COVID-19 Testing and Linkage to Care with African American Church and Health Agency Partners

项目总结 在所有相关病例中，非裔美国人(AA)感染COVID19的负担不成比例， 与白人相比，住院人数和死亡人数。许多多层屏障增加了COVID19的风险 AA包括贫困、接触病毒增加的基本工作、文化规范(例如，否认风险、 医疗/接触者追踪不信任)，以及获得医疗保健和其他服务/资源的机会有限。这些 障碍突出了对可获得的、可信的COVID19测试和护理(LTC)服务的需求(例如， 健康、预防计划、社区资源、接触者追踪)，以帮助减缓CoVID19在AA中的传播 社区。AA教会是一个在AA社区具有广泛影响力的机构，可能是一个理想的 为在遭受重创的AA社区扩大COVID19测试和LTC的覆盖范围做好准备。然而，没有受控的AA 目前已有基于教会的关于COVID19检测干预措施的研究。这项研究的主要目的是全面测试 文化/宗教定制、基于教会的COVID19测试和LTC干预条件 成人AA教会成员6个月后COVID19检测率的量身定制干预条件 他们所服务的社区成员。教会将根据会员规模、教派和历史进行匹配。 参加教会健康干预研究，然后根据治疗情况随机分组。十六座教堂(8座 教会/手臂；45个教会和15个社区成员/教会；总共N=960人)将参与研究。LTC 使用、接触者追踪批准和COVID19预防行为也将在6个月内进行审查， 次要结果。在计划行为理论和社会生态模型的指导下，我们的社区- 参与式方法包括训练有素的教会领袖提供适合教会文化的COVID19工具包 包括数字工具：a)个人自助材料和定制短信；b)面对面/虚拟小组 为新冠病毒感染者的照顾者举办研讨会；c)与新冠病毒19相关的面对面/虚拟教会服务 材料/活动(例如，布道、感谢信、响应性读物)；和d)教会社区一级的长期教会 提供服务(如保险、医疗保健、预防计划、社区资源、接触者追踪) 虚拟由社区卫生工作者、教会-社区为基础的重新开放指南和以教会为基础的 COVID19与卫生机构的检测活动。审查LTC的使用和接触者追踪批准将有助于 通过满足参与者的基本需求，了解干预对COVID19测试的影响。潜力 将对与新冠肺炎测试接收相关的调解人/主持人进行评估，并进行过程评估，以 确定与提高COVID19测试率相关的实施促进者、障碍和忠诚度。我们的 与我们长期的信仰和健康合作伙伴的持续会议使我们能够迅速调整我们的AA教会- 以艾滋病毒检测和糖尿病预防干预为基础的拟议研究。这项多层次的研究可能 提供有效、可扩展的模型，用于增加COVID19检测、预防和LTC/接触者跟踪 与卫生机构合作批准AA教会，并提供简化战略 未来新冠肺炎疫苗接种的交付/吸收。

PROJECT SUMMARY African Americans (AA) are disproportionately burdened by COVID19 across the spectrum of related cases, hospitalizations, and deaths compared to Whites. Many multilayered barriers increase risk for COVID19 among AA including poverty, essential jobs with increased virus exposure, cultural norms (eg, risk denial, medical/contact tracing mistrust), and limited access to healthcare and other services/resources. These barriers highlight the need for accessible, trusted COVID19 testing and linkage to care (LTC) services (eg, health, prevention programs, community resources, contact tracing) to help slow COVID19 spread in AA communities. The AA church is an institution with extensive influence in AA communities and may be an ideal setting for increasing reach of COVID19 testing and LTC in hard hit AA communities. Yet, no controlled AA church-based studies exist on COVID19 testing interventions. The primary aim of this study is to fully test a culturally/religiously-tailored, church-based COVID19 testing and LTC intervention condition against a non- tailored intervention condition on COVID19 testing rates at 6 months with adult AA church members and the community members they serve. Churches will be matched on membership size, denomination and past participation in church health intervention studies, then randomized to treatment condition. Sixteen churches (8 churches/arm; 45 church and 15 community members/church; N=960 total) will participate in the study. LTC use, contact tracing approval, and COVID19 prevention behaviors will also be examined at 6 months as secondary outcomes. Guided by the Theory of Planned Behavior and Socioecological Model, our community- engaged approach includes trained church leaders delivering a culturally, church-appropriate COVID19 Toolkit inclusive of digital tools: a) individual self-help materials and tailored text messages; b) in-person/virtual group seminars for caregivers of persons with COVID19; c) in-person/virtual church services with COVID19 related materials/activities (e.g., sermons, testimonials, responsive readings); and d) church-community level LTC services (eg, insurance, healthcare, prevention programs, community resources, contact tracing) provided virtually by community health workers, church-community-based re-opening guidelines, and church-based COVID19 testing events with health agencies. Examination of LTC use and contact tracing approval will aid in understanding intervention impact on COVID19 testing by addressing participant essential needs. Potential mediators/moderators related to receipt of COVID-19 testing will be evaluated, and a process evaluation to determine implementation facilitators, barriers, and fidelity related to increasing COVID19 testing rates. Our ongoing meetings with our long-term faith and health partners is enabling us to quickly adapt our AA church- based HIV testing and diabetes prevention interventions for the proposed study. This multilevel study could provide an effective, scalable model for increasing COVID19 testing, prevention, and LTC/contact tracing approval with AA churches in partnership with health agencies, and provide strategies to streamline delivery/uptake of future COVID-19 vaccination.