Center for American Indian and Rural Health Equity

项目摘要 COVID-19大流行对美国印第安人（AI）和拉丁裔社区的影响不成比例， 这些群体还具有由于慢性疾病如糖尿病的高发病率而增加的不良预后的风险， 心血管疾病和癌症。在美国西北部，人工智能和拉丁裔社区已经 在获得医疗保健方面面临着巨大的差距，这一差距因COVID-19而进一步加剧 流行病在拟议的研究中，保护我们的社区：一项基于家庭的实用随机试验 COVID测试与美国印第安人和拉丁裔社区，我们将利用我们的长期社区- 基于参与性研究伙伴关系，以测试假设，以家庭为基础的测试将是可行的， 有影响力的，更好地接受使用积极交付的测试工具包，由值得信赖的社区卫生教育工作者在两个 脆弱、高风险的农村社区。我们的两个长期合作伙伴社区是平头印第安人 蒙大拿州的萨利希部落和库特奈部落联盟保留地， 华盛顿，一个大型拉丁裔社区。我们将确定文化，社会，行为和经济 家庭SARS-CoV-2检测的障碍;在文化上调整和加强家庭检测教材 并创建家庭测试教学图形和YouTube视频;进行双臂实用随机 主动（由社区健康教育者提供）与被动（邮寄）家庭检测试剂盒的试验（n = 200/社区）进行测试完成;并创建模型社区驱动的测试协议， 这对全国AI和拉丁裔社区增加家庭测试的吸收产生了重大影响。这 这项工作将使服务不足的人工智能和拉丁裔社区能够充分利用即将到来的快速增长浪潮， 家庭护理点检测，并减少COVID-19对其社区的重大影响。

Project Summary The COVID-19 pandemic has disproportionately affected American Indian (AI) and Latino communities, and these groups also have increased risk of poor prognosis due to high rates of chronic disease such as diabetes, cardiovascular disease, and cancer. In the northwestern United States, AI and Latino communities already face significant disparities in health care access, which have been further exacerbated by the COVID-19 pandemic. In the proposed study, Protecting Our Community: A Pragmatic Randomized Trial of Home-Based COVID Testing with American Indian and Latino Communities, we will leverage our long-term community- based participatory research partnerships to test the hypothesis that home-based testing will be feasible, impactful, and better-accepted using active delivery of test kits by trusted community health educators in two vulnerable, high-risk rural communities. Our two long-term partner communities are the Flathead Indian Reservation of the Confederated Salish and Kootenai Tribes in Montana, and the Yakima Valley of Washington, a large Latino community. We will determine the cultural, social, behavioral, and economic barriers to home-based SARS-CoV-2 testing; culturally adapt and enhance home-testing educational materials and create home-testing instructional graphics and YouTube videos; conduct a 2-arm pragmatic randomized trial of active (delivered by community health educator) vs. passive (mailed) home-based testing kits (n = 200/community) for testing completion; and create model community-driven testing protocols that can have significant impact for increasing home-based testing uptake among AI and Latino communities nationally. This work will enable underserved AI and Latino communities to take full advantage of the coming wave of rapid point-of-care home tests and decrease the significant impact of COVID-19 in their communities.