Community-Academic Partnerships to Address COVID-19 Inequities within African American Communities

摘要 几个月后，出现了冠状病毒病(新冠肺炎)，这是一种高传染性疾病 由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起，导致数百万人和 仅在美国就杀死了数十万人。与许多其他可传播和非可传播的 传染病，非裔美国人不成比例地承担着新冠肺炎发病率高的负担- 相关发病率和死亡率。在公共场合、人际交往中对戴口罩的负面情绪上升 和结构性种族主义，以及无法就地避难，进一步加剧了SARS-CoV-2在 弱势群体的成员，包括非裔美国人。最近的预测估计，几乎 到2020年12月，将有5万多美国人死于新冠肺炎相关并发症，至少有30%的可能性 作为非裔美国人，目前的公共卫生努力显然是由专家驱动和 自上而下，都在失败。因此，创新的解决方案：1)增强和装备社区，使其发挥积极的 在促进公共卫生和响应方面的作用，2)利用社区资产和多部门 伙伴关系，以及3)促进团结意识和集体责任，如果我们要 遏制SARS-CoV-2，消除与新冠肺炎相关的发病率和死亡率，特别是在 承受着不成比例的更糟糕的结果。公共卫生运动和非药物干预 (NPIS)，由社区驱动，并与社区成员、公共卫生 机构和研究人员可能会提供一种更可接受和更有效的方法，使美国能够 大幅减少新冠肺炎传播，解决导致以下问题的个人和社会结构性障碍 非裔美国人中与新冠肺炎相关的结果更差。我们的研究目标是使用众包 比赛旨在确定促进新冠肺炎检测的特殊想法，并鼓励公众采用健康- 促进行为。然后我们将进行一项随机实验，以检验比赛对 有针对性的健康促进行为。接下来，与格蕾丝项目合作，一个学术社区 为了在北卡罗来纳州农村建立伙伴关系，我们将发起一个名为快速反应团队的NPI，这将是一个社区- 基于接触者追踪和病例调查计划，将专注于识别当地的新冠肺炎感染 他们的社区，提供有关执行安全协议的援助和信息，并举行会议 通过利用NCCARE360，北卡罗来纳州农村社区内社区成员的现有需求， 一个新的数字、全州协调的护理网络，旨在更好地将个人与当地服务和 资源。然后，我们将确定快速反应小组的可行性、可接受性和覆盖范围 关于联系社区成员并根据需要将他们链接到当地资源，增加COVID- 19测试，并在北卡罗来纳州东部农村的成年人中增加3W的实践。

Abstract In a few months’ time, the emergence of the coronavirus disease (COVID-19), a highly contagious disease resulting from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), sickened millions and killed hundreds of thousands of people in the United States alone. As with many other communicable and non- communicable diseases, African Americans disproportionately bear the burden of elevated rates of COVID-19- related morbidity and mortality. The rise in negative sentiments towards wearing masks in public, interpersonal and structural racism, and inability to shelter-in-place further exacerbate risk of SARS-CoV-2 exposure for members of vulnerable populations, including African Americans. With recent projections estimating that nearly 50,000 more Americans will die of COVID-19-related complications by December 2020, with at least 30% likely to be African American, it is clear that current public health efforts, which are overwhelmingly expert-driven and top-down, are failing. As such, innovative solutions that: 1) empower and equip communities to play an active role in promoting public health and responsiveness, 2) leverage community assets and multisectoral partnerships, and 3) facilitate a sense of unity and collective responsibility are sorely needed if we are to contain SARS-CoV-2 and eliminate COVID-19-related morbidity and mortality, particularly amongst those suffering disproportionately worse outcomes. Public health campaigns and non-pharmaceutical interventions (NPIs) that are community-driven and developed in collaboration with community members, public health agencies, and researchers may offer a more acceptable and effective approach that could enable the US to drastically reduce COVID-19 transmission and address individual and socio-structural barriers that lead to worse COVID-19-related outcomes among African Americans. Our study goals are to use a crowdsourcing contest to identify exceptional ideas that promote COVID-19 testing and encourage the public to adopt health- promotive behaviors. We will then conduct a randomized experiment to examine the impact of the contest on the targeted health-promotive behaviors. Next, in partnership with Project Grace, an academic-community partnership in rural NC, we will initiate an NPI called the Rapid Response Team, which will be a community- based contact tracing and case investigation program that will focus on identifying local COVID-19 infections in their communities, providing assistance and information regarding implementing safety protocols, and meeting existing needs of community members within a rural community in North Carolina by leveraging NCCARE360, a new digital, statewide coordinated care network intended to better connect individuals to local services and resources. Then, we will determine the feasibility, acceptability, and reach of the Rapid Response Team regarding contacting community members and linking them to local resources as needed, increasing COVID- 19 testing, and increasing the practice of the 3Ws among adults in rural, Eastern North Carolina.