Psychosocial Factors and Lupus Disease Progression Among African American Women

非裔美国女性的心理社会因素和狼疮疾病进展

基本信息

批准号：
10414260
负责人：
H. David Chae
金额：
$ 69.62万
依托单位：
TULANE UNIVERSITY OF LOUISIANA
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-17 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10414260
关键词：
Address African American Alabama Anxiety Appointment Appointments and Schedules Area Attention Autoimmune Diseases Behavior Behavior Therapy Bereavement COVID-19 COVID-19 pandemic COVID-19 testing COVID-19 vaccination COVID-19 vaccine Chronic Disease Clinic Clinical Control Groups Coupled Diagnosis Diagnostic Reagent Kits Disease Disease Management Disease Progression Economics Education and Outreach Educational Intervention Employment Experimental Designs Family Financial Hardship Flare Focus Groups Foundations Friends Funding Future Geographic Locations Health Health behavior Healthcare Hospitals Hour Household Income Individual Intervention Intervention Studies Interview Investigation Job loss Location Louisiana Lupus Medical center Mental Depression Mental Health Methods Parents Participant Patients Population Prevalence Prevention Process Provider Psychosocial Factor Psychosocial Stress Public Health Randomized Randomized Controlled Trials Recommendation Reporting Research Research Support Rheumatology Risk Role SARS-CoV-2 infection Site Social Network Social isolation Source Stress Structure Systemic Lupus Erythematosus Technology Testing Time Transportation Treatment Efficacy Unemployment United States National Institutes of Health Vaccinated Vaccination Vaccines Waiting Lists Woman Wood material barrier to care base case finding cohort community engagement efficacy evaluation evidence base experience food insecurity health care availability health inequalities home test housing instability innovation member metropolitan novel outreach peer preference prevent programs psychosocial psychosocial stressors racism recruit side effect stressor testing access tool transportation access trial design uptake vaccine acceptance vaccine evaluation virtual

项目摘要

PROJECT SUMMARY/ABSTRACT People living with an autoimmune disease, including those with systemic lupus erythematosus (SLE), have been especially impacted by the COVID-19 pandemic. People with a pre-existing health condition such as SLE are more susceptible to severe disease. Hence, testing and vaccination among people with SLE, and others in their household and social network is a paramount public health concern. However, structural barriers have prevented optimization of testing and vaccination, and African American women in particular have experienced qualitatively unique challenges to engage in these behaviors. Though only about 7% of the total U.S. population, African American women represent approximately half of all SLE cases. Existing barriers in access to health care (e.g., distance, transportation, access to technology) have been magnified during this unprecedented period. Other psychosocial stressors, including those related to COVID-19 illness and bereavement, employment, racism, and multiple role responsibility and other family demands, compromise chronic disease management as well as testing and vaccination behaviors. The purpose of this competitive revision application is to identify barriers and facilitators to COVID-19 testing and vaccination among people living with SLE using both qualitative and quantitative methods. We will evaluate the efficacy of a novel peer-led intervention to enhancing these behaviors among people living with SLE and others in their household/social network using a randomized controlled trial design. The aims of this project will be achieved by leveraging an existing patient roster of over 2500 people living with SLE in Birmingham, Alabama. We also recruit people living with SLE in New Orleans, Louisiana. These two areas are a high priority given low rates of testing and vaccination in the region. Our intervention is based on individually tailored outreach and education that addresses concerns about COVID-19 specifically in the context of having an autoimmune disease; plus providing options for home testing, and a “vaccine concierge” program that involves identifying the most convenient location, scheduling the appointment, arranging for transportation, and sending reminders for them and their network members. This approach is supported by research indicating that hesitancy may be effectively addressed by increasing opportunities and implementing facilitators to get tested and vaccinated. Lessening barriers mitigates hesitancy and passive refusal; when offered testing and vaccination, even those who are hesitant may accept. Moreover, there are those who are indeed testing and vaccine “willing,” but have not yet been because of other constraints (e.g., time, inconvenience, not knowing where to go); providing them with tools to access testing and vaccination will facilitate engagement. We also hypothesize that recruiting a testing/vaccination “partner” will enhance these behaviors as suggested by other behavioral intervention research on the importance of social networks and peer norms in supporting health- related behaviors. This research has broader implications for testing/vaccination in clinical populations.

项目概要/摘要患有自身免疫性疾病的人，包括患有系统性红斑狼疮 (SLE) 的人，已患有健康状况的人尤其受到 COVID-19 大流行的影响。由于 SLE 更容易患严重疾病，因此，对 SLE 患者进行检测和接种疫苗，以及家庭和社交网络中的其他人是最重要的公共卫生问题。然而，结构性障碍。阻碍了检测和疫苗接种的优化，尤其是非裔美国妇女尽管只占总数的 7% 左右，但他们在从事这些行为时经历了性质上独特的挑战。在美国人口中，非裔美国女性约占所有系统性红斑狼疮病例的一半。在此期间，获得医疗保健的机会（例如距离、交通、获得技术）得到了放大其他社会心理压力源，包括与 COVID-19 疾病相关的压力源。丧亲之痛、就业、种族主义、多重角色责任和其他家庭要求、妥协慢性病管理以及检测和疫苗接种行为。此竞争性修订申请的目的是确定 COVID-19 的障碍和促进因素我们将使用定性和定量方法对 SLE 患者进行检测和疫苗接种。评估一种新颖的同伴主导的干预措施对增强患有此类疾病的人的这些行为的有效性 SLE 和其他人在他们的家庭/社交网络中使用随机对照试验设计。该项目将通过利用现有超过 2500 名 SLE 患者的名册来实现我们还在路易斯安那州新奥尔良招募 SLE 患者。鉴于该地区的检测和疫苗接种率较低，我们的干预措施是基于个体的。量身定制的外展和教育，专门解决人们对 COVID-19 的担忧自身免疫性疾病；再加上提供家庭检测选项，以及“疫苗礼宾”计划包括确定最方便的地点、安排预约、安排交通，以及研究表明，向他们及其网络成员发送提醒。通过增加机会和实施促进者可以有效地解决犹豫不决的问题接受测试和接种疫苗，减少障碍，减少犹豫和被动拒绝；疫苗接种，即使是那些犹豫不决的人也可能会接受，而且，也有人确实在测试和接受。疫苗“愿意”，但由于其他限制（例如时间、不便、不知道）尚未接种去哪里）；为他们提供检测和疫苗接种的工具将促进参与。寻求招募测试/疫苗接种“合作伙伴”将增强这些行为，正如其他人所建议的那样关于社交网络和同伴规范在支持健康方面的重要性的行为干预研究这项研究对临床人群的检测/疫苗接种具有更广泛的影响。