨在检查卫生部门的多样化，区域学习协作的有效性， 快速适应，测试和实施社区驱动的解决方案， 混合II型试验设计。根据社区主导的方法的初步数据， 受影响的堪萨斯县（Wyandotte），该项目将在10个县（4 城市和6个农村地区），并为他们提供培训和资源 实现COVID检测公平性的必要条件。这些地方卫生平等行动小组将共同组成一个 多辖区学习协作或“社区合作伙伴计划”（目标1），可分享最佳做法 合作开发、测试和评估多组件干预方案， COVID.最初的支助干预措施将包括：社区赞助的弹出式测试活动; 和工作地点测试;社区知情的沟通战略;以及对处于危险中的人的“一揽子支助” 接受检测的个人和家庭。我们当地政府制定或提出的其他干预措施 社区合作伙伴或通过国家RADx-UP工作确定的合作伙伴将继续由 协作。与当地行动小组合作，我们将进行一系列半结构化访谈， 在每个地方社区内进行调查（目标2），以更好地了解共同和亚组（种族，族裔， 地理等）测试的障碍和促进因素。我们将利用现有的流行病学监测 开发和跟踪一系列县级COVID检测不公平指标的工具。以RE-AIM为导向 框架和干预研究的综合框架，我们将检查有效性（目的 3)合作提高弱势社区对COVID检测的接受率，并检查覆盖范围， 在每个地方社区采用、实施和维持干预措施。这 这项研究不仅将增进我们对如何实现COVID检测公平性的理解， 支持服务不足社区应对未来突发公共卫生事件的框架， 新冠疫苗接种挑战。

Project Abstract Local health departments are employing widely varying approaches to address the dramatic health inequities associated with the COVID-19 pandemic. Learning collaboratives have been effective in other settings for bringing entities together to support joint problem solving and reduce variance in approach. These collaboratives build upon shared experiences to help their members understand not only what to do but how to do it, providing knowledge and skills that are critical to successful implementation of interventions. This study aims to examine the effectiveness of a diverse, regional learning collaborative of health departments that will rapidly adapt, test, and implement community-driven solutions for COVID testing disparities using a pragmatic, hybrid type II trial design. Based on preliminary data from a community-led approach developed in a severely affected Kansas county (Wyandotte), the project will build Local Heath Equity Action Teams in 10 counties (4 urban and 6 rural) disproportionately affected by COVID and provide them with the training and resources needed to achieve COVID testing equity. These Local Health Equity Action Teams will come together into a multi-jurisdictional learning collaborative or `Community Partner Program' (Aim 1) that can share best practices and collaborate on developing, testing and evaluating multi-component intervention packages for addressing COVID. Initial supported interventions will include: community-sponsored pop-up testing events; home-based and worksite testing; community-informed communication strategies; and `support packages' for at-risk individuals and families receiving testing. Additional interventions developed or proposed by our local community partners or identified through national RADx-UP efforts will be continuously considered by the collaborative. Working with the local Action teams, we will conduct a series of semi-structured interviews and surveys within each local community (Aim 2) to better understand common and subgroup (racial, ethnic, geographic, etc.) barriers to and facilitators of testing. We will leverage existing epidemiologic surveillance tools to develop and track a series of county-level metrics of COVID testing inequities. Guided by the RE-AIM framework and the Consolidated Framework for Intervention Research, we will examine the effectiveness (Aim 3) of the collaborative in improving uptake of COVID testing in vulnerable communities and examine the reach, adoption, implementation and maintenance of intervention components within each local community. This study will not only advance our understanding of how to achieve COVID testing equity but will also provide a framework for supporting underserved communities as they respond to future public health emergencies and COVID vaccination challenges.