SARS-CoV-2 in Correctional Populations: A collaborative, ethical approach to application of wastewater-based surveillance

惩教人群中的 SARS-CoV-2：应用基于废水的监测的协作、道德方法

基本信息

批准号：
10447465
负责人：
ANNE C SPAULDING
金额：
$ 67.1万
依托单位：
EMORY UNIVERSITY
依托单位国家：
美国
项目类别：
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/10447465
关键词：
2019-nCoV Address Administrator Adopted Affect American Boston COVID detection COVID-19 COVID-19 detection COVID-19 monitoring COVID-19 outbreak COVID-19 pandemic COVID-19 surveillance COVID-19 vaccine Characteristics Chicago Collaborations Collection Communicable Diseases Communities Complement Consent Consolidated Framework for Implementation Research Coronavirus Correctional Institutions Crowding Data Discrimination Disease Disease Outbreaks District of Columbia Effectiveness Employee Ensure Ethics Feces Focus Groups General Population Goals Health Hot Spot Hybrids Imprisonment Individual Infection Intervention Interview Jail Knowledge Measurement Meta-Analysis Methods Minority Modeling Monitor Municipalities Nursing Services Outcome Persons Physician Executives Play Policy Maker Population Population Density Prevalence Process Reporting Research Research Personnel Risk Role SARS-CoV-2 infection SARS-CoV-2 transmission SARS-CoV-2 variant Sampling Sewage Site Specimen Structural Racism Structure Substance Use Disorder Surveys System Testing Underserved Population Vaccines Variant Viral Load result Virus base cohort college cost design effective intervention effectiveness outcome evidence base experience falls implementation evaluation implementation measures implementation outcomes implementation process implementation strategy improved member multidisciplinary new technology novel people of color response risk mitigation screening severe mental illness stem suburb surveillance data tool transmission process trend uptake vaccine hesitancy vigilance vulnerable community wastewater monitoring wastewater surveillance webinar

项目摘要

Throughout the COVID19 pandemic in the U.S., persons in jails have borne a share of disease 3-fold or greater than that seen in the general population. While many cases have been imported from surrounding communities, crowding in these congregate settings has led to rapid in-house transmission, especially since testing in jails has been sparse. Vaccine hesitancy among staff and those detained mean the population is ill prepared for new waves of infection, perhaps from virus variants. Better surveillance could warn systems earlier, and allow jails to stem the tide of a new outbreak. At least half, if not more, of infected persons shed coronavirus in their stool. Monitoring wastewater is a promising practice that only a few jails have adopted. Our overarching goal is to introduce or refine Wastewater Based Surveillance (WBS) as an evidence-based strategy for SARS-CoV-2 surveillance in the jails of Atlanta, Chicago, suburban Boston and Washington DC. We will adapt it to the needs of jail settings and evaluate the implementation with the Consolidated Framework for Implementation Research. Implementation teams will be formed of both correctional staff and formerly incarcerated individuals. Our aims: (1) To assess the barriers to and facilitators of implementing WBS for SARS-CoV-2 detection in 4 jail demonstration sites. Guided by CFIR, we hold an informational webinar, then conduct focus groups. Four will be with leaders at each of the jails; these will discuss the site-specific context in which WBS will be introduced or refined. A fifth, cross-site focus group of jail workers, and a sixth, cross-site group of persons with lived jail experience, will reflect on characteristics of WBS approaches and implementation strategies in jail settings. (2) To measure implementation outcomes associated with WBS and use these outcomes to inform key stakeholders, using a knowledge to action framework. We will study uptake, acceptability, appropriateness and feasibility of WBS as a sensitive early warning system and a way of quantifying SARS-CoV-2 levels to monitor trends in COVID19 prevalence. Feasibility, the suitability of how WBS data are acted upon, will be of utmost importance. We will use the Knowledge to Action process model, leveraging implementation outcomes to further engage stakeholders and characterize the adaptions needed to successfully implement WBS in jails. (3, Pilot) To study the process and the perceived effectiveness of incorporating diverse stakeholders, including the formerly incarcerated, on the WBS implementation team. We will use the Research Engagement Survey Tool (REST), to survey early in the implementation process and eight months later, individuals on the implementation team who have lived experience in jail; all other consenting implementation team members will be surveyed once early in the implementation process. Successfully completing the aims will determine factors that promote WBS implementation to improve disease monitoring in jails. By including persons recently released from jail on the implementation teams, we hope to inform researchers and policy makers about the ethics and process of collaboration in implementation.

在美国的整个COVID19大流行中，监狱中的人占3倍或更高的疾病比普通人群所看到的。尽管许多案件是从周围社区进口的，但在这些聚集环境中的拥挤导致了内部的快速传播，尤其是因为监狱的测试稀疏。工作人员和被拘留者之间的疫苗犹豫不决，意味着人口为新的浪潮做好了准备感染，也许来自病毒变体。更好的监视可以更早警告系统，并允许监狱阻止新爆发的潮流。至少有一半（如果不是更多的话）被感染的人在凳子上脱落冠状病毒。监测废水是一种有前途的做法，只有少数监狱被采用。我们的总体目标是引入或完善基于废水的监视（WBS）作为SARS-COV-2的基于证据的策略亚特兰大，芝加哥，波士顿郊区和华盛顿特区监狱的监视。我们将适应需求监狱设置并使用合并的实施研究框架评估实施。实施团队将由惩教人员和以前被监禁的人组成。我们的目标：（1）评估在4监狱中实施WBS的SARS-COV-2检测的障碍和促进者演示站点。在CFIR的指导下，我们举办了一个信息网络研讨会，然后进行焦点小组。四个意志与每个监狱的领导人在一起；这些将讨论将引入WB或精制。第五，跨场地的监狱工人和一个六个跨站点的人居住监狱经验，将反思WBS方法的特征和监狱环境中的实施策略。（2）衡量与WBS相关的实现结果并使用这些结果告知密钥利益相关者，利用知识来行动框架。我们将研究吸收，可接受性，适当性和 WBS作为敏感的预警系统的可行性和量化SARS-COV-2水平的一种方法 COVID19患病率的趋势。可行性，WBS数据的作用的适用性将是最大的重要性。我们将使用知识来行动过程模型，利用实施结果来进一步聘请利益相关者并描述成功在监狱中实施WBS所需的改编。（3，飞行员）研究过程以及将各种利益相关者纳入包括的过程和有效性以前被监禁的WBS实施团队。我们将使用研究参与调查工具（休息），要在实施过程的早期进行调查，八个月后，实施的个人在监狱中有经验的团队；所有其他同意实施团队成员将接受一次调查在实施过程的早期。成功完成目标将确定促进WBS实施以改善疾病的因素监狱监视。通过包括最近在实施团队中从监狱释放的人，我们希望向研究人员和政策制定者告知实施中协作的道德和过程。