Implementing expanded COVID-19 testing in Massachusetts community health centers through community partnerships: Protocol for an interrupted time series and stepped wedge study design.

COVID-19 testing Community health centers Community-engaged research Health equity Implementation science

Journal

Contemporary clinical trials
ISSN: 1559-2030
Titre abrégé: Contemp Clin Trials
Pays: United States
ID NLM: 101242342

Informations de publication

Date de publication:
07 2022
Historique:
received: 27 01 2022
revised: 15 04 2022
accepted: 01 05 2022
pubmed: 10 5 2022
medline: 22 6 2022
entrez: 9 5 2022
Statut: ppublish

Résumé

Community Health Centers (CHCs) are a critical source of care for low-income and non-privately insured populations. During the pandemic, CHCs have leveraged their infrastructure and role as a trusted source of care to engage the communities they serve in COVID-19 testing. To directly address the impact that COVID-19 has had on historically marginalized populations in Massachusetts, we designed a study of community-engaged COVID-19 testing expansion: (1) leveraging existing partnerships to accelerate COVID-19 testing and rapidly disseminate effective implementation strategies; (2) incorporating efforts to address key barriers to testing participation in communities at increased risk for COVID-19; (3) further developing partnerships between communities and CHCs to address testing access and disparities; (4) grounding the study in the development of a shared ethical framework for advancing equity in situations of scarcity; and (5) developing mechanisms for communication and science translation to support community outreach. We use a controlled interrupted time series design, comparing number of COVID-19 tests overall and among people identified as members of high-risk groups served by intervention CHCs compared with six matched control CHCs in Massachusetts, followed by a stepped wedge design to pilot test strategies for tailored outreach by CHCs. Here, we describe a community-partnered strategy to accelerate COVID-19 testing in historically marginalized populations that provides ongoing resources to CHCs for addressing testing needs in their communities. The study aligns with principles of community-engaged research including shared leadership, adequate resources for community partners, and the flexibility to respond to changing needs over time.

Sections du résumé

BACKGROUND
Community Health Centers (CHCs) are a critical source of care for low-income and non-privately insured populations. During the pandemic, CHCs have leveraged their infrastructure and role as a trusted source of care to engage the communities they serve in COVID-19 testing.
METHODS
To directly address the impact that COVID-19 has had on historically marginalized populations in Massachusetts, we designed a study of community-engaged COVID-19 testing expansion: (1) leveraging existing partnerships to accelerate COVID-19 testing and rapidly disseminate effective implementation strategies; (2) incorporating efforts to address key barriers to testing participation in communities at increased risk for COVID-19; (3) further developing partnerships between communities and CHCs to address testing access and disparities; (4) grounding the study in the development of a shared ethical framework for advancing equity in situations of scarcity; and (5) developing mechanisms for communication and science translation to support community outreach. We use a controlled interrupted time series design, comparing number of COVID-19 tests overall and among people identified as members of high-risk groups served by intervention CHCs compared with six matched control CHCs in Massachusetts, followed by a stepped wedge design to pilot test strategies for tailored outreach by CHCs.
CONCLUSIONS
Here, we describe a community-partnered strategy to accelerate COVID-19 testing in historically marginalized populations that provides ongoing resources to CHCs for addressing testing needs in their communities. The study aligns with principles of community-engaged research including shared leadership, adequate resources for community partners, and the flexibility to respond to changing needs over time.

Identifiants

pubmed: 35533978
pii: S1551-7144(22)00109-4
doi: 10.1016/j.cct.2022.106783
pmc: PMC9076025
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

106783

Subventions

Organisme : NHLBI NIH HHS
ID : K24 HL159680
Pays : United States
Organisme : NCI NIH HHS
ID : P50 CA244433
Pays : United States
Organisme : NCI NIH HHS
ID : U54 CA156732
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002541
Pays : United States

Informations de copyright

Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

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Auteurs

Gina R Kruse (GR)

Massachusetts General Hospital, Division of General Internal Medicine, Boston, MA 02114, USA; Harvard Medical School, Boston, MA 02114, USA. Electronic address: gkruse@mgh.harvard.edu.

Leslie Pelton-Cairns (L)

Massachusetts League of Community Health Centers, Boston, MA 02114, USA.

Elsie M Taveras (EM)

Harvard Medical School, Boston, MA 02114, USA; Massachusetts General Hospital, Kraft Center for Community Health, Boston, MA 02114, USA; Massachusetts General Hospital, Division of Academic Pediatrics, Boston, MA 02114, USA.

Susan Dargon-Hart (S)

Massachusetts League of Community Health Centers, Boston, MA 02114, USA.

Daniel A Gundersen (DA)

Dana Farber Cancer Institute, Division of Population Sciences, Boston, MA, USA.

Rebekka M Lee (RM)

Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, USA; Harvard Catalyst | The Harvard Clinical and Translational Science Center, Boston, MA, USA.

Barbara E Bierer (BE)

Harvard Medical School, Boston, MA 02114, USA; Harvard Catalyst | The Harvard Clinical and Translational Science Center, Boston, MA, USA; Brigham and Women's Hospital, Boston, MA, USA.

Erica Lawlor (E)

Harvard Medical School, Boston, MA 02114, USA; Harvard Catalyst | The Harvard Clinical and Translational Science Center, Boston, MA, USA.

Regina C LaRocque (RC)

Harvard Medical School, Boston, MA 02114, USA; Massachusetts General Hospital, Division of Infectious Diseases, Boston, MA 02114, USA.

Julia L Marcus (JL)

Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.

Madeline E Davies (ME)

Massachusetts General Hospital, Kraft Center for Community Health, Boston, MA 02114, USA.

Karen M Emmons (KM)

Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, USA; Harvard Catalyst | The Harvard Clinical and Translational Science Center, Boston, MA, USA.

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Classifications MeSH