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

基本信息

批准号：
10546460
负责人：
Camille C Cioffi
金额：
$ 74.44万
依托单位：
UNIVERSITY OF OREGON
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 2024-06-30
项目状态：
已结题

项目摘要

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.

项目概要注射吸毒者 (PWID) 极易感染 SARS-CoV-2 并受到病毒的影响由 SARS-CoV-2、2019 年冠状病毒病 (COVID-19) 引起的疾病。医疗条件和不稳定的住房使他们面临着更高的 COVID-19 发病和死亡风险。吸毒者还面临一些障碍，例如医疗保健系统的污名化和歧视史接触错误信息会减少获得医疗保健服务的机会，例如 SARS-CoV-2 检测和拟议的项目建立在我们的第一阶段快速加速诊断项目（#67；PI： Stormshak）成功地将 SARS-CoV-2 测试嵌入到注射器交换计划 (SEP) 中俄勒冈州与艾滋病毒联盟 (HIVA) 合作，该检测计划的成功与以下因素有关。应急管理 (CM) 干预将测试利用率从 4% 提高到 24% (d = 1.36），尽管全国范围内的测试利用率正在下降，该项目的首要目标是测试鉴于当前 COVID-19 疫苗不断增加的背景，CM 对检测结果的持续有效性检测对于防止 SARS-CoV-2 在吸毒者中传播仍然至关重要。处于高暴露风险且对疫苗犹豫不决的人，我们还将利用与他们的合作关系。 HIVA 在 HIVA 的 SEP 建立 COVID-19 疫苗计划的第二个目标是进行随机试验。对照试验 (RCT) 检查是否进行短暂的动机增强 (ME) 干预（即 Connect2Test）我们的第一阶段研究表明，增强 CM 对 SARS-CoV-2 检测和疫苗接种的影响。 CM 还可以提高 SARS-CoV-2 检测利用率。其他传染病，例如乙型肝炎。另外，与研究表明 ME 一致增强 CM 对健康行为结果的影响，我们预计 Connect2Test 将增强 CM 的效果此外，ME 会激发并增强注射吸毒者的检测和疫苗接种的积极性。长期的行为改变，而 CM 促进即时和短期的行为改变，我们预计 CM + ME 与单独 CM 相比，将对 SARS-CoV-2 检测产生长期影响，证据如下随着时间的推移参与重复测试。拟议项目的第三个目标是评估 CM 和 Connect2Test 实施，包括单独 CM 与 CM plus 的成本效益分析 Connect2Test，提高检测、疫苗接种和干预方法的长期可持续性减轻 SARS-CoV-2 的传播。