Community-engaged partnership to reduce COVID-19 through self-testing in Hispanic and NHPI communities

社区参与伙伴关系，通过在西班牙裔和 NHPI 社区进行自我测试来减少 COVID-19

• 批准号: 10409310
• 负责人: Pearl Mcelfish
• 金额: $ 57万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-29 至 2023-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10409310
• 关键词: Adult; Arkansas; Budgets; COVID-19; COVID-19 disparity; COVID-19 morbidity; COVID-19 mortality; COVID-19 testing; COVID-19 vaccination; Centers for Disease Control and Prevention (U.S.); Cessation of life; Communication; Communities; County; Data; Data Collection; Discrimination; Effectiveness; Ethnic Origin; Event; Face; Funding; Grant; Healthcare; Hispanics; Hospitalization; Incidence; Insurance; Knowledge; Latinx; Lead; Location; Methods; Minority Groups; Monitor; Native Hawaiian; Nonprofit Organizations; Occupations; Pacific Island Americans; Patients; Policies; Population; Publications; RADx; RADx Underserved Populations; Race; Recording of previous events; Report (document); Reporting; Research; Research Personnel; Resources; Site; Socioeconomic Status; Testing; Trust; United States National Institutes of Health; Vulnerable Populations; Washington; Work; base; community clinic; data harmonization; data submission; distrust; ethnic minority population; experience; health care availability; implementation study; improved; member; multi-site trial; population based; programs; public health relevance; racial and ethnic; racial and ethnic disparities; racial minority; recruit; self testing; sex; social health determinants; standard measure; uptake; vaccine acceptance; vaccine hesitancy; willingness

Abstract The racial/ethnic disparities in Northwest Arkansas (Benton and Washington Counties) were so stark that the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health sent investigators. The CDC's report documented that 45% of all adult cases in Northwest Arkansas were among Hispanic/Latinx patients and 19% were Native Hawaiian/Pacific Islander (NHPI) patients.1 Hispanic/Latinxs and NHPIs only account for 17% and 2.4% of the two-county population, respectively. COVID-19 deaths in Northwest Arkansas were also disparate across race and ethnicity. NHPI deaths were estimated to be more than 200 per 100K — much higher than the overall death ratio for the county of 5.10 per 100K, as well as the death ratio for Whites of 4.03 per 100K.1 Among racial/ethnic minorities, the Northwest Arkansas NHPI population stands out as having much higher odds of death from COVID-19.1 Even with the increased availability of COVID-19 testing and vaccination, barriers remain for racial and ethnic minority populations. While the availability of COVID-19 testing has improved, disparities in testing across race, ethnicity, and socioeconomic status continue to stymie efforts to reduce COVID-19 morbidity and mortality. Hispanic/Latinx and NHPIs have also experienced increased discrimination related to COVID-19. Our preliminary research documents that these experiences with discrimination may reduce Hispanic/Latinx and NHPI willingness to get tested. Minority populations are more likely to distrust traditional approaches to health care. In addition to concerns with trust and discrimination, Hispanic/Latinx and NHPI community members face access barriers including long-working shifts, inability to take off work for health care, and lack of insurance. Self-testing for COVID-19 holds promise in overcoming the barriers of trust, discrimination, and health care access. Yet no studies have tested the best distribution methods for self-testing among Hispanic/Latinx and NHPI. This study fills that gap and holds promise for increasing sustained access for Hispanic/Latinx and NHPI communities and reducing significant COVID-19 disparities in incidence, hospitalization, and death. Our specific aims are: Aim 1. Leverage and fully engage our long-standing community-based partnerships to overcome barriers of trust, discrimination, and health care access to increase the use of COVID-19 self-testing. Aim 2. Implement and evaluate access and uptake strategies of two self-testing distribution approaches (local community clinics and community-based non-profit organizations) to understand effectiveness and impact for vulnerable populations. Aim 3. Fully collaborate with the RADx-UP Coordination and Data Collection Center (CDCC) and other RADx sites.

抽象的 阿肯色州西北部（本顿县和华盛顿县）的种族/民族差异如此明显，以至于 美国疾病控制与预防中心 (CDC) 和美国国立卫生研究院派出了调查人员。 疾病预防控制中心的报告记录了阿肯色州西北部所有成人病例中 45% 是西班牙裔/拉丁裔 患者中，19% 是夏威夷原住民/太平洋岛民 (NHPI) 患者。1 仅西班牙裔/拉丁裔和 NHPI 分别占阿肯色州西北部两个县死亡人数的 17% 和 2.4%。 据估计，每 10 万人中有超过 200 人死于 NHPI—— 远高于该县每 10 万 5.10 人的总体死亡率，以及白人的死亡率 每 100K 中有 4.03 人。1 在少数种族/族裔中，阿肯色州西北部 NHPI 人口脱颖而出 尽管 COVID-19 检测的可用性有所增加，但死于 COVID-19.1 的几率仍要高得多 尽管获得了新冠肺炎 (COVID-19) 疫苗，但种族和族裔人口仍面临障碍。 测试有所改善，但不同种族、民族和社会经济地位之间的测试差异继续阻碍 降低西班牙裔/拉丁裔和 NHPI 发病率和死亡率的努力也取得了成效。 我们的初步研究表明，这些经历表明与 COVID-19 相关的歧视有所增加。 歧视可能会降低西班牙裔/拉丁裔和 NHPI 少数族裔人群接受检测的意愿。 除了对信任和信任的担忧之外，他们更有可能不信任传统的医疗保健方法。 歧视，西班牙裔/拉丁裔和 NHPI 社区成员面临准入障碍，包括长期工作 轮班、无法因医疗保健而请假以及缺乏新冠病毒 (COVID-19) 自我检测是有希望的。 然而，还没有研究测试过在克服信任、歧视和获得医疗保健方面的障碍的最佳方法。 这项研究填补了这一空白并保持了西班牙裔/拉丁裔和 NHPI 自我测试的分配方法。 承诺增加西班牙裔/拉丁裔和 NHPI 社区的持续准入，并减少大量 COVID-19 发病率、住院率和死亡率的差异 我们的具体目标是： 目标 1. 充分利用。 与我们长期的社区伙伴关系合作，克服信任、歧视和歧视的障碍 目标 2. 实施和评估获取和评估医疗保健的可及性，以增加 COVID-19 自我测试的使用。 两种自测分发方法（当地社区诊所和社区为基础）的采用策略 目标 3. 完全 与 RADx-UP 协调和数据收集中心 (CDCC) 以及其他 RADx 站点合作。