dbGaP Study Accession: phs002906

NIH Institute/Center: NIDA

RADx Data Program: RADx-UP

Release Date: 08/30/2023

DOI: 10.60773/enx6-h124

Study Description: New York City (NYC) is a global epicenter of the SARS-CoV-2/COVID-19 pandemic, with 222,000 cases and more than 25,000 deaths at the time of study. Neighborhood-level disparities in cases and deaths in NYC can be explained by socioeconomic and racial/ethnic characteristics, where Latinx and Black New Yorkers and those living in high poverty neighborhoods are 1.5 times more likely to test positive and more than twice as likely to die as a result of COVID-19. The community of Mott Haven is located in the South Bronx - the poorest congressional district within the continental United States. Mott Haven is highly diverse (73% are Latinx and 24% are Black), and COVID-19 mortality was once among the highest NYC and higher than in NYC as a whole - an epicenter within an epicenter. Yet, although Mott Haven is clearly a priority community for COVID-related prevention, detection, vaccination, and treatment initiatives, fewer than 2% of residents had been tested at the time of study. COVID-19 secondary attack rates are highest in households, varying between 12-38%. This project involved a COVID-19 testing and mitigation intervention in public housing households in Mott Haven, which are characterized by crowding, intergenerational co-residence, and a high proportion of low wage "essential workers" who leave the home for work even during lockdown periods. This project evaluated the effectiveness of an innovative Nurse-Community Health Worker (CHW)-Family Partnership intervention designed to promote COVID-19 testing uptake, adoption of COVID-19 control measures, and mutual aid capacity at the household level. The intervention was adapted from the Nurse-Family Partnership model, which has been shown to be effective and cost-effective in improving maternal and child health outcomes in high-poverty, racially- and ethnically-diverse communities. CHWs provided culturally-appropriate support to families, addressing stigma, medical mistrust, and other common barriers to engagement in healthcare. A 2-arm randomized controlled trial was conducted, in which 270 households (810 individuals) were randomly assigned (2:1) to either the experimental group of families who received the Nurse-CHW-Family Partnership intervention and the offer of in-home testing, or the treatment-as-usual control group referred to free testing located within walking distance. Participants in both arms were assessed at baseline and monthly for 9 months. The findings from this study provided an evidence-base to inform current and future public health initiatives related to COVID-19 mitigation in other high-risk settings. Sustainability was addressed by building local capacity and expertise among participants, CHWs and CAB members, and partnering with them to develop the community's best practices for COVID-19. This intervention can be tailored to increase testing and other COVID-19 control measures in other settings of vulnerability and disadvantage.

Updated Date: 04/17/2024

Principal Investigator: Hagan, Holly

Has Data Files: Yes

Study Domain: Community Outreach Programs; Diagnostic Testing; Social Determinants of Health; Testing Rate or Uptake

Data Collection Method: Survey

Keywords: COVID in Public Housing; Congregate Settings; Individuals Living in Public Housing

Study Design: Case-Control

Multi-Center Study: No

Data Types: Behavioral; Cognitive; Environmental; Psychological; Questionnaire or Survey; Social

Study Start Date: 09/24/2020

Study End Date: 08/31/2022

Species: Human

Estimated Cohort Size: 810

Study Population Focus: Adults; African Americans; Hispanics or Latinos; Lower Socioeconomic Status (SES) Populations; Older Adults or Elderly; Racial or Ethnic Minorities; Underserved or Vulnerable Populations

ClinicalTrials.gov URL: https://clinicaltrials.gov/study/NCT04832919

Publication URL: https://pubmed.ncbi.nlm.nih.gov/33743850/

Acknowledgement Statement: This study was supported through funding, 3P30DA011041-25S1, for the National Institute on Drug Abuse (NIDA) as part of the RADx-UP program. We would also like to acknowledge the contributions of project staff and participants. Approved users should acknowledge the provision of data access by dbGaP for accession phs002906.v1.p1, and the NIH RADx Data Hub. Approved users should also acknowledge the specific version(s) of the dataset(s) obtained from the NIH RADx Data Hub.

Funding Opportunity Announcement (FOA) Number: PAR-14-186

NIH Grant or Contract Number(s): 3P30DA011041-25S1

Consent/Data Use Limitations: General Research Use