This time sensitive proposal, Getting Asian Americans INFORMED to Facilitate COVID-19 Testing and Vaccinations, is to identify and address sociocultural, ethical and behavioral barriers related to COVID-19 testing and vaccination to enable Asian Americans to make well-informed decisions about getting tested for COVID-19. Asian Americans have experienced among the highest COVID-19 mortality rates when measured in case fatality and proportionate mortality due to COVID-19. Excess COVID-19 related deaths observed in Asian Americans are in part due to under-testing. Asian Americans may face multiple challenges, including sociocultural (limited English proficiency, lack of trust, excess fears and social stigma related COVID-19), ethical (lack of proven benefits of various guidelines, unequal access to testing resources), and behavioral (tobacco and e-cigarette use, other competitive behaviors) factors. The pandemic is rapidly evolving and presents urgent needs to develop highly efficient channels to communicate accurate, easily comprehensive, cultural appropriate and practical information. This application is a supplement to a parent R01 ?A Family- Focused Intervention for Asian American Male Smokers,? as known to the public as a community-based intervention research program ?Healthy Family Project.? The Healthy Family Project has provided more than 1,100 smokers and families a family-oriented intervention delivered by lay health workers (LHW) showing efficacies in in reducing tobacco use and promoting healthy nutrition and physical activity among Chinese and Vietnamese Americans. Prior to the parent R01, our team tested LHW interventions targeting individual behavior change in increasing colorectal, cervical and breast cancer screening and hepatitis B and C testing, and healthy nutrition and physical activity among Chinese, Hmong, Korean, Filipino and Vietnamese Americans. Leveraging the community partnerships and the individual / family-based LHW intervention approaches that we developed, we propose these aims: (1) Develop and evaluate ?INdividual and Family- Oriented Responsive Messaging EDucation? (INFORMED) intervention in increasing knowledge about COVID- 19 testing and decreasing decisional conflicts of getting tested for COVID-19. A 2-arm randomized controlled trial will compare INFORMED delivered by LHW educational outreach plus SMS text messaging to SMS text with LHW support. (2) Conduct in-depth prospective investigation of sociocultural, ethical and behavioral factors related to COVID-19 testing in Chinese, Hmong and Vietnamese American over-time. In addition, we will explore factors affecting acceptance for vaccination research trial participation and vaccination uptake and how vaccination acceptance is associated with COVID-19 testing uptake.
The COVID-19 pandemic has brought unprecedented burdens to communities of color, including Asian Americans. Excess COVID-19 related deaths observed in Asian Americans are in part due to under-testing. This is the first study to use a novel approach ?Individual and Family-Oriented Responsive Messaging and Education? (INFORMED) combining lay health worker education outreach with automated text messaging to facilitate COVID-19 testing uptake in Chinese, Hmong and Vietnamese Americans from both urban and rural communities.
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