Investigating the effectiveness of COVID-19 testing choices, community engagement, and culturally-embedded mHealth literacy delivery in a medically-underserved, community-based sample

在医疗服务不足、基于社区的样本中调查 COVID-19 检测选择、社区参与和嵌入文化的移动医疗素养传播的有效性

• 批准号: 10258548
• 负责人: Ayman Al-Hendy
• 金额: $ 160.98万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-11-11 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10258548
• 关键词: Adherence; Adult; Advertisements; African American; Agreement; Ambulatory Care; Ambulatory Care Facilities; Anxiety; Behavior; Behavior Control; Behavioral; Biometry; COVID-19; COVID-19 morbidity; COVID-19 testing; Caring; Case Study; Catchment Area; Cessation of life; Chicago; Child; Clinic; Clinical Microbiology; Collaborations; Collection; Common Data Element; Communities; County; Coupled; Data; Data Analyses; Data Collection; Development; Diagnosis; Diagnostic Reagent Kits; Disclosure; Early Diagnosis; Economics; Effectiveness; Epidemiologic Monitoring; Epidemiology; Ethics; Exposure to; FDA approved; Food; Frequencies; Future; Glass; Health; Healthcare; Healthcare Systems; Home; Hospitals; Hour; Illinois; Individual; Infection; Infection Control; Informed Consent; Infrastructure; Intensive Care Units; Intervention; Knowledge; Laboratories; Latinx; Low income; Measures; Mediator of activation protein; Medical; Mental Health; Methods; Microbiology; Molecular; Monitor; Multilingualism; Neighborhoods; Nose; Participant; Patient Self-Report; Patients; Perception; Persons; PhenX Toolkit; Preparation; Quarantine; Radio; Recording of previous events; Research Methodology; Respiratory Tract Infections; Risk; Sampling; Schools; Secure; Sentinel; Site; Specimen; Stress; Swab; Test Result; Testing; Time; United States National Institutes of Health; Universities; Viral; Viral Load result; Washington; base; community engagement; community partnership; comparative effectiveness analysis; cooking; data acquisition; disparities in morbidity; empowerment; follow-up; health care availability; health disparity; high risk; intervention effect; literacy; mHealth; medically underserved; mortality; mortality disparity; multi-racial; nasal swab; novel; outreach; person centered; point of care testing; posters; prevent; racial and ethnic; racial and ethnic disparities; satisfaction; social; social capital; social determinants; social media; social stigma; testing uptake; theories; underserved community; uptake; willingness

Since the first U.S. cases were identified in Washington on January 20th and soon thereafter in Chicago on January 24th, COVID-19 has rapidly emerged as the most prevalent and deadly respiratory infection within the State of Illinois, with 220,178 total confirmed cases and 7,880 (3.6%) deaths. The UIC Hospital and Health Care System (UI Health), in collaboration with its 14 partnering Federally Qualified Mile Square Heath Center practice sites (FQHCs) (where this project will be implemented), saw over 4,000 of these cases between March and June, 2020 (6), noting the disproportionately higher rates if COVID-19 in Latinx people (47.1% with 32.7% of deaths) and in people identifying as African American or Black (28.9% with 43.1% of deaths). Of 48,111 cases reported in Cook County alone, 7,231 (15.0%) were hospitalized with 2,234 (4.6%) in an intensive care unit. These COVID-19-related morbidity and mortality disparities are accompanied by numerous other health disparities. Many of our FQHCs lack the staffing and revenue to test on-site and provide extensive follow-up outpatient care for the large influxes of symptomatic patients concerned about COVID-19. These challenges have likely resulted in increased COVID-19-related complications and deaths that might have been prevented with clearer and more accurate public messaging about COVID-19, wider access to testing, earlier diagnosis, and an increased perception that care is confidential, accessible, and self-driven. This project will employ sentinel and community-based epidemiological surveillance and participatory research methods to evaluate whether a person-centered, rapid COVID-19 testing intervention (at-home swab and send, or on-site point of care testing), coupled with a novel mHealth COVID-19 Literacy and Outreach Suite of apps and videos, will serve to increase the acceptance, access, reach, uptake, and impact of COVID-19 testing at UI Health and in the 14 FQHC practice sites and their corresponding catchment areas. We will also analyze the social, ethical, economic, and behavioral drivers and consequences of our outreach and testing approaches according to the degree to which participants contribute to the co-creation of study-related messaging. Finally, we will leverage our existing infrastructures to expand testing uptake and analyze (by PCR) viral load at infection onset/exposure and following onset/exposure to determine viral dynamics and identify individuals at early and late stages of infection. PhenX measures will be used to test intervention effects on testing and retesting uptake, time-to-diagnosis, COVID-19 knowledge, healthcare access and seeking, disclosure, medical adherence, and practice of home self-isolation, quarantine, and other infection control behaviors. All data acquisition, collection and curation approaches will be informed by the CDCC, including AboutML-informed consent approaches and with the other RADxUP studies and relevant federal agencies.

由于第一个美国案件于1月20日在华盛顿确定，此后不久在芝加哥确定 1月24日，Covid-19迅速成为最普遍，最致命的呼吸道感染 伊利诺伊州，共有220,178例确认病例和7,880例（3.6％）死亡。 UIC医院和健康 护理系统（UI Health）与其14个合作联邦合格的英里广场荒地中心合作 练习场（FQHCS）（将在此项目实施该项目），在3月之间看到了4,000多个案件 以及2020年6月（6），指出，如果与2019年的covid-19中的比率高度更高（47.1％，为32.7％ 死亡人数）和被识别为非裔美国人或黑人的人（28.9％，43.1％的死亡）。 48,111例 仅在库克县报道，重症监护病房中有7,231（15.0％）在2,234（4.6％）住院。 这些与19个相关的发病率和死亡率差异伴随着许多其他健康状况 差异。我们的许多FQHC缺乏测试现场测试的人员和收入，并提供广泛的随访 涉及Covid-19的有症状患者大量涌入的门诊护理。这些挑战 可能导致共同19-19相关的并发症和死亡的增加可能被阻止 关于COVID-19的更清晰，更准确的公共消息传递，更广泛地访问测试，较早的诊断， 以及人们对护理是机密，可访问和自我驱动的一种看法。这个项目将采用 哨兵和基于社区的流行病学监视和参与式研究方法评估 是以人为中心的快速共同的19测试干预措施（在家拭子和发送，或现场点 护理测试），再加上新颖的MHealth Covid-19素养和应用程序和视频的外展套件，将 有助于增加COVID-19对UI Health和UI Health和在 14个FQHC练习站点及其相应的集水区。我们还将分析社会，道德， 经济和行为驱动因素以及我们的外展和测试方法的后果 参与者有助于研究与研究相关的消息传递的程度。最后，我们将利用 我们现有的基础设施以扩大感染时的测试摄取和分析（通过PCR）病毒负载 发作/暴露和随后的发作/暴露以确定病毒动态并在早期和 感染的晚期。苯二甲苯克；将用于测试干预对测试和重新测试的影响 吸收时间，诊断时间，covid-19知识，医疗保健访问和寻求，披露，医疗依从性， 以及家庭自我隔离，隔离和其他感染控制行为的实践。所有数据获取， 收集和策展方法将由CDCC告知，包括大约有信息的同意 方法以及其他RADXUP研究和相关的联邦机构。