Scaling and Sustaining COVID-19 Vaccination through Meaningful Community Engagement and Care Coordination for Underserved Communities

通过对服务不足的社区进行有意义的社区参与和护理协调来扩大和维持 COVID-19 疫苗接种

• 批准号: 10710200
• 负责人: Adrienn Borsika Rabin
• 金额: $ 57.1万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-26 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10710200
• 关键词: Action Research; Address; Adoption; Adult; Appointment; Appointments and Schedules; Behavior; Black, Indigenous, People of Color; Border Community; COVID-19; COVID-19 disparity; COVID-19 testing; COVID-19 vaccination; COVID-19 vaccine; Clinic; Combined Vaccines; Communicable Diseases; Communities; Community Healthcare; Complex; Country; Data; Disparity; Effectiveness; Elements; Ethnic Origin; Evaluation; FDA approved; Federally Qualified Health Center; Goals; Health; Health behavior; Healthy People 2020; Hybrids; Immigrant; Immunization; Individual; Inequity; Influenza vaccination; Institution; Knowledge; Latino; Learning; Linguistics; Low income; Maintenance; Mammography; Methods; Mexico; Morbidity - disease rate; Persons; Practical Robust Implementation and Sustainability Model; Preventive; Preventive care; Preventive healthcare; Process; Public Health; RADx Underserved Populations; Recommendation; Refugees; Reporting; Research Personnel; Resources; SARS-CoV-2 infection; Schedule; Scientist; Screening for cancer; Sequential Multiple Assignment Randomized Trial; Services; Social Change; Surveys; Technology; Testing; Text; Text Messaging; Thinking; Trust; Vaccination; Vaccines; Voice; Work; care coordination; care outcomes; colorectal cancer screening; community center; community engagement; diabetes management; driving force; effectiveness outcome; enhanced care; experience; health care availability; health communication; health disparity; health equity; health literacy; implementation evaluation; implementation outcomes; implementation research; implementation science; implementation/effectiveness; improved; innovation; long-standing disparities; low and middle-income countries; mHealth; mobile computing; mortality; outreach; pandemic response; post implementation; prevent; programs; public health priorities; screening; social health determinants; success; trial design; underserved community; uptake; vaccine acceptance; vaccine distribution; vaccine hesitancy

PROJECT SUMMARY/ABSTRACT COVID-19 vaccines have been inequitably distributed and vaccine uptake has lagged, particularly for immigrant, refugee, Latino, and Black, Indigenous, People of Color (BIPOC) communities. Underlying reasons for the slow and variable uptake of COVID-19 vaccines include individual (e.g., health literacy, trust), cultural (e.g., linguistic needs), and structural barriers, such as technological and systemic factors (e.g., complex and onerous processes to schedule and attend vaccine appointments). There is no one-size-fits-all approach to vaccine implementation. This is borne out in the data indicating enormous disparities in COVID-19 testing, morbidity, mortality, and inoculation rates. Culturally relevant and linguistically appropriate, dynamic, and scalable strategies are essential to the immediate and long-term success of COVID-19 vaccine uptake and pandemic mitigation. Changing COVID-19 vaccine uptake behaviors offers an opportunity to concurrently improve engagement in other preventive health behaviors that are important public health priorities (e.g., diabetes management, cancer screenings, recommended adult vaccinations). We propose to co-refine, test, and scale a multicomponent health program to address the multi-level barriers to vaccine uptake and engagement in preventative healthcare in immigrant, refugee, Latino, and BIPOC communities in San Diego. Harnessing reverse innovation thinking, we will apply the Practical Robust Implementation and Sustainability Model (PRISM) to co-create with our community partners, the Global ARC, and San Ysidro Health, the elements of a health program that combines mHealth outreach (community-driven text and voice messages) and enhanced care coordination. Responsive to NOSI NOT-MD-22-006, this R01 will build on our current CEAL and RADx-UP implementation research to scale and sustain a multicomponent health program to increase acceptance, access, and uptake of COVID-19 vaccination and preventive care engagement among underserved communities. We assembled an experienced team of community-engaged implementation scientists, health equity, public health, and infectious disease researchers to accomplish the following aims: 1) Optimize a multicomponent health program to promote COVID-19 vaccine uptake and engagement in preventive healthcare using our established co-creation approach to address multi-level (individual, community, systemic) barriers to vaccine uptake and preventive care engagement; 2) Evaluate the implementation, effectiveness, and sustainment of the multicomponent COVID-19 vaccine and preventive care engagement program using a hybrid type 3 implementation-effectiveness sequential multiple assignment randomized trial design across immigrant, refugee, Latino, and BIPOC communities in Central and East San Diego.

