Puipuia le Ola: Increasing reach and uptake of COVID-19 testing among Pacific Islanders in Hawaii and Guam

摘要 非土著夏威夷太平洋岛民(PI)，定义为起源于关岛的土著民族 北马里亚纳群岛联邦、美属萨摩亚、密克罗尼西亚联邦、共和国 马绍尔群岛和帕劳共和国是新冠肺炎相关发病率和 在美国，PI的死亡率也受到医疗合并症的影响，已知这会增加他们患严重疾病的风险 新冠肺炎。此外，PI获得医疗保健机会很差，没有或没有医疗保险，居住在 几代人或多个家庭的过度拥挤的住房，并有低收入的服务工作，使他们面临 受感染的公众。夏威夷正在经历新冠肺炎的戏剧性激增，每天的微博数量达到三位数，甚至更多 一万多箱。PI仅占该州人口的4%，占新冠肺炎病例的32%。 我们的长期目标是缩小跨界别之间的新冠肺炎差距。拟议研究的总体目标 是使用与文化产生共鸣的社区参与战略来增加对新冠肺炎的接触和接受 测试以更好地了解夏威夷和关岛PI中SARS-CoV-2的感染模式。我们的中央 假设是文化上合适的和语言上正确的策略会增加对新冠肺炎的接受 在PI中进行检测，从而获得更准确的SARS-CoV-2感染和血清阳性率。我们的 由医生和社区卫生工作者组成的多学科调查小组，社区参与 研究人员以及基础和应用科学家。这一目标将通过以下具体目标来实现。 具体目标1.制定和评估文化定制的社区参与战略，以增加 新冠肺炎在夏威夷和关岛的PI中进行测试。 方法：让PI社区参与，共同设计一项在文化和语言上合适的战略 内容为推进新冠肺炎战略的测试和实施，并对其效果进行评估。 具体目标2：确定夏威夷和关岛无症状PI中SARS-CoV-2的感染模式。 方法：对无症状成年猪进行新冠肺炎反转录聚合酶链式反应和SARS-CoV-2特异性免疫球蛋白和免疫球蛋白M检测 在夏威夷和关岛，以确定感染率和血清阳性率。 一个高度承诺的社区和科学咨询委员会，由PI社区的杰出领导人组成 致力于改善知识产权健康的院士将为与文化相关的设计提供指导 缩小跨界别间新冠肺炎差距的策略。得到社会各界、学术界和社会各界的大力支持 政府证实了这一社区参与的测试研究项目的紧迫性。

Abstract Non-Native Hawaiian Pacific Islanders (PI), defined as indigenous people having origins in Guam, the Commonwealth of the Northern Mariana Islands, American Samoa, Federated States of Micronesia, Republic of the Marshall Islands and Republic of Palau, have among the highest COVID-19-associated morbidity and mortality rates in the U.S. PI also suffer from medical co-morbidities known to increase their risk of severe COVID-19. In addition, PI have poor access to health care, inadequate or no health insurance, live in multi-generational or multi-family overcrowded housing, and have low-paying service jobs that expose them to the infected public. Hawaii is experiencing a dramatic surge in COVID-19, with triple-digit daily counts and more than 10,000 cases. PI, who comprise only 4% of the State’s population, account for 32% of COVID-19 cases. Our long-term goal is to reduce COVID-19 disparities among PI. The overall objective of the proposed research is to use culturally resonant community-engagement strategies to increase the reach and uptake of COVID-19 testing to better understand SARS-CoV-2 infection patterns among PI in Hawaii and on Guam. Our central hypothesis is that culturally appropriate and linguistically correct strategies will increase uptake of COVID-19 testing among PI, resulting in more precise SARS-CoV-2 infection and seroprevalence rates. Our multi-disciplinary investigative team comprises physicians and community health workers, community-engaged researchers and basic and applied scientists. The objective will be achieved by the following specific aims. Specific Aim 1. Develop and evaluate culturally tailored community-engaged strategies to increase COVID-19 testing among PI in Hawaii and Guam. Approach: Engage PI communities to jointly design a strategy with culturally and linguistically appropriate content to promote COVID-19 testing and mplement the strategy and evaluate its effectiveness. Specific Aim 2: Determine SARS-CoV-2 infection patterns in asymptomatic PI in Hawaii and Guam. Approach: Perform COVID-19 RT-PCR and SARS-CoV-2-specific IgG and IgM testing of asymptomatic adult PI in Hawaii and Guam to ascertain infection rates and seroprevalence. A highly committed Community and Scientific Advisory Board, comprising prominent leaders in the PI community and academicians who are dedicated to improving IP health, will provide guidance to design culturally relevant strategies to mitigate COVID-19 disparities among PI. Strong support from the community, academia and government attest to the to the urgency of this Community-Engaged Testing Research Project.