Research Project
10413517
SUMMARY Until there is widespread suppression of COVID-19, SARS-CoV-2 testing will remain an essential public health tool to monitor infection patterns and address outbreaks, especially in vulnerable populations. To date, the primary focus in public health has been on reduction of COVID-19 cases in the adult population, who experience higher mortality and complications compared to the pediatric population. Nonetheless, it has been noted that COVID-19 is impacting the health, safety, and well-being of children and their caregivers. Furthermore, there are limited reports on SARS-CoV-2 testing or COVID-19 vaccinations among children and youth with special healthcare needs or their caregivers. In collaboration with community partners, this RADx-UP Phase II project will enhance a statewide system to monitor COVID-19 testing and vaccination patterns to guide improvements in access to testing and vaccine uptake among high-risk pediatric populations, defined as those who either live in vulnerable areas or with special healthcare needs. This RADx-UP Phase II project will build on our previous work to leverage the unique infrastructure of CurrentCare, the Health Information Exchange (HIE) in Rhode Island (RI), which connects data across the entire RI healthcare ecosystem, to obtain clinical data for most people receiving care in RI including SARS-CoV-2 test results and vaccinations. A major objective of this project is to quantify the impact of vaccination on vulnerable populations, focused on children, in near real-time. We are uniquely positioned to build on our explanatory sequential mixed methods design to combine HIE quantitative data with focus group and interview data (from both community members and providers in community health clinics) to further address challenges with testing and vaccination. The specific aims of this project are to: (1) Identify vaccination rates relative to COVID-19 positivity rates for high-risk pediatric populations; (2) Determine barriers to SARS-CoV-2 testing and community hesitancy to COVID-19 vaccination; and (3) Implement community-based approaches to increase testing and vaccination rates for high-risk children. In accomplishing these aims, our approach is designed around community health teams, who will facilitate the improvement of SARS-CoV-2 diagnostic testing and work with community members to understand and address vaccine hesitancy. Community health teams are widely accepted lay heath educators who have demonstrated their effectiveness in addressing community health needs. We will develop and integrate culturally congruent tools to support understanding of vaccination and possible side effects, promote conversations that help individuals move to vaccine acceptance, help with scheduling of subsequent vaccination doses, as well as continue support for access to testing and post-testing guidance. This RADx-UP Phase II project will expand the community-based infrastructure that we have developed in Phase I for enabling structured, longitudinal relationships with underserved patient populations.
