Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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ACTIVE_NOT_RECRUITING
NA
600 participants
INTERVENTIONAL
2023-04-22
2024-12-31
Brief Summary
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In this Phase III study, study investigators build on the successful Phase I and Phase II partnerships with Latinx-serving community-based organizations and the project's established Community Scientific Advisory Board (CSAB) to employ a data-informed approach for implementing preventive interventions designed to advance health equity and ameliorate health disparities among vulnerable populations. Based on identity-stress and stereotype threat models for racial and ethnic minorities, study investigators will further tailor the Promotores de Salud COVID-19 evidence-based health promotion intervention to experimentally evaluate a brief behavioral self-affirming implementation intention (SAII) intervention; an approach that is evidence-based for increasing acceptance of health messaging, increasing intentions to change, increasing health promoting behaviors, and decreasing psychological distress.
In collaboration with the Mexican Consulate (MC), research team members will attend the MC mobile