Leveraging community health workers to improve SARS-CoV-2 testing and mitigation among criminal justice-involved individuals accessing a corrections-focused community-based organization

利用社区卫生工作者来改善接触以惩教为重点的社区组织的刑事司法相关个人的 SARS-CoV-2 检测和缓解措施

• 批准号: 10310923
• 负责人: Matthew Akiyama
• 金额: $ 75.16万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-21 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10310923
• 关键词: 2019-nCoV; Accounting; Address; Adherence; Antigens; Behavior; COVID-19; COVID-19 testing; Cellular Phone; Cessation of life; Client; Color; Communities; Community Health Aides; Contracts; Coronavirus; Cost Measures; Counseling; Coupled; Criminal Justice; Data Sources; Disease Outbreaks; Dose; Economics; Education; Educational Background; Educational Intervention; Effectiveness of Interventions; Endemic Diseases; Environment; Face; Fortune; General Population; Goals; HIV; Halfway Houses; Hand; Healthcare; Hepatitis C; Homelessness; Housing; Hygiene; Illinois; Immunocompromised Host; Imprisonment; Individual; Infection; Intervention; Jail; Justice; Lead; Low Prevalence; Masks; Medical; Modeling; Needle-Exchange Programs; Needs Assessment; New York City; Online Systems; Outcome; Participant; Persons; Play; Prisons; Public Health; Questionnaires; Randomized; Records; Risk; Risk Factors; Role; SARS-CoV-2 infection; SARS-CoV-2 transmission; Services; Shelter facility; Site; Social Distance; Societies; Surveys; Test Result; Testing; United States; Vaccination; Vulnerable Populations; barrier to care; base; comorbidity; compare effectiveness; comparison intervention; cost; cost effective; cost effectiveness; effectiveness evaluation; effectiveness testing; experience; high risk; high risk population; homeless shelters; improved; low socioeconomic status; markov model; mortality; novel; pandemic disease; point of care; point of care testing; primary outcome; programs; randomized trial; secondary outcome; social cognitive theory; standard of care; stem; supported housing; testing uptake; transmission process; vaccine acceptance; ventilation

Abstract. The United States (U.S.) has experienced higher mortality than any other nation due to COVID-19 with nearly 13.5 million cases and over 268,103 deaths. Due to the limited ability to socially distance, poor ventilation, and limited hygiene supplies, U.S. prisons and jails have observed explosive transmission of SARS-CoV-2 accounting for the 10 largest U.S. outbreaks. Because 95% of criminal justice-involved individuals reenter society COVID-19 transmission extends beyond those who are currently incarcerated. As justice-involved individuals reenter the community, they face high rates of homelessness, and many others live in other congregate settings such as converted hotels and halfway houses. The increased risk of SARS-CoV-2 while incarcerated coupled with the likelihood of living in congregate settings after incarceration, create conditions ripe for rapid COVID-19 transmission that will be critical to address in order to gain control of COVID-19 in the U.S. The goal of this study is to test the impact and cost-effectiveness of an intervention to mitigate SARS-CoV-2 transmission among justice-involved individuals recently released from incarceration. We will conduct a randomized trial to compare the effectiveness of an onsite Point-of-Care SARS-CoV-2 testing and education intervention with community health workers (CHWs) as a central component compared to the standard of care at a community-based organization (CBO) that provides services to justice-involved individuals in New York City. We will measure costs of testing, education, and navigation, and explore the cost-effectiveness of the onsite Point-of-Care intervention compared to the standard of care. Our specific aims are to: 1) Test the effectiveness of an onsite PoC SARS- CoV-2 intervention in a corrections-focused CBO; 2) Model the cost-effectiveness of an onsite PoC SARS-CoV- 2 intervention among CJIs compared to SoC. Because testing, education, and navigation will be provided by CHWs in a culturally-sensitive environment and test results will be received in minutes (rather than days), we hypothesize that O-PoC will be associated with improved testing uptake and receipt of test results, mitigation behaviors (mask wearing, hand hygiene, social distancing), and those who attend more O-PoC sessions will have better adherence to mitigation behaviors.

抽象的。 由于 COVID-19，美国 (U.S.) 的死亡率比任何其他国家都要高，几乎 1,350 万例病例，超过 268,103 人死亡。由于社交距离能力有限，通风不良， 卫生用品有限，美国监狱和看守所观察到 SARS-CoV-2 爆发性传播 是美国十大疫情爆发的原因之一。因为 95% 的刑事司法相关人员重新进入社会 COVID-19 的传播范围超出了目前被监禁的人。作为参与正义的个人 重新进入社区后，他们面临着很高的无家可归率，而许多其他人则住在其他聚集的环境中 例如改建的酒店和中途宿舍。监禁期间感染 SARS-CoV-2 的风险增加 由于入狱后有可能生活在聚集环境中，为 COVID-19 的快速传播创造了成熟的条件 为了在美国控制 COVID-19，解决这一传播问题至关重要 本研究的目标 目的是测试减轻 SARS-CoV-2 在人群中传播的干预措施的影响和成本效益 最近从监狱释放的参与正义的个人。我们将进行一项随机试验来比较 现场 SARS-CoV-2 护理点检测和社区教育干预的有效性 与社区护理标准相比，卫生工作者 (CHW) 作为核心组成部分 为纽约市参与司法的个人提供服务的组织 (CBO)。我们将衡量成本 测试、教育和导航，并探索现场护理点干预的成本效益 与护理标准相比。我们的具体目标是： 1) 测试现场 PoC SARS 的有效性 对以惩教为重点的 CBO 进行 CoV-2 干预； 2) 对现场 PoC SARS-CoV 的成本效益进行建模 2 与 SoC 相比，CJI 之间的干预。因为测试、教育和导航将由 处于文化敏感环境中的社区卫生工作者将在几分钟（而不是几天）内收到测试结果，我们 假设 O-PoC 将与改进测试的采用和测试结果的接收、缓解 行为（戴口罩、手部卫生、社交距离），参加更多 O-PoC 课程的人将 更好地遵守缓解行为。