RCMI@Morgan: Center for Urban Health Disparities Research and Innovation

RCMI@摩根：城市健康差异研究与创新中心

• 批准号: 10216666
• 负责人: Hongtao Yu
• 金额: $ 18.88万
• 依托单位: MORGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-31 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10216666
• 关键词: 2019-nCoV; Address; Appointment; Baltimore; Benefits and Risks; CD4 Lymphocyte Count; COVID-19; COVID-19 pandemic; Caring; Case Series; Cessation of life; Characteristics; Clinic; Clinic Visits; Clinical; Clinical Management; Communities; Continuity of Patient Care; County; Data; Data Collection; Disease; Disease Outbreaks; Focus Groups; Frequencies; Future; Gender; HIV; HIV/HCV; Health; Health Personnel; Health Services Accessibility; Healthcare; Healthcare Systems; Hepatitis C virus; Hospitalization; Hospitals; Individual; Intensive Care; Internships; Interview; Lesbian Gay Bisexual Transgender Intersex; Maryland; Medical; Medical Records; Minority; Modeling; Monitor; Natural History; Neighborhood Health Center; Outcome; Pathogenesis; Patient Care; Patients; Perception; Plasma; Population; Population trends; Predictive Factor; Questionnaires; Readiness; Research; Research Design; Retrospective cohort study; Risk; Rural; Schedule; Series; Severities; Severity of illness; Sexual and Gender Minorities; Structure; Students; Subgroup; Surveys; System; Testing; Time trend; Treatment Effectiveness; Treatment Protocols; Treatment outcome; Urban Health; Ventilator; Viral Load result; Visit; Vulnerable Populations; base; care providers; care seeking; career; community clinic; compare effectiveness; electronic data; experience; health care availability; health care service organization; health care service utilization; health disparity; improved outcome; innovation; medical specialties; minority health; novel; pandemic disease; patient subsets; predictive modeling; racial and ethnic; rural area; suburb; telehealth; testing services; trend; trend analysis

PROJECT SUMMARY Similar to HIV and hepatitis C virus, SARS-CoV-2, the cause of COVID-19, is most devastating to people of health disparity populations (HDP). However, we hypothesize that COVID-19 could cause health disparities among different HDP (i.e. “disparities within”) and certain circumstances and determinants could contribute to and predict the “disparities within”. Our ongoing partnerships with a multi-hospital healthcare system and a multisite community health center for the study of HIV/HCV-related health disparities provide an immediate, practical, and pertinent platform to study the impacts of COVID-19 on health outcomes and healthcare access and utilization among people of various HDP. The hospitals of the healthcare system and the clinics of the community health center are situated in urban, suburban, and rural areas with major health disparities. The healthcare system has provided SARS-CoV-2 testing services and treated many hospitalized COVID-19 patients. The community health center provides HIV care to people of racial/ethnic and sexual/gender minorities and other vulnerable populations. We will take advantage of the ongoing partnerships, using a retrospective cohort study design with data from the medical records, to dissect the “disparities within” caused by COVID-19. First, we will delineate the clinical features and natural history of COVID-19 among the hospitalized patients, and determine the factors associated with COVID-19 pathogenesis, disease severity, and treatment effectiveness. We also aim to establish novel, unique, and tailored clinical “scoring” systems/models that can be used to predict COVID-19 outcomes and severity in patients of different HDP. Second, we will analyze the trends in and characteristics of the SARS-CoV-2 testing and assess whether people of the HDP were underrepresented in the testing. We will also analyze the factors associated with SARS-CoV-2 positivity among those tested. For those who tested positive, we will assess their participation/engagement in the COVID-19 cascade of care and determine the factors associated with attending or missing each of the stages in the care cascade. Next, we will assess the HIV continuum of care during the COVID-19 lockdown, analyzing the trends and factors associated with missing appointments, labs, and/or prescriptions as well as the utilization of telehealth. We will also examine the HIV-related health outcomes among those who continued care during the lockdown. Finally, we will perform questionnaire surveys or interviews to assess the experiences and perceptions of (1) COVID-19 patient care from the frontline healthcare workforce and (2) the pros and cons of telehealth in HIV care from the HIV patients and care providers. We will also evaluate how the COVID-19 pandemic has changed/shaped the perception and career/specialty choice of the medical residents, interns, and students. The results from this project will help reduce the health disparities caused by COVID-19 among the HDP. PROJECT SUMMARY

项目摘要 类似于艾滋病毒和丙型肝炎病毒，sars-cov-2是covid-19的原因，是最毁灭性的 健康差异人群（HDP）。但是，我们假设Covid-19可能会导致健康差异 在不同的HDP（即“内部差异”）中，某些情况和决定者可能有助于 并预测“内部差异”。我们与多医院医疗系统和一个持续的合作伙伴关系 艾滋病毒/HCV相关健康分配研究多场地社区健康中心提供了直接的，即 研究Covid-19对健康结果和医疗保健访问的影响的实用和相关平台 以及各种高清PP的人之间的利用。医疗系统的医院和 社区卫生中心位于城市，郊区和具有重大健康差异的粗糙地区。 医疗保健系统提供了SARS-COV-2测试服务，并治疗了许多住院的Covid-19 患者。社区卫生中心为种族/种族和性别/性别少数民族的人提供艾滋病毒护理 和其他弱势群体。我们将利用回顾性利用正在进行的合作伙伴关系 队列研究设计具有来自病历的数据，以剖析Covid-19引起的“内部差异”。 首先，我们将在住院的患者中描述Covid-19的临床特征和自然历史，以及 确定与COVID-19的发病机理，疾病严重程度和治疗有效性相关的因素。 我们还旨在建立可用于预测的新颖，独特和量身定制的临床“评分”系统/模型 不同HDP患者的COVID-19结果和严重程度。其次，我们将分析和 SARS-COV-2测试和评估HDP的人的特征是否不足 测试。我们还将在测试者中分析与SARS-COV-2潜力相关的因素。对于那些 谁测试了阳性，我们将评估他们参与/参与Covid-19级联的护理和 确定与参加或缺少护理级联的每个阶段相关的因素。接下来，我们会的 评估COVID-19锁定期间的HIV护理连续性，分析相关的趋势和因素 由于缺少任命，实验室和/或处方以及远程医疗的利用。我们还将检查 在锁定期间继续护理的人中，与HIV相关的健康结果。最后，我们将表演 问卷调查或访谈，以评估（1）COVID-19患者护理的经验和看法 来自前线医疗保健员工队伍，（2）艾滋病毒患者远程医疗的利弊 和护理提供者。我们还将评估COVID-19大流行如何改变/塑造了感知和 医疗居民，实习生和学生的职业/专业选择。该项目的结果将有所帮助 减少HDP中Covid-19引起的健康分布。 项目摘要