Exploring barriers and facilitators to women who use drugs (WWUD) awareness, acceptance and uptake of COVID-19 testing, the CARE study.

CARE 研究探讨了女性吸毒者 (WWUD) 对 COVID-19 检测的认识、接受和采用的障碍和促进因素。

• 批准号: 10661309
• 负责人: Susan G. Sherman
• 金额: $ 62.59万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10661309
• 关键词: AIDS prevention; Address; Area; Awareness; Baltimore; Behavioral; Biological; COVID-19 testing; Caring; Communities; Complex; Cost Measures; Counseling; Crack Cocaine; Cross-Sectional Studies; Dancing; Data; Distant; Drug usage; Education; Effectiveness; Enrollment; Environment; Epidemic; Exposure to; Funding; Geography; Goals; HIV; HIV Infections; HIV risk; HIV/STD; Homelessness; Hotlines; Hour; Housing; Human immunodeficiency virus test; Incidence; Infection; Intervention; Interview; Legal; Link; Location; Maryland; Measures; Mediator of activation protein; Medical; National Institute of Drug Abuse; Nature; Occupational activity of managing finances; Opioid; Outcome Study; Participant; Pharmacotherapy; Population; Poverty; Prevention approach; Primary Health Care; Reporting; Reproductive Health; Research; Risk; Risk Behaviors; Risk Reduction; Role; Sampling; Service provision; Services; Sex Behavior; Statistical Data Interpretation; Testing; Time; Training; Unsafe Sex; Visit; Woman; base; behavioral health; behavioral outcome; cocaine use; cohort; community engagement; comparison group; cost; design; effectiveness evaluation; empowerment; experience; female sex worker; financial literacy; follow-up; geographically distant; high risk; implementation intervention; implementation research; innovation; intervention effect; intimate partner violence; member; multidisciplinary; outreach; peer; preventive intervention; professional atmosphere; program costs; programs; recruit; referral services; sex; skills; social cohesion; social stigma; social structure; systematic review; theories; therapy development; uptake

Project Summary In the U.S. women who use illicit drugs (WWUD) have disproportionately high rates of infectious (e.g., HIV, HCV), chronic, and pulmonary diseases that elevate their risk for COVID-19. Their health and disease profile is driven by enduring social conditions (e.g., scarcity of income, food insecurity, access to health services, housing, discrimination). These prevailing social conditions can also undermine WWUDs’ ability to protect themselves from COVID-19 (e.g., washing hands, social distancing). Drug procurement and use, which are largely social processes, further challenge these self-protection measures. Testing and future vaccination is vital to reducing COVID-19 among this high-risk population, necessitating accessible testing schemes. We propose a mixed methods study that draws upon the Andersen Behavioral Model10 and is grounded in eco-social theory. Specifically, the Baltimore-based study aims to: 1) explore predisposing social factors (e.g., housing, food security), individual-level factors (e.g., drug use, mental health), and beliefs (e.g., medical mistrust) that are facilitators and barriers of COVID-19 testing and perceived risks (e.g., income generation, violence) resulting from a diagnosis through in-depth interviews among WWUD (N=15) and a cultural domain analysis (N=45); 2) gain an understanding of the enabling community-level environment (e.g., medical and social service agencies that currently serve WWUD, existing city-wide COVID-19 testing sites) that could facilitate or hinder WWUDs’ COVID-testing uptake through observations (N=8-10) and key informant interviews (N=10); and examine predisposing social factors, individual-level factors, and beliefs that are associated with COVID-19 testing and retesting among a cohort (N=250) of WWUD at baseline and 3-month follow-up. Optional testing offered at both study visits will be a self-administered, rapid antigen test. We will also examine the role of medical mistrust in shaping women’s use of healthcare services as well as experiences of stigma and discrimination in healthcare settings, particularly among Black participants. In Baltimore, this mistrust is particularly pronounced, with Johns Hopkins Hospital having a long history of mistrust in the Black community owing to experimentation and deception of research engagement. The study will be guided by a community advisory board (CAB) who will inform its design and implementation as well as engage in disseminating the results at community meetings to inform COVID-testing scale up.

项目摘要 在美国，使用非法药物的妇女（WWUD）的感染率高得多 （例如HIV，HCV），慢性和肺部疾病，升高了其COVID-19的风险。他们的健康和 疾病特征是由持久的社会状况驱动的（例如，收入稀缺，粮食不安全，获得的机会 卫生服务，住房，歧视）。这些盛行的社会条件也可能破坏wwuds’ 能够保护自己免受COVID-19的能力（例如，洗手，社会距离）。药物采购 和使用主要是社会过程，进一步挑战了这些自我保护措施。测试 未来的疫苗接种对于在这种高风险人群中减少COVID-19至关重要，必要 可访问的测试方案。我们提出了一项混合方法研究，该研究借鉴了安德森 行为模型10，并以生态社会理论为基础。具体而言，基于巴尔的摩的研究旨在： 1）探索诱人的社会因素（例如住房，粮食安全），个人级别因素（例如，吸毒， 心理健康）和信念（例如，医学不信任）是Covid-19测试的促进者和障碍 诊断至深入的风险（例如，收入产生，暴力）的风险（例如收入，暴力） WWUD（n = 15）和文化领域分析（n = 45）之间的访谈； 2）了解 启用社区级环境（例如，目前服务的医疗和社会服务机构 WWUD，现有的城市范围的Covid-19测试站点），可以促进或阻碍WWUDS的共同测试 通过观察（n = 8-10）和关键的线人访谈（n = 10）的吸收；并检查易感性 社会因素，个人级别的因素，并认为与COVID-19的测试和重新测试有关 在基线和3个月的随访中，WWUD的队列中（n = 250）。两者提供的可选测试 研究访问将是自我管理的快速抗原测试。我们还将检查医学的作用 不信任塑造妇女对医疗服务的使用以及污名和经验 医疗保健环境中的歧视，尤其是黑人参与者。在巴尔的摩，这种不信任是 特别明显，约翰·霍普金斯医院的黑人历史悠久 社区由于研究参与的实验和欺骗。该研究将由 一个社区顾问委员会（CAB），将告知其设计和实施并参与 在社区会议上传播结果，以告知Covid测试规模。