项目概要/摘要 COVID-19 疫苗分配不均，疫苗接种滞后，特别是对于 移民、难民、拉丁裔以及黑人、原住民、有色人种 (BIPOC) 社区。根本原因 对于 COVID-19 疫苗的缓慢且可变的吸收，包括个人（例如健康素养、信任）、文化 （例如，语言需求）和结构性障碍，例如技术和系统因素（例如，复杂和 安排和参加疫苗预约的繁琐流程）。没有一种放之四海而皆准的方法 疫苗实施。数据证明了这一点，表明 COVID-19 检测存在巨大差异， 发病率、死亡率和接种率。文化相关、语言恰当、充满活力且 可扩展的策略对于 COVID-19 疫苗接种的近期和长期成功至关重要 疫情缓解。改变 COVID-19 疫苗接种行为提供了同时 提高对其他重要公共卫生优先事项的预防性健康行为的参与（例如， 糖尿病管理、癌症筛查、推荐的成人疫苗接种）。我们建议共同完善、测试、 扩大多方面的卫生计划，以解决疫苗接种和接种方面的多层次障碍 参与圣地亚哥的移民、难民、拉丁裔和 BIPOC 社区的预防性医疗保健。 利用逆向创新思维，我们将实践稳健的实施和可持续发展 与我们的社区合作伙伴 Global ARC 和 San Ysidro Health 共同创建的模型 (PRISM) 结合移动医疗外展（社区驱动的文本和语音消息）的健康计划的要素 并加强护理协调。响应 NOSI NOT-MD-22-006，这款 R01 将基于我们当前的 CEAL 和 RADx-UP 实施研究旨在扩展和维持多组成部分的健康计划，以 提高人们对 COVID-19 疫苗接种和预防性护理的接受度、获取率和采用率 服务不足的社区。我们组建了一支经验丰富的社区参与实施团队 科学家、健康公平、公共卫生和传染病研究人员实现以下目标：1) 优化多组成部分的健康计划，以促进 COVID-19 疫苗的接种和参与 使用我们既定的共同创造方法来解决多层次（个人、 社区、系统性）疫苗接种和预防性护理参与的障碍； 2) 评估 多成分 COVID-19 疫苗和预防保健的实施、有效性和维持 使用混合类型 3 实施效果连续多重分配的参与计划 圣保罗中部和东部的移民、难民、拉丁裔和 BIPOC 社区的随机试验设计 迭戈.

项目成果

Scaling and sustaining COVID-19 vaccination through meaningful community engagement and care coordination for underserved communities: hybrid type 3 effectiveness-implementation sequential multiple assignment randomized trial.

• DOI: 10.1186/s13012-023-01283-2
• 发表时间: 2023-07-14
• 期刊: IMPLEMENTATION SCIENCE
• 影响因子: 7.2
• 作者: Rabin, Borsika A. A.;Cain, Kelli L. L.;Watson Jr, Paul;Oswald, William;Laurent, Louise C. C.;Meadows, Audra R. R.;Seifert, Marva;Munoz, Fatima A. A.;Salgin, Linda;Aldous, Jeannette;Diaz, Edgar A. A.;Villodas, Miguel;Vijaykumar, Santosh;O'Leary, Sean T. T.;Stadnick, Nicole A. A.
• 通讯作者: Stadnick, Nicole A. A.