Increasing representation of Black communities in COVID-19 home testing and surveillance data

增加黑人社区在 COVID-19 家庭测试和监测数据中的代表性

• 批准号: 10845413
• 负责人: Heather Bradley
• 金额: $ 54.75万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-11-01 至 2024-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10845413
• 关键词: 2019-nCoV; Address; Adverse event; Age; Agreement; Anterior nares; Antibodies; Attitude; Behavior; Biological; Black Populations; Black race; Blood specimen; COVID-19; COVID-19 mortality; COVID-19 pandemic; COVID-19 prevention; COVID-19 test; COVID-19 testing; Cessation of life; Characteristics; Clinic; Collaborations; Collection; Communication; Communities; Data Collection; Decision Making; Diagnostic Reagent Kits; Disease; Effectiveness of Interventions; Ensure; Focus Groups; Genetic; Health; Health Knowledge Attitudes Practice; Home; Individual; Intervention Studies; Interview; Knowledge; Laboratories; Medical; Methods; Modality; Morehouse School of Medicine; Motivation; Nose; Oral; Participant; Persons; Phase; Polymerase Chain Reaction; Population; Population Surveillance; Prevention strategy; Privacy; Public Health; RADx Underserved Populations; Reporting; Research; SARS-CoV-2 infection; SARS-CoV-2 transmission; SARS-CoV-2 variant; Sampling; Specimen; Structural Racism; Surveys; System; Test Result; Testing; Trust; United States; Variant; Visual; Work; Writing; adverse outcome; aged; antigen test; burden of illness; community based participatory research; cultural competence; empowerment; graduate student; health care availability; health knowledge; high risk; home test; improved; member; novel; outcome disparities; pandemic disease; point of care testing; post intervention; preventive intervention; racial disparity; rapid testing; research study; serosurvey; severe COVID-19; sociodemographics; surveillance data; variant detection; vigilance; willingness

Abstract Black communities in the U.S. have disproportionately experienced adverse outcomes attributable to the COVID-19 pandemic. While COVID-19 cases and deaths have declined in recent months, emergent variants continue to pose threats to the health of Black communities and others. COVID-19 testing has recently shifted from primarily point-of-care testing to widespread use of rapid home antigen tests. Home testing may be preferable to clinic-based testing for Black persons, many of whom have a high degree of well-founded, historically based mistrust of the medical system, but very little is currently known about knowledge, attitudes, and behaviors surrounding COVID-19 home testing among Black people. In addition to challenges related to affordability and accessibility of home testing, the privacy afforded by home testing comes at the expense of surveillance information. Home tests are rarely reported to public health surveillance, and specimens are unavailable for genetic sequencing and variant detection. This results in a substantial gap in public health knowledge about COVID-19 burden of disease and circulating variants, which may be particularly problematic for Black communities with higher risk for adverse outcomes. We propose a pre-post intervention study based in Black communities in Atlanta, GA to assess willingness of research participants to use a COVID-19 rapid home test and to simultaneously mail a self-collected anterior nares sample to a commercial laboratory for confirmatory PCR testing. We will provide culturally competent oral and illustrated written communication messages encouraging continued COVID-19 vigilance and home testing alongside self-collection of a specimen for mail-off testing. These messages will be packaged with a home test kit for rapid testing and self- collecting and mailing a second specimen to a laboratory. If a subset of home testers were willing to self-collect and mail a specimen for confirmatory testing, multiplier methods could be used to estimate burden of disease and circulating variants among home testers. However, people with medical mistrust may not elect to share biological specimens for surveillance purposes. We aim to understand motivations and barriers for using this type of testing modality in Black communities while also assessing general knowledge, attitudes, and behaviors related to home testing. Specific aims are to: (1) Develop culturally appropriate, empowering communications strategies underscoring the importance of home COVID-19 testing for individual and public health; (2) Assess knowledge, attitudes, and behaviors regarding COVID-19 rapid home testing among socio- demographically diverse Black communities; (3) Assess willingness to provide, in conjunction with a rapid home test, a self-collected specimen to a laboratory for confirmatory COVID-19 testing; (4) Conduct in-depth interviews with persons completing (N=10) and not completing (N=10) the study-provided home test to further improve communications strategies using participants’ open-ended reflections on intervention effectiveness.

抽象的 美国的黑人社区不成比例地经历了由于以下原因造成的不利后果： 尽管近几个月来 COVID-19 病例和死亡人数有所下降，但新出现的变种仍然存在。 继续对黑人社区和其他人的健康构成威胁。最近，COVID-19 检测发生了变化。 从主要的护理点检测到广泛使用快速家庭抗原检测可能会有所不同。 比对黑人进行基于临床的测试更可取，其中许多人都有充分的依据， 历史上对医疗系统的不信任，但目前对知识、态度、 除了与黑人相关的挑战外，黑人中围绕 COVID-19 家庭测试的行为。 家庭测试的可负担性和可及性，家庭测试提供的隐私是以牺牲 监测信息很少报告给公共卫生监测部门，样本也很少报告给公共卫生监测部门。 无法进行基因测序和变异检测，这导致公共卫生方面存在巨大差距。 有关 COVID-19 疾病负担和循环变异的知识，这可能特别成问题 对于不良后果风险较高的黑人社区，我们提出了一项基于前后干预研究的建议。 在佐治亚州亚特兰大的黑人社区中评估研究参与者使用 COVID-19 快速检测的意愿 家庭测试，同时将自己收集的前鼻孔样本邮寄到商业实验室 我们将提供具有文化背景的口头和图文并茂的书面交流。 鼓励人们继续对 COVID-19 保持警惕并进行家庭检测以及自我收集的信息 用于邮寄测试的样本 这些消息将与家庭测试套件一起包装，以进行快速测试和自我测试。 如果一部分家庭测试人员愿意自行收集，则收集第二份样本并将其邮寄到实验室。 并邮寄样本进行验证性检测，乘数法可用于估计疾病负担 然而，对医疗不信任的人可能不会选择分享。 我们的目标是了解使用该生物样本的动机和障碍。 黑人社区的测试方式类型，同时还评估一般知识、态度和 与家庭测试相关的行为的具体目标是： (1) 培养适合文化的、赋权的行为。 沟通策略强调家庭 COVID-19 检测对个人和公众的重要性 (2) 评估社会群体对 COVID-19 快速家庭检测的知识、态度和行为 (3) 结合快速评估提供意愿 家庭检测、自行采集标本到实验室进行确诊性COVID-19检测； (4) 进行深入检测； 对完成（N = 10）和未完成（N = 10）研究提供的家庭测试的人进行访谈，以进一步 利用参与者对干预有效性的开放式反思来改进沟通策略。