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Tytuł pozycji:

Evaluation of a novel community-based COVID-19 'Test-to-Care' model for low-income populations.

Tytuł :
Evaluation of a novel community-based COVID-19 'Test-to-Care' model for low-income populations.
Autorzy :
Kerkhoff AD; Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States of America.
Sachdev D; San Francisco Department of Public Health, San Francisco, CA, United States of America.
Mizany S; The San Francisco Latino Task Force on COVID-19, San Francisco, CA, United States of America.
Rojas S; The San Francisco Latino Task Force on COVID-19, San Francisco, CA, United States of America.
Gandhi M; Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States of America.
Peng J; Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States of America.
Black D; Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States of America.
Jones D; Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States of America.
Rojas S; The San Francisco Latino Task Force on COVID-19, San Francisco, CA, United States of America.
Jacobo J; The San Francisco Latino Task Force on COVID-19, San Francisco, CA, United States of America.
Tulier-Laiwa V; The San Francisco Latino Task Force on COVID-19, San Francisco, CA, United States of America.
Petersen M; Division of Epidemiology and Biostatistics, The School of Public Health, University of California, Berkeley, Berkeley, CA, United States of America.
Martinez J; Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States of America.
Chamie G; Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States of America.
Havlir DV; Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States of America.
Marquez C; Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States of America.
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Źródło :
PloS one [PLoS One] 2020 Oct 09; Vol. 15 (10), pp. e0239400. Date of Electronic Publication: 2020 Oct 09 (Print Publication: 2020).
Typ publikacji :
Journal Article; Research Support, Non-U.S. Gov't
Język :
English
Imprint Name(s) :
Original Publication: San Francisco, CA : Public Library of Science
MeSH Terms :
Models, Theoretical*
Poverty*
Coronavirus Infections/*diagnosis
Pneumonia, Viral/*diagnosis
Adolescent ; Adult ; Aged ; Betacoronavirus/genetics ; Betacoronavirus/isolation & purification ; Child ; Child, Preschool ; Community Health Workers/education ; Community Health Workers/psychology ; Coronavirus Infections/economics ; Coronavirus Infections/therapy ; Coronavirus Infections/virology ; Female ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Pandemics/economics ; Pneumonia, Viral/economics ; Pneumonia, Viral/therapy ; Pneumonia, Viral/virology ; Primary Health Care ; Quarantine ; Social Support ; Surveys and Questionnaires ; Young Adult
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Grant Information :
T32 AI060530 United States AI NIAID NIH HHS
SCR Disease Name :
COVID-19
Entry Date(s) :
Date Created: 20201009 Date Completed: 20201021 Latest Revision: 20201113
Update Code :
20201116
PubMed Central ID :
PMC7546468
DOI :
10.1371/journal.pone.0239400
PMID :
33035216
Czasopismo naukowe
Background: After a COVID-19 diagnosis, vulnerable populations face considerable logistical and financial challenges to isolate and quarantine. We developed and evaluated a novel, community-based approach ('Test-to-Care' Model) designed to address these barriers for socioeconomically vulnerable Latinx individuals with newly diagnosed COVID-19 and their households.
Methods: This three-week demonstration project was nested within an epidemiologic surveillance study in a primarily Latinx neighborhood in the Mission district of San Francisco, California. The Test-to-Care model was developed with input from community members and public health leaders. Key components included: (1) provision of COVID-19-related education and information about available community resources, (2) home deliveries of material goods to facilitate safe isolation and quarantine (groceries, personal protective equipment and cleaning supplies), and (3) longitudinal clinical and social support. Newly SARS-CoV-2 PCR-positive participants were eligible to participate. Components of the model were delivered by the Test-to-Care team, which was comprised of healthcare providers and community health workers (CHWs) who provided longitudinal clinic- and community-based support for the duration of the isolation period to augment existing services from the Department of Public Health (DPH). We evaluated the Test-to-Care Model using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) Framework and drew upon multiple data sources including: programmatic data, informal interviews with participants and providers/CHWs and structured surveys among providers/CHWs.
Results: Overall, 83 participants in the surveillance study were diagnosed with COVID-19, of whom 95% (79/83) were Latinx and 88% (65/74) had an annual household income <$50,000. Ninety-six percent (80/83) of participants were reached for results disclosure, needs assessment and DPH linkage for contact tracing. Among those who underwent an initial needs assessment, 45% (36/80) were uninsured and 55% (44/80) were not connected to primary care. Sixty-seven percent (56/83) of participants requested community-based CHW support to safely isolate at their current address and 65% (54/83) of all COVID-19 participants received ongoing community support via CHWs for the entire self-isolation period. Participants reported that the intervention was highly acceptable and that their trust increased over time-this resulted in 9 individuals who disclosed a larger number of household members than first reported, and 6 persons who requested temporary relocation to a hotel room for isolation despite initially declining this service; no unintended harms were identified. The Test-to-Care Model was found to be both acceptable and feasible to providers and CHWs. Challenges identified included a low proportion of participants linked to primary care despite support (approximately 10% after one month), and insufficient access to financial support for wage replacement.
Conclusions: The Test-to-Care Model is a feasible and acceptable intervention for supporting self-isolation and quarantine among newly diagnosed COVID-19 patients and their households by directly addressing key barriers faced by socioeconomically vulnerable populations.
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