Core C Clinical Core

核心 C 临床核心

• 批准号: 10267800
• 负责人: MICHAEL J MUGAVERO
• 金额: $ 332.36万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-23 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10267800
• 关键词: 2019-nCoV; AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Advocate; African American; Alabama; Algorithms; Americas; Area; Asians; Behavioral; COVID-19; COVID-19 pandemic; Centers for Disease Control and Prevention (U.S.); Clinical; Collaborations; Communities; Community Health; Community Health Aides; Contact Tracing; Country; County; Data; Deep South; Disease; Effectiveness; Epidemic; Epidemiology; Ethics; Ethnic Origin; European; Evaluation; Foundations; Future; Geography; HIV; Health; Health education; Human immunodeficiency virus test; Individual; Infrastructure; Interview; Knowledge; Location; Medical; Methods; Modeling; Morbidity - disease rate; Persons; Phase; Population; Positioning Attribute; Preparation; Process; Public Health; Race; Research; Research Design; Research Personnel; Research Support; Resources; Risk Factors; Rural; Rural Community; Scientist; Series; System; Test Result; Testing; Time; Training; United States; Universities; Update; Vulnerable Populations; Work; base; combat; community partnership; comparative; coronavirus disease; design; evidence base; experience; experimental study; indexing; infection rate; innovation; meetings; metropolitan; mortality; novel virus; pandemic disease; peer; primary outcome; programs; public health intervention; racism; response; rural counties; rural underserved; scale up; secondary outcome; social; social stigma; socioeconomic disadvantage; socioeconomics; success; uptake; vaccination strategy

Alabama is ranked as the state most vulnerable to COVID-19 by the community vulnerability index, and among the bottom 5 states in meeting SARS-CoV-2 testing targets. COVID-19 case rates are 3-fold higher in several rural counties in Alabama relative to metropolitan areas like Birmingham, with SARS-CoV-2 testing percent positivity approaching or exceeding 20% in a majority of rural counties. Meaningful community engagement in developing and implementing SARS-CoV-2 testing programs is vital to proactively address social, ethical and behavioral considerations germane to underserved communities. University of Alabama at Birmingham (UAB) Center for AIDS Research (CFAR) investigators have long-standing relationships working with clinical, community, and public health agencies to conduct innovative HIV testing and prevention studies, and are poised to act swiftly in response to the COVID-19 pandemic. A Dynamic COVID-19 Community-Engaged Testing Strategy in Alabama (COVID COMET AL) will transfer vast community-informed HIV testing knowledge to address the urgent need for rapid scale-up of SARS-CoV-2 testing among underserved rural, socio-economically disadvantaged, and Black/African American populations. COVID COMET AL is grounded in the ADAPT framework for tailoring evidence-based public health interventions for new settings and populations, and includes Assessment, Preparation, and Implementation phases. In collaboration with well-established clinical and community testing partners, regional health education centers, and additional community-based organizations, CFAR investigators will work together with interdisciplinary scientists from across campus at UAB to conduct the following specific aims: Aim 1 (Assessment): Refine a data-driven, time-updated algorithm to identify the underserved rural counties most impacted by COVID-19 in Alabama, Aim 2 (Preparation): Use a communityengaged sequential mixed-methods approach to inform tailored adaptation and implementation of the COVID COMET AL strategy in highly impacted rural counties selected for implementation, Aim 3 (Implementation): Deploy the iteratively adapted COVID COMET AL strategy, which includes peer health advocates, community health workers, and venue based testing, in 3 highly impacted rural Alabama counties at a time, in two sequential waves, each lasting 6-months, and Aim 4: Evaluate the implementation process of COVID COMET AL in partnering with community stakeholders to maximize program reach, effectiveness, and sustainability. Using a quasi-experimental, paired, comparative time series study design, temporal change in SARS-CoV-2 testing percent positivity will be compared in the 6 implementation counties relative to 6 matched control counties as the primary outcome, with testing reach, time to return test results, and time to contact tracing as secondary outcomes. Evaluation of COVID COMET AL implementation grounded in the Interactive Systems Framework will inform dissemination of this dynamic, data-driven public health testing strategy to maximize impact in addressing disparities in underserved rural communities, and will also guide COVID-19 vaccination strategies

阿拉巴马州被评为最容易受到社区脆弱性指数的国家，以及 在满足SARS-COV-2测试目标的底部5个州。 COVID-19病例率在几个中高3倍 阿拉巴马州的农村县相对于伯明翰等大都市地区，SARS-COV-2测试百分比 大多数农村县接近或超过20％的积极性。有意义的社区参与 制定和实施SARS-COV-2测试计划对于主动解决社会，道德和 行为方向对服务不足的社区的依密考虑。阿拉巴马大学伯明翰（UAB） 艾滋病研究中心（CFAR）研究人员与临床合作有长期的关系， 社区和公共卫生机构进行创新的艾滋病毒测试和预防研究，并有望 迅速对19009年大流行作用。动态的COVID-19社区参与测试 阿拉巴马州的策略（Covid Comet al）将将广泛的社区信息测试知识转移到 迫切需要在服务不足的农村，社会经济上快速扩大SARS-COV-2测试 处境不利，黑人/非裔美国人人口。 Covid Comet Al扎根于适应 针对新的环境和人群调整基于证据的公共卫生干预措施的框架，其中包括 评估，准备和实施阶段。与公认的临床合作 社区测试合作伙伴，区域卫生教育中心和其他基于社区的组织， CFAR调查人员将与来自UAB校园的跨学科科学家合作，进行 以下具体目的：目标1（评估）：完善数据驱动的，更新的算法以识别 服务不足的农村县受到阿拉巴马州Covid-19的影响最大 在被选为实施的高度影响的农村县的彗星战略，AIM 3（实施）： 部署迭代改编的Covid Comet Al策略，其中包括同伴健康倡导者，社区 卫生工作者和基于场地的测试，一次在阿拉巴马州的3个高度影响的农村县中，两个顺序 波浪，每个持续6个月，目标4：评估Covid Comet al的实施过程 与社区利益相关者合作，以最大程度地提高计划覆盖范围，有效性和可持续性。使用 准实验，配对，比较时间序列研究设计，SARS-COV-2测试的时间变化 相对于6个匹配的控制县，将在6个实施县中比较阳性百分比 主要结果，随着测试范围，返回测试结果的时间以及接触次要跟踪的时间 结果。在交互式系统框架中基于的Covid Comet Al实施的评估 将告知传播这种动态，数据驱动的公共卫生测试策略，以最大程度地影响 解决服务不足的农村社区的差异，还将指导Covid-19疫苗接种策略