COVID-19 testing in Underserved and Vulnerable Populations Receiving Care in San Diego Community Health Centers

项目总结/摘要 2019冠状病毒病（COVID-19）发病率和死亡率的显著不平等和差异 据报道，在黑人和拉丁美洲人中，主要是由于共病条件和社会 健康的决定因素。大约95%的COVID-19相关死亡发生在以下人群中： 潜在的医疗条件。在所有种族/民族群体中，圣地亚哥县的拉丁裔社区 经历了COVID-19疾病和死亡的最大负担。此外，迄今为止的测试挑战 是显而易见的，包括长期周转的测试结果和更长的等待时间为黑人和拉丁美洲人相比， 白人。这个社区参与的提案的目标是开发、测试和评估一个快速、可扩展的 能力建设项目，以加强在三个地区社区卫生中心（CHC）的COVID-19检测， 圣地亚哥县。与我们的CHC合作伙伴，他们的联盟组织（健康质量 合作伙伴）和社区利益相关者，我们提出以下具体目标：1）比较有效性 自动化和实时提示和提醒及其组合，用于在 患有特定疾病的无症状成人患者和接受治疗的65岁及以上患者 参与CHC。我们还将邀请所有研究参与者：a）接受流感疫苗接种;和B）评估 研究参与者转介身为基本工人的成年家庭成员的可行性和可接受性 用于COVID-19检测;以及2）收集患者、提供者、CHC领导层和社区利益相关者的见解， 为未来扩大COVID-19检测可持续性和疫苗接种建立最佳实践。我们的目标是 测试9,000名患者（每组3,000人）。我们的社区参与项目包括服务不足（社会经济 弱势群体和大部分西班牙裔/拉丁裔）和COVID-19易感人群（ 医疗条件和65岁及以上的人）。我们的方法考虑了区域COVID-19 提高发病率和死亡率，以解决弱势群体和 边缘化人口承受着大流行病的不成比例的负担。

PROJECT SUMMARY/ABSTRACT Pronounced inequities and disparities in coronavirus disease (COVID-19)COVID-19 morbidity and mortality have been reported among Black and Latinx individuals, largely due to comorbid conditions and social determinants of health. Approximately 95% of COVID-19 related deaths occur among individuals with underlying medical conditions. Of all racial/ethnic groups, Latinx communities in San Diego County have experienced the greatest burden of COVID-19 disease and deaths. Furthermore, testing challenges to date are evident, including long turnaround of test results and longer waiting times for Black and Latinxs compared to whites. The goal of this community-engaged proposal is to develop, test, and evaluate a rapid, scalable capacity building project to enhance COVID-19 testing in three regional community health centers (CHCs) in San Diego County. In collaboration with our CHC partners, their consortium organization (Health Quality Partners), and community stakeholders, we propose the following Specific Aims: 1) Compare the effectiveness of automated and live prompts and reminders and their combination for uptake of COVID-19 testing among asymptomatic adult patients with select medical conditions and those 65 years of age and older receiving care at participating CHCs. We also will invite all study participants to: a) receive a flu vaccination; and b) assess feasibility and acceptability of study participants to refer adult household members who are essential workers for COVID-19 testing; and 2) Gather patient, provider, CHC leadership, and community stakeholder insights to establish best practices for future scale-up of COVID-19 testing sustainability and vaccination. Our goal is to test 9,000 patients (3,000 per arm). Our community-engaged project includes underserved (socioeconomically disadvantaged and large proportion of Hispanic/Latinos) and COVID-19 vulnerable individuals (patients with medical conditions and those 65 years of age and older). Our approach considers regional COVID-19 morbidity and mortality to address disproportionate infection and death rates among vulnerable and marginalized populations who bear a disproportionate burden of the pandemic.