Scaling and sustaining COVID-19 vaccination through meaningful community engagement and care coordination for underserved communities: hybrid type 3 effectiveness-implementation sequential multiple assignment randomized trial

Implementation Science

Study Protocol

Marva Seifert¹  Louise C. Laurent²  Audra R. Meadows³  Sean T. O’Leary⁴  Santosh Vijaykumar⁵  Miguel Villodas⁶  Nicole A. Stadnick⁷  Kelli L. Cain⁸  Borsika A. Rabin⁹  Jeannette Aldous^1,10  Fatima A. Munoz^1,10  Linda Salgin^1,10  Edgar A. Diaz^1,10  William Oswald^1,11  Paul Watson^1,11 

[1] Department of Medicine, University of California San Diego, La Jolla, CA, USA;Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA;Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA;Department of Medicine, University of California San Diego, La Jolla, CA, USA;Department of Pediatrics-Infectious Diseases, University of Colorado Anschutz Medical Campus, Aurora, CO, USA;Department of Psychology, Northumbria University, Newcastle Upon Tyne, UK;Department of Psychology, San Diego State University, San Diego, CA, USA;Child and Adolescent Services Research Center, San Diego, CA, USA;Dissemination and Implementation Science Center, University of California San Diego Altman Clinical and Translational Research Institute, La Jolla, CA, USA;Child and Adolescent Services Research Center, San Diego, CA, USA;Department of Psychiatry, University of California San Diego, La Jolla, CA, USA;Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA;Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA;Dissemination and Implementation Science Center, University of California San Diego Altman Clinical and Translational Research Institute, La Jolla, CA, USA;San Ysidro Health, San Diego, CA, USA;The Global Action Research Center, San Diego, CA, USA;

关键词: Implementation science;    Hybrid type 3 effectiveness-implementation study;    Sequential multiple assignment randomized trial;    COVID-19;    Underserved communities;    Health equity;    Care coordination;    mHealth;    Vaccination;   

DOI  :  10.1186/s13012-023-01283-2

 received in 2023-05-17, accepted in 2023-06-18,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundCOVID-19 inequities are abundant in low-income communities of color. Addressing COVID-19 vaccine hesitancy to promote equitable and sustained vaccination for underserved communities requires a multi-level, scalable, and sustainable approach. It is also essential that efforts acknowledge the broader healthcare needs of these communities including engagement in preventive services.MethodsThis is a hybrid type 3 effectiveness-implementation study that will include a multi-level, longitudinal, mixed-methods data collection approach designed to assess the sustained impact of a co-created multicomponent strategy relying on bidirectional learning, shared decision-making, and expertise by all team members. The study capitalizes on a combination of implementation strategies including mHealth outreach with culturally appropriate messaging, care coordination to increase engagement in high priority preventive services, and the co-design of these strategies using community advisory boards led by Community Weavers. Community Weavers are individuals with lived experience as members of an underserved community serving as cultural brokers between communities, public health systems, and researchers to co-create community-driven, culturally sensitive public health solutions. The study will use an adaptive implementation approach operationalized in a sequential multiple assignment randomized trial design of 300 participants from three sites in a Federally Qualified Health Center in Southern California. This design will allow examining the impact of various implementation strategy components and deliver more intensive support to those who benefit from it most. The primary effectiveness outcomes are COVID-19 vaccine completion, engagement in preventive services, and vaccine confidence. The primary implementation outcomes are reach, adoption, implementation, and maintenance of the multicomponent strategy over a 12-month follow-up period. Mixed-effects logistic regression models will be used to examine program impacts and will be triangulated with qualitative data from participants and implementers.DiscussionThis study capitalizes on community engagement, implementation science, health equity and communication, infectious disease, and public health perspectives to co-create a multicomponent strategy to promote the uptake of COVID-19 vaccination and preventive services for underserved communities in San Diego. The study design emphasizes broad engagement of our community and clinic partners leading to culturally sensitive and acceptable strategies to produce lasting and sustainable increases in vaccine equity and preventive services engagement.Trial registrationClinicalTrials.gov Identifier: NCT05841810 May 3, 2023

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 8