Motivational enhancement to augment contingency management for SARS-CoV-2 testing and vaccination utilization among syringe exchange clients

增强动机，以加强注射器交换客户中 SARS-CoV-2 检测和疫苗接种利用的应急管理

• 批准号: 10447247
• 负责人: Camille C Cioffi
• 金额: $ 109.52万
• 依托单位: UNIVERSITY OF OREGON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-15 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10447247
• 关键词: 2019-nCoV; Address; American; Behavioral; CLIA certified; COVID-19; COVID-19 health disparity; COVID-19 morbidity; COVID-19 mortality; COVID-19 risk; COVID-19 testing; COVID-19 vaccination; COVID-19 vaccine; Caring; Cessation of life; Client; Collaborations; Communicable Diseases; Contracts; Cost Effectiveness Analysis; Data Collection; Discrimination; Disease; Effectiveness; Evaluation; Exposure to; General Population; Goals; HIV; HIV/HCV; Health behavior outcomes; Healthcare Systems; Hepatitis B; Herd Immunity; Human immunodeficiency virus test; Hygiene; Immunization; Immunization Programs; Immunocompromised Host; Infrastructure; Injecting drug user; Intervention; Laboratories; Link; Long-Term Effects; Medical; Misinformation; Motivation; Needle-Exchange Programs; Oregon; Outcome; Penetration; Phase; Population Decreases; Preventive; Probability; Procedures; Process; RADx; RADx Underserved Populations; Randomized Controlled Trials; Recording of previous events; Reporting; Research; Risk; SARS-CoV-2 infection; SARS-CoV-2 transmission; Sampling; Services; Site; Specimen; Stigmatization; Testing; Time; Trust; Tuberculosis; Universities; Vaccination; Vaccines; Viral hepatitis; Vulnerable Populations; arm; base; behavior change; community based participatory research; comparative effectiveness; contingency management; effective intervention; experience; extrinsic motivation; follow-up; health care availability; health care service; high risk; housing instability; implementation evaluation; improved; phase 1 study; prevent; programs; sample collection; service intervention; success; testing uptake; transmission process; treatment arm; vaccine acceptance; vaccine access; vaccine hesitancy

PROJECT SUMMARY People who inject drugs (PWIDs) are highly vulnerable to contracting SARS-CoV-2 and to the effects of the disease caused by SARS-CoV-2, coronavirus disease 2019 (COVID-19). PWIDs experience underlying medical conditions and unstable housing that put them at increased risk for COVID-19 morbidity and mortality. PWIDs also experience barriers such as a history of stigmatization and discrimination by health care systems and exposure to misinformation that reduces access to health care services, such as SARS-CoV-2 testing and vaccination. The proposed project builds on our Phase I Rapid Acceleration of Diagnostics project (#67; PI: Stormshak) that successfully embedded SARS-CoV-2 testing into syringe exchange programs (SEPs) across the state of Oregon, in collaboration with HIV Alliance (HIVA). The testing program’s success is linked to a contingency management (CM) intervention that increased the rates of testing utilization from 4% to 24% (d = 1.36), even as nationwide testing utilization was decreasing. The first aim of the proposed project is to test the sustained effectiveness of CM on testing outcomes, given the current context of increasing COVID-19 vaccine accessibility. Testing remains critical to prevent the transmission of SARS-CoV-2 among PWIDs who continue to be at high exposure risk, and for whom vaccine hesitancy is high. We will also leverage our partnership with HIVA to establish a COVID-19 vaccine program at HIVA’s SEPs. The second aim is to conduct a randomized control trial (RCT) to examine whether a brief motivational enhancement (ME) intervention (i.e., Connect2Test) augments the effects of CM on SARS-CoV-2 testing and vaccination uptake. Our Phase I study demonstrates that CM improves SARS-CoV-2 testing utilization. CM is also known to increase immunization rates against other infectious diseases, such as Hepatitis B. Additionally, consistent with research showing that ME enhances the effects of CM on health behavior outcomes, we anticipate that Connect2Test will augment CM’s effects on testing and vaccination among PWIDs. Moreover, because ME elicits and strengthens motivation for long-term behavior change, whereas CM prompts immediate and short-term behavior change, we anticipate that CM + ME, versus CM alone, will have long-term effects on SARS-CoV-2 testing, evidenced by participation in repeated testing over time. The third aim of the proposed project is to assess CM and Connect2Test implementation, including a cost-effectiveness analysis of CM alone versus CM plus Connect2Test, to improve long-term sustainability of testing, vaccination, and intervention approaches to mitigate the spread of SARS-CoV-2.

项目摘要 注射毒品（PWID）的人非常容易受到签约SARS-COV-2和对 由SARS-COV-2，2019年冠状病毒疾病引起的疾病（Covid-19）。 PWIDS经验的基础 医疗状况和不稳定的住房，使他们面临19009年发病率和死亡率的风险。 PWID还遇到诸如医疗保健系统污名和歧视史之类的障碍 并暴露于降低获得医疗服务的访问权限（例如SARS-COV-2测试）和 疫苗接种。拟议的项目建立在我们I阶段诊断项目的快速加速度基础上（＃67; PI：： Stormshak）成功将SARS-COV-2测试嵌入注射器交换计划（SEP） 俄勒冈州与艾滋病毒联盟（HIVA）合作。测试计划的成功与 应急管理（CM）干预措施，将测试利用率从4％提高到24％（d = 1.36），即使全国性测试利用率也在减少。拟议项目的第一个目的是测试 鉴于当前增加Covid-19疫苗的情况，CM在测试结果中的持续有效性 可访问性。测试对于防止SARS-COV-2在继续的PWID中的传播至关重要 处于高暴露风险，疫苗犹豫很高。我们还将利用与 Hiva在Hiva的SEPS建立Covid-19疫苗计划。第二个目的是进行随机 控制试验（RCT）检查是否有简短的动机增强（ME）干预（即Connect2 -Test）是否 增强CM对SARS-COV-2测试和疫苗接种的影响。我们的研究阶段证明了 CM改善了SARS-COV-2测试利用率。众所周知，CM也会提高针对的免疫接种率 其他感染性疾病，例如乙型肝炎。此外，与研究表明我一致 增强CM对健康行为结果的影响，我们预计Connect2 -Test将增加CM的 对PWID的测试和疫苗接种的影响。而且，因为我引起了动力 长期行为改变，而CM提示立即和短期行为改变，我们预计 CM +我与CM相比，将对SARS-COV-2测试产生长期影响，证明 随着时间的推移，参与重复测试。拟议项目的第三个目的是评估CM和 连接2-Test实施，包括单独使用CM与CM Plus的成本效益分析 Connect2Test，以提高测试，疫苗接种和干预方法的长期可持续性 减轻SARS-COV-2的传播。