Understanding Factors Influencing COVID-19 Testing and Vaccination in Immigrant Low-income and Homeless Populations and Testing Targeted Interventions

了解影响移民低收入和无家可归人群的 COVID-19 检测和疫苗接种的因素以及测试有针对性的干预措施

• 批准号: 10413438
• 负责人: CLIFFORD JAMES ROSEN
• 金额: $ 94.09万
• 依托单位: MAINEHEALTH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-07 至 2022-08-04
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10413438
• 关键词: Address; Affect; Africa South of the Sahara; Area; Attitude; Belief; COVID-19; COVID-19 diagnosis; COVID-19 pandemic; COVID-19 testing; COVID-19 vaccination; COVID-19 vaccine; Caring; Central America; Clinic; Communication; Communities; Contact Tracing; County; Data; Decision Making; Disadvantaged; Drops; Economic Factors; Economics; Education; Exposure to; Family; Feedback; Foundations; Fright; Health; Health Care Research; Health care facility; Homelessness; Household; Immigrant; Imprisonment; Individual; Intervention; Interview; Justice; Knowledge; Learning; Longitudinal Studies; Low Income Population; Low income; Maine; Measures; Mental disorders; Middle East; Modeling; Needle-Exchange Programs; Patients; Perception; Persons; Population; Public Health; Qualitative Methods; Quarantine; Research; SARS-CoV-2 infection; Secondary Immunization; Sexually Transmitted Diseases; Site; Social Environment; Structure; Suggestion; Surveys; Testing; Time; United States; Vaccinated; Vaccination; Vaccines; Vulnerable Populations; Work; base; behavioral economics; cohort; expectation; experience; health disparity; high risk; insight; interest; marginalized population; member; outreach; pandemic disease; preference; programs; public health intervention; rapid testing; social; social stigma; testing uptake; vaccine acceptance; vaccine hesitancy

The COVID-19 pandemic has disproportionately affected people from vulnerable and disadvantaged communities. Research to date has highlighted the factors that contribute to these disparities including differential treatment and experience of marginalized populations in healthcare and research settings, reduced access to testing and care, living in congregate or multigenerational households, the economic consequences of being diagnosed with COVID-19 and quarantining, differing understanding of and attitudes towards the pandemic, and concerns about contact tracing. Immigrant and low income populations, and people experiencing homelessness, many with mental illnesses, and/or have been recently incarcerated, are hesitant to participate in testing and to accept COVID-19 testing and vaccination. There is an urgent need to understand how to deliver information about testing and vaccination that is understandable and resonates with higher risk communities in their cultural and social contexts. Effective public health strategies for delivering this information must include community input and partnerships. Working closely with community partners who have insight into cultural, behavioral, economic, and factors impacting people’s decision making about testing and vaccine acceptance is essential to developing effective communication and outreach strategies for engaging individuals in testing, vaccination, and care. Working with our community partners, we will create and evaluate the impact of a public health intervention in the area of Cumberland County, Maine, to provide outreach, testing, and vaccination education to a large community of immigrants from sub-Saharan Africa, the Middle East, and Central America, higher-risk low-income people accessing a public health facility (with a sexually transmitted infections clinic, needle exchange, and a free clinic), and individuals experiencing homelessness. This will be a longitudinal study to understand beliefs about and knowledge of COVID-19, and barriers and beliefs about testing and vaccination. Results will inform a community-developed and based intervention to engage the cohort and other members of these populations in testing and vaccine education, and evaluate the impact of this intervention on testing and vaccination uptake in our immigrant, low-income, and homeless communities. Specific Aims: 1) To understand patient perceptions of, fears about, and experiences with COVID-19 testing and vaccination, including booster vaccination in our immigrant, low- income, and homeless populations. 2) To use the data from Aim 1 to develop and pilot test a public health messaging and testing program to increase vaccine and testing uptake in our populations of interest. 3) To evaluate the impact of a public health messaging and testing program developed in Aim 2 on rapid COVID-19 testing and vaccine uptake. While it will need to be adapted based on local communities’ cultures and needs, this work could be foundational for creating and sustaining public health measures that will contribute to the control of the pandemic and reducing the COVID-19 related disparities of vulnerable populations in the US.

COVID-19 大流行对弱势群体和弱势群体造成了不成比例的影响 迄今为止的研究强调了造成这些差异的因素，包括 边缘化人群在医疗保健和研究环境中的差别待遇和经验减少 获得检测和护理的机会、生活在集体或多代家庭中、经济后果 被诊断出患有 COVID-19 并进行隔离、对病毒的不同理解和态度 大流行，以及对移民和低收入人群以及人们的接触追踪的担忧。 无家可归者，许多患有精神疾病，和/或最近被监禁，都犹豫不决 迫切需要参与检测并接受 COVID-19 检测和疫苗接种。 了解如何提供易于理解且引起共鸣的有关检测和疫苗接种的信息 高风险社区在其文化和社会背景下实现这一目标的有效公共卫生战略。 信息必须包括社区的意见和与社区合作伙伴的密切合作。 深入了解文化、行为、经济以及影响人们测试决策的因素 疫苗的接受对于制定有效的沟通和外展策略至关重要 我们将与社区合作伙伴合作，让个人参与检测、疫苗接种和护理。 评估缅因州坎伯兰县地区公共卫生干预措施的影响，以提供 向来自撒哈拉以南非洲的一大群移民提供外展、检测和疫苗接种教育， 中东和中美洲，高风险低收入人群使用公共卫生设施（有 性传播感染诊所、针具交换和免费诊所）以及经历过的个人 这将是一项关于对 COVID-19 的信念和知识的纵向研究，以及 有关测试和疫苗接种的障碍和信念结果将告知社区制定的和基于社区的信息。 进行干预，让队列和这些人群的其他成员参与测试和疫苗教育， 并评估这种干预措施对我们的移民、低收入、 具体目标： 1) 了解患者的看法、恐惧和恐惧。 COVID-19 检测和疫苗接种的经验，包括在我们的移民中进行加强疫苗接种，低 收入和无家可归人口 2) 使用目标 1 的数据来制定和试点测试公共卫生。 消息传递和测试计划，以提高我们感兴趣的人群对疫苗和测试的接受度 3) 。 评估目标 2 中制定的公共卫生信息传递和测试计划对快速 COVID-19 的影响 虽然需要根据当地社区的文化和需求进行调整， 这项工作可以为制定和维持公共卫生措施奠定基础，从而有助于 控制大流行并减少美国弱势群体与 COVID-19 相关的差异。