Faithful Response II: COVID-19 Rapid Test-to-Treat with African American Churches

项目总结 许多多层壁垒增加了新冠肺炎在AA中的风险，包括贫困，基本工作 更多的病毒暴露、文化规范(例如，否认风险、医疗/接触者追踪不信任)、慢性健康 条件差，获得医疗保健和其他服务/资源的机会有限。这些障碍突显出需要 可访问、可信的新冠肺炎测试以及与抗病毒治疗和护理服务(LTC；例如，健康， 预防方案、社区资源、接触者追踪)和社区资源(例如食物、租金 援助)，帮助减缓新冠肺炎在AA社区的传播。AA教会是一个拥有广泛的 在再生障碍性贫血社区中的影响力，可能是扩大新冠肺炎试验治疗覆盖范围的理想环境 对受灾严重的再生障碍性贫血社区进行长期TC干预。然而，目前还没有基于教会的受控AA研究 新冠肺炎的TTT干预。这项研究的主要目的是全面测试一种文化/宗教定制的、 基于教会的新冠肺炎TTT，带有LTC干预条件，针对非定制教育条件 6个月后对成年AA教会成员和他们的社区成员进行新冠肺炎快速测试率 发球。教会将根据成员规模、教派和过去参与教会健康的情况进行匹配。 干预性研究，然后随机到治疗条件。12座教堂(每臂6座教堂；55座教堂 和20名社区成员/教会；N=900人)将参与研究。抗病毒和接触者追踪 意图和使用情况也将在6个月后作为次要结果进行检查。其他类型的新冠肺炎 还将评估测试和与护理使用的联系。在计划行为理论的指导下 社会生态模式，我们的社区参与方法包括训练有素的教会领袖提供 文化上，适合教会的新冠肺炎TTT工具包包括数字工具：a)个人自助材料 和自动化/定制文本消息；b)事工小组教育信息；c)虚拟/面对面教会 利用新冠肺炎相关材料/活动提供服务(例如，布道、牧师建模快速自我测试、 证言、公告)；以及d)教会-社区一级的关爱联动(LTC)服务(例如，接触者追踪， 治疗、保健、社区资源)由接触者作为社区卫生工作者提供 (CHW)。干预教会将举办2场新冠肺炎TTT活动，并为会员提供带回家的食物 新冠肺炎快速自检试剂盒。与接收新冠肺炎测试相关的潜在调解人/版主将是 评估，并进行流程评估，以确定实施促进者、障碍和与 提高COVID19检测率。我们与长期的信仰和健康合作伙伴正在进行的会议是 使我们能够迅速调整我们基于AA教会的新冠肺炎检测、艾滋病毒检测和糖尿病预防 拟议研究的干预措施。这项新颖的研究是第一次完全测试新冠肺炎对TTT的干预 AA级教堂。它可以提供一个基于理论的、多层次的可扩展模型，用于装备AA教堂以交付 与卫生机构合作伙伴广泛开展新冠肺炎快速检测和推广治疗。

PROJECT SUMMARY Many multilayered barriers increase risk for COVID-19 among AA including poverty, essential jobs with increased virus exposure, cultural norms (eg, risk denial, medical/contact tracing mistrust), chronic health conditions, and limited access to healthcare and other services/resources. These barriers highlight the need for accessible, trusted COVID-19 testing and linkage to antiviral treatment and care services (LTC; e.g., health, prevention programs, community resources, contact tracing) and to community resources (e.g., food, rent assistance) to help slow COVID-19 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 COVID-19 test-to-treat (TTT) interventions with LTC in hard hit AA communities. Yet, no controlled AA church-based studies exist on COVID-19 TTT interventions. The primary aim of this study is to fully test a culturally/religiously-tailored, church-based COVID-19 TTT with LTC intervention condition against a non-tailored education condition on COVID-19 rapid 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. Twelve churches (6 churches per arm; 55 church and 20 community members/church; N=900 total) will participate in the study. Antiviral and contact tracing intentions and use will also be examined at 6 months as secondary outcomes. Other types of COVID-19 testing and linkage to care use will also be assessed. Guided by the Theory of Planned Behavior and Socioecological Model, our community-engaged approach includes trained church leaders delivering a culturally, church-appropriate COVID-19 TTT Toolkit inclusive of digital tools: a) individual self-help materials and automated/tailored text messages; b) ministry group educational information; c) virtual/in-person church services with COVID-19 related materials/activities (e.g., sermons, pastors modeling rapid-self testing, testimonials, bulletins); and d) church-community level linkage to care (LTC) services (e.g., contact tracing, treatment, healthcare, community resources) provided by contact tracers serving as community health workers (CHW). Intervention churches will host 2 COVID-19 TTT events and will also provide members with take-home COVID-19 rapid self-test kits. 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 COVID-19 testing, HIV testing and diabetes prevention interventions for the proposed study. This novel study is the first to fully test a COVID-19 TTT intervention in AA churches. It could provide a theory-based, multilevel scalable model for equipping AA churches to deliver wide-reaching COVID-19 rapid testing and promote treatment with health agency partners.