Scaling and Sustaining COVID-19 Vaccination through Meaningful Community Engagement and Care Coordination for Underserved Communities

项目总结/摘要 COVID-19疫苗分配不公平，疫苗接种滞后，特别是 移民，难民，拉丁美洲人，黑人，土著，有色人种（BIPOC）社区。深层原因 对于COVID-19疫苗的缓慢和可变吸收，包括个体（例如，卫生知识、信任）、文化 (e.g.,语言需要）和结构性障碍，如技术和系统因素（例如，复杂和 安排和参加疫苗预约的繁重过程）。没有一种放之四海而皆准的方法， 疫苗实施。数据显示，COVID-19检测存在巨大差异， 发病率、死亡率和接种率。具有文化相关性和语言适当性、动态性， 可扩展的策略对于COVID-19疫苗接种的即时和长期成功至关重要， 大流行缓解。改变COVID-19疫苗接种行为提供了一个同时 改善参与其他预防性健康行为，这些行为是重要的公共卫生优先事项（例如， 糖尿病管理、癌症筛查、推荐的成人疫苗接种）。我们建议共同完善，测试， 并扩大多方面的卫生计划，以解决疫苗接种的多层次障碍， 在圣地亚哥的移民，难民，拉丁裔和BIPOC社区参与预防性医疗保健。 利用逆向创新思维，我们将应用实用的稳健实施和可持续性 模型（PRISM）与我们的社区合作伙伴，全球ARC和圣伊西德罗健康， 结合移动健康外展（社区驱动的文本和语音消息）的健康计划的要素 加强护理协调。响应NOSI NOT-MD-22-006，该R 01将基于我们目前的 CEAL和RADx-UP实施研究，以扩展和维持多组分健康计划， 增加接受、获得和接受COVID-19疫苗接种和预防保健的人数， 服务不足的社区。我们组建了一支经验丰富的社区参与实施团队， 科学家、卫生公平、公共卫生和传染病研究人员，以实现以下目标：1） 优化多组分卫生计划，促进COVID-19疫苗接种和参与 预防性医疗保健使用我们建立的共同创造方法来解决多层次（个人， 社区、系统性）疫苗接种和预防保健参与的障碍; 2）评估 多组分COVID-19疫苗和预防性护理的实施、有效性和可持续性 采用第三类实施-效能混合型顺序多重分配的交战计划 在旧金山中部和东部的移民、难民、拉丁裔和BIPOC社区进行随机试验设计 迪亚哥

PROJECT SUMMARY/ABSTRACT COVID-19 vaccines have been inequitably distributed and vaccine uptake has lagged, particularly for immigrant, refugee, Latino, and Black, Indigenous, People of Color (BIPOC) communities. Underlying reasons for the slow and variable uptake of COVID-19 vaccines include individual (e.g., health literacy, trust), cultural (e.g., linguistic needs), and structural barriers, such as technological and systemic factors (e.g., complex and onerous processes to schedule and attend vaccine appointments). There is no one-size-fits-all approach to vaccine implementation. This is borne out in the data indicating enormous disparities in COVID-19 testing, morbidity, mortality, and inoculation rates. Culturally relevant and linguistically appropriate, dynamic, and scalable strategies are essential to the immediate and long-term success of COVID-19 vaccine uptake and pandemic mitigation. Changing COVID-19 vaccine uptake behaviors offers an opportunity to concurrently improve engagement in other preventive health behaviors that are important public health priorities (e.g., diabetes management, cancer screenings, recommended adult vaccinations). We propose to co-refine, test, and scale a multicomponent health program to address the multi-level barriers to vaccine uptake and engagement in preventative healthcare in immigrant, refugee, Latino, and BIPOC communities in San Diego. Harnessing reverse innovation thinking, we will apply the Practical Robust Implementation and Sustainability Model (PRISM) to co-create with our community partners, the Global ARC, and San Ysidro Health, the elements of a health program that combines mHealth outreach (community-driven text and voice messages) and enhanced care coordination. Responsive to NOSI NOT-MD-22-006, this R01 will build on our current CEAL and RADx-UP implementation research to scale and sustain a multicomponent health program to increase acceptance, access, and uptake of COVID-19 vaccination and preventive care engagement among underserved communities. We assembled an experienced team of community-engaged implementation scientists, health equity, public health, and infectious disease researchers to accomplish the following aims: 1) Optimize a multicomponent health program to promote COVID-19 vaccine uptake and engagement in preventive healthcare using our established co-creation approach to address multi-level (individual, community, systemic) barriers to vaccine uptake and preventive care engagement; 2) Evaluate the implementation, effectiveness, and sustainment of the multicomponent COVID-19 vaccine and preventive care engagement program using a hybrid type 3 implementation-effectiveness sequential multiple assignment randomized trial design across immigrant, refugee, Latino, and BIPOC communities in Central and East San Diego.