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.

自 1 月 20 日在华盛顿发现美国首例病例以来，不久之后在芝加哥发现了第一例病例 1 月 24 日，COVID-19 已迅速成为国内最流行、最致命的呼吸道感染。 伊利诺伊州共有 220,178 例确诊病例，7,880 例死亡（3.6%）。 UIC 医院与健康中心 护理系统 (UI Health) 与其 14 个联邦合格的 Mile Square 健康中心合作 实践地点 (FQHC)（该项目将在此实施），3 月份期间出现了 4,000 多起此类案例 和 2020 年 6 月 (6)，注意到拉丁裔人群中 COVID-19 的发病率不成比例地较高（47.1% 和 32.7% 死亡人数）以及非裔美国人或黑人（28.9%，死亡人数 43.1%）。共 48,111 例 据报道，仅库克县就有 7,231 人（15.0%）住院治疗，其中 2,234 人（4.6%）在重症监护室。 这些与 COVID-19 相关的发病率和死亡率差异还伴随着许多其他健康问题 差异。我们的许多 FQHC 缺乏人员和收入来进行现场测试并提供广泛的后续行动 为大量涌入的担心 COVID-19 的有症状患者提供门诊护理。这些挑战 可能导致本可避免的与 COVID-19 相关的并发症和死亡增加 提供有关 COVID-19 的更清晰、更准确的公共信息、更广泛的检测机会、更早的诊断、 人们越来越认识到护理是保密的、可及的和自我驱动的。本项目将聘用 哨点和社区流行病学监测和参与性研究方法进行评估 是否采取以人为本的快速 COVID-19 检测干预措施（在家擦拭并发送，或现场检测点） 护理测试），再加上新颖的 mHealth COVID-19 识字和外展应用程序和视频套件，将 旨在提高 UI Health 和医疗机构对 COVID-19 检测的接受度、获取率、覆盖面、采用率和影响力 14个FQHC执业点及其相应的服务区域。我们还将分析社会、道德、 经济和行为驱动因素以及我们的推广和测试方法的后果 参与者对共同创造与研究相关的信息传递做出贡献的程度。最后，我们将利用 我们现有的基础设施可扩大检测范围并分析（通过 PCR）感染时的病毒载量 发病/暴露以及发病/暴露后确定病毒动态并尽早识别个体 感染的晚期阶段。 PhenX措施将用于测试测试和重新测试的干预效果 吸收率、诊断时间、COVID-19 知识、医疗保健获取和寻求、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。所有数据采集， 收集和管理方法将由 CDCC 告知，包括 AboutML 知情同意 方法以及其他 RADxUP 研究和相关联邦机构。