Marshallese: Alternate Surveillance for COVID-19 in a Unique Population

马绍尔语：对特殊人群中的 COVID-19 进行替代监测

基本信息

批准号：
10321000
负责人：
KA'IMI ALOHILANI SINCLAIR
金额：
$ 72.99万
依托单位：
WASHINGTON STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-12-21 至 2023-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10321000
关键词：
Address Adopted Adult Age Anosmia Area Arkansas Body Temperature COVID-19 COVID-19 complications COVID-19 disparity COVID-19 impact COVID-19 morbidity COVID-19 mortality COVID-19 pandemic COVID-19 risk COVID-19 surveillance Caring Cessation of life Chronic Disease Clinic Communities Community Health Aides Complement Complex Coronavirus County Data Disease Surveillance Early Diagnosis Early identification Ecology Ecosystem Ego Ethnic group Event Food Food Processing Generations Government Health Health Personnel Healthcare Healthcare Systems High Prevalence Hospitalization Household Individual Intervention Longitudinal cohort Marshall Islands Minority Groups Modality Non-Insulin-Dependent Diabetes Mellitus Northwestern United States Nuclear Weapons Testings Occupations Pacific Islander Participant Personal Satisfaction Persons Plants Politics Population Population Surveillance Poultry Products Prevalence Public Health Race Radiation exposure Reporting Research Restaurants Risk SARS-CoV-2 infection Speed Structure Surveillance Methods Surveys Symptoms System Technology Testing Text Messaging Thermometers Time Training Tuberculosis Underserved Population Uninsured Ursidae Family Variant Virus Vulnerable Populations Washington asymptomatic COVID-19 base bilingualism citizen science cohort cost cultural values disorder prevention experience health care disparity health disparity high risk improved innovation long-standing disparities member multimodality novel outreach services pandemic disease prevent preventive intervention programs recruit screening social social contact social health determinants social media social stigma stem symptomatic COVID-19 wireless

项目摘要

ABSTRACT Marshallese Pacific Islanders bear a disproportionate burden of COVID-19 infection, hospitalization, and death, with rates 4 to 25 times higher than those of other US racial and ethnic groups in the Continental US.2,3 For example, in Northwest Arkansas Marshallese people represent less than 3% of the total population, but they account for 1 out of 5 COVID-19 cases in this area.2 Similarly, Marshallese represent just 1% of the population in Spokane County, Washington, but were nearly 30% of COVID-19 cases between March and May, 2020.4 Social determinants of health have powerful influences on community and individual risks for COVID-19.18 Culturally, the Marshallese community is extremely tight-knit, self-contained, and highly clustered; they often live in multi-generational households; and they traditionally value close contact and large social events, all of which increase vulnerability to the COVID-19 pandemic.19,20Marshallese are important recipients of effective surveillance efforts given the disproportionate impact of COVID-19 on this population and the long- standing disparities in health and health care. The MASC-UP study will generate novel data that reflect variation in risk of COVID-19 infection based on one’s place in the highly clustered Marshallese community. For Specific Aim 1, bilingual Marshallese Community Health Workers will recruit and train a longitudinal cohort of 800 Marshallese adults, ages 18 and older, in participatory disease surveillance methods that include using a wireless thermometer to continuously track body temperature; social media and text messaging in which participants (aka citizen scientists) can report symptoms; and a CHW helpline to report symptoms and request COVID-19 information. Participatory disease surveillance complements traditional surveillance systems by engaging communities in reporting COVID-19 symptoms and events. Its strengths lie in the speed at which data can be made available, the ability to scale the technology to obtain data at low cost, and the ability to cover populations that might not otherwise be tracked. For Specific Aim 2 participants will complete an ego-centric contact survey to characterize the social contact networks of members in the disease surveillance cohort from Aim 1. The networks will allow identification of people at highest risk of COVID-19 infection and elucidate targets for high-impact preventive intervention. For Specific Aim 3 we will integrate findings from Aims 1 and 2 into the existing test-based disease surveillance currently being performed at the state and local levels. This Aim will augment existing surveillance systems that have proved insufficient to stem the pandemic in Marshallese people. The proposed study will be generalizable to other high risk, clustered underserved populations.

抽象的马绍尔太平洋岛民承受着不成比例的 COVID-19 感染、住院和住院负担死亡率，比美国大陆其他种族和族裔群体高 4 至 25 倍。2,3 例如，在阿肯色州西北部，马绍尔人占总人口的比例不到 3%，但他们占该地区 5 例 COVID-19 病例中的 1 例。2 同样，马绍尔人仅占 1% 华盛顿州斯波坎县的人口，但 3 月至 3 月期间，近 30% 的 COVID-19 病例 2020 年 5 月.4 健康的社会决定因素对社区和个人的风险有强大的影响 COVID-19.18 在文化上，马绍尔社区组织极其紧密、自给自足且高度聚集；他们通常生活在多代同堂的家庭中；他们传统上重视密切接触和广泛的社交活动。事件，所有这些都增加了人们对 COVID-19 大流行的脆弱性。19,20马绍尔人是重要的接收者鉴于 COVID-19 对这一人群的影响不成比例，而且长期健康和保健方面的长期差距。 MASC-UP 研究将生成反映 COVID-19 感染风险变化的新数据一个人在高度聚集的马绍尔社区中的位置对于特定目标 1，双语马绍尔人。社区卫生工作者将招募和培训 800 名马绍尔成人纵向队列，年龄分别为 18 岁和较旧的参与式疾病监测方法，包括使用无线温度计连续监测追踪体温；社交媒体和短信（又称公民科学家）可以报告症状；以及 CHW 帮助热线，用于报告症状并请求参与性的 COVID-19 信息。疾病监测通过让社区参与报告来补充传统监测系统 COVID-19 症状和事件的优势在于提供数据的速度和能力。扩展技术以低成本获取数据，并能够覆盖原本可能无法覆盖的人群对于特定目标 2，参与者将完成一项以自我为中心的接触调查来描述目标 1 中疾病监测队列成员的社交网络联系。该网络将允许识别感染 COVID-19 的最高风险人群并阐明高效预防的目标对于具体目标 3，我们将把目标 1 和 2 的发现整合到现有的基于测试的结果中。目前正在州和地方各级进行的疾病监测将加强现有的监测。事实证明，监测系统不足以阻止马绍尔人的流行病。研究将推广到其他高风险、聚集性服务不足的人群。