Community-engaged optimization of COVID-19 rapid evaluation and testing experiences: roll-out implementation optimization trial

Implementation Science

Study Protocol

Marva Seifert¹  Maria Linda Burola²  Louise C. Laurent²  Justin D. Smith³  Kelli L. Cain⁴  Jingjing Zou⁴  Sharon F. Velasquez⁵  Fatima A. Munoz⁵  Linda Salgin⁶  William Oswald⁷  Paul Watson⁷  Nicole A. Stadnick⁸  Borsika A. Rabin⁹ 

[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 Population Health Sciences, Division of Health System Innovation and Research, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA;Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA;San Ysidro Health, San Diego, CA, USA;San Ysidro Health, San Diego, CA, USA;Joint Doctoral Program in Public Health School, UC San Diego and San Diego State University, San Diego, CA, USA;The Global Action Research Center, San Diego, CA, USA;University of California San Diego Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center, La Jolla, CA, USA;Department of Psychiatry, University of California San Diego, La Jolla, CA, USA;Child and Adolescent Services Research Center, San Diego, USA;University of California San Diego Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center, La Jolla, CA, USA;Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA;

关键词: Implementation science;    COVID-19;    Underserved communities;    Health equity;    Promotores;    Testing;    Roll out implementation optimization design;    RE-AIM framework;   

DOI  :  10.1186/s13012-023-01306-y

 received in 2023-08-24, accepted in 2023-09-18,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThere continues to be a need for COVID-19 testing that is pragmatic, community-centered, and sustainable. This study will refine and test implementation strategies prioritized by community partners: (1) walk-up no-cost testing, (2) community health worker (promotores)-facilitated testing and preventive care counseling, (3) vending machines that dispense no-cost, self-testing kits.MethodsA co-designed Theory of Change from an earlier study phase and the Practical, Robust Implementation and Sustainment Model (PRISM) will guide the study design, measures selection, and evaluation. The first aim is to refine and operationalize a multi-component implementation strategy bundle and outcome measures for COVID-19 testing. A Community and Scientific Advisory Board (CSAB) will be established and include community members, clinical providers/staff from the partnering Federally Qualified Health Center (FQHC), public health researchers, policymakers, and a county health department ambassador. Engagement of CSAB members will be assessed through structured ethnography and a survey about the quality and quantity of engagement practices. The second aim is to implement and evaluate the impact of the implementation strategy bundle to optimize COVID-19 testing in communities using a roll-out implementation optimization (ROIO) design. Seven thousand and five hundred community members will be enrolled across four FQHC clinics over 18 months. Participants will be invited to complete an electronic survey about their demographics, health, and COVID-19 testing results and experiences. CSAB members and clinic partners will participate in PRISM fit and determinant assessments prior to each clinic rollout and post-trial. Interviews will be conducted with 60 community participants and 12 providers/staff following a 3-month rollout period at each clinic, inquiring about their experiences with the implementation strategies. Quantitative data will be analyzed using hierarchical multilevel models to determine the impact of implementation strategies. Qualitative data will be analyzed using rapid qualitative approaches to summarize implementation experiences and identify necessary changes prior to subsequent rollouts. A matrix approach will be used to triangulate data from quantitative and qualitative sources based on PRISM domains.DiscussionThis is one of the first pragmatic implementation trials to use a ROIO design and aims to co-create a sustainable and equitable COVID-19 testing program. Findings are likely to generalize to other public health prevention efforts.Trial registrationNCT05894655 March 2, 2023.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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