LinkUP: COVID-19 Intervention for Underserved Populations

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-03-15

Study Completion Date

2024-01-31

Brief Summary

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The goal of the present study is to evaluate a pilot intervention (LinkUP) to improve the uptake of COVID-19 testing and vaccination among PWID in San Diego County. Results will be shared with RADxUP consortium members, policymakers and program planners in California and across the US and used to estimate effect sizes for a future efficacy trial. Our study will inform efforts to leverage any of the 185 SSPs around the US as 'touchpoints' to reach marginalized communities, strengthening the nation's pandemic preparedness infrastructure to reduce COVID-19 health disparities.

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Detailed Description

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Together with our community partner, the Harm Reduction Coalition of San Diego's (HRCSD) OnPoint, a mobile safe syringe program (SSP), we will evaluate develop and evaluate an intervention to improve uptake of COVID-19 testing and vaccination. HRCSD's OnPoint will rely on UCSD's IRB review and approval for all aspects related to oversight of study and intervention implementation. Completion of primary endpoint data analyses was achieved on April 13, 2023. Study final completion date is January 31, 2024. Our Study Aims are :

1. To adapt an existing behavioral intervention incorporating motivational interviewing (MI) to improve uptake of HIV pre-exposure prophylaxis among people who inject drugs (PWID), by replacing the educational content with information intended to improve uptake of COVID19 testing and COVID19 vaccination.
2. To pilot test the intervention in Aim 1 (called LinkUP) at OnPoint's 4 mobile SSP locations across San Diego County. We expect that the LinkUP intervention will be acceptable to PWID and considered feasible and sustainable by OnPoint staff and the project's Community Scientific Advisory Board (CSAB).

Conditions

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Motivational Interviewing

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

The four OnPoint syringe exchange locations will be randomized to deliver either the active (intervention) or didactic (control) version of the LinkUP intervention. The randomization scheme will be developed using an algorithm by La Frontera's statistician. Half way into enrollment, there will be a one-week 'washout' period, after which time the two original intervention syringe exchange sites will become control sites and the two original control sites will become intervention sites. This cluster randomization scheme will help ensure that no neighborhood in San Diego County is denied access to the LinkUP intervention. By the end of the study, 75 LinkUP participants will have been randomized to an intervention site and 75 will have been randomized to a control site.

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Investigators

Neither study participants or principal investigator will know which group participants have been assigned to.

Study Groups

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LinkUP Active intervention

The counselor will present basic evidence-based COVID-19 information on SARS-CoV-2 biology and epidemiology, testing and the safety and efficacy of available COVID-19 vaccines. The counselor will also address COVID-19 misinformation (e.g., that COVID is no worse than the flu), and COVID-19 disinformation (e.g., that COVID vaccines include a tracking device).

The LinkUP active intervention combines education, motivational interviewing (MI), problem-solving, and ongoing support from peer counselors. Through an open discussion with one of OnPoint's peer counselors who are trained in MI, the counselor will present evidence-based COVID-19 information. Next, the counselor will attempt to identify the participant's concerns about COVID-19 and vaccination in an attempt to tip their decisional balance.

Group Type EXPERIMENTAL

COVID-19 education

Intervention Type BEHAVIORAL

This session will be completed within 45 minutes. The LinkUP intervention will be available in English and Spanish.

LinkUP Control Condition (didactic intervention)

As described above, the control condition is a one-way sharing of COVID-19 information presented by an OnPoint counselor. The counselor will be instructed to answer any questions the participant may have but will not engage in motivational interviewing counseling. The same educational materials used in the LinkUP intervention module will be used for this session and it will be completed within 45 minutes.

Group Type PLACEBO_COMPARATOR

COVID-19 education

Intervention Type BEHAVIORAL

This session will be completed within 45 minutes. The LinkUP intervention will be available in English and Spanish.

Interventions

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COVID-19 education

This session will be completed within 45 minutes. The LinkUP intervention will be available in English and Spanish.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

1. Enrolled in La Frontera,

AND
2. Report NOT having been voluntarily tested for COVID-19 outside of La Frontera or report having had a mandatory COVID-19 test more than 2 months ago

AND
3. a) Never vaccinated OR b) Received 1 shot of the Moderna vaccine (\>=1 month ago) OR c) received 1 shot of the Pfizer vaccine (\>=3 weeks ago) OR d) received 1 shot of the Jenssen vaccine (\>=2 months ago) OR e) received 2 shots of the Moderna OR Pfizer vaccine (last shot \>=5 months ago) OR f) received 1 shot of another vaccine (\>=1 month ago) OR g) received 2 shots of another vaccine (last shot \>=5 months ago). NOTE: participants who indicate that they were vaccinated but don't remember what vaccine they received would fall under the f category if they only received one shot and under the g category if they received 2 shots.

OR
4. Enrolled in La Frontera AND report TWO or more of the following symptoms: a) new loss of smell or taste, b) cough, c) sore throat/congestion/runny nose, d) skin rash within the last week without having tested positive for COVID within the last month.

OR
5. Enrolled in La Frontera AND report having EITHER fever/chills OR shortness of breath within the last week without having tested positive for COVID within the last month.

Exclusion Criteria

1. Not enrolled in La Frontera,

AND
2. Report having been voluntarily tested for COVID-19 outside of La Frontera or report having had a mandatory COVID-19 test less than 2 months ago

AND
3. a) Be vaccinated OR b) Received 1 shot of the Moderna vaccine (\<1 month ago) OR c) received 1 shot of the Pfizer vaccine (\<3 weeks ago) OR d) received 1 shot of the Jenssen vaccine (\<2 months ago) OR e) received 2 shots of the Moderna OR Pfizer vaccine (last shot \<5 months ago) OR f) received 1 shot of another vaccine (\<1 month ago) OR g) received 2 shots of another vaccine (last shot \<5 months ago). NOTE: participants who indicate that they were vaccinated but don't remember what vaccine they received would fall under the f category if they only received one shot and under the g category if they received 2 shots.

OR
4. Not enrolled in La Frontera AND do NOT report TWO or more of the following symptoms: a) new loss of smell or taste, b) cough, c) sore throat/congestion/runny nose, d) skin rash within the last week without having tested positive for COVID within the last month.

OR
5. Not enrolled in La Frontera AND do NOT report having EITHER fever/chills OR shortness of breath within the last week without having tested positive for COVID within the last month.

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Responsible Party

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Steffanie Strathdee

Distinguished Professor and Harold Simon Chair, Associate Dean of Global Health Sciences, Division of Infectious Disease and Global Public Health, UCSD Department of Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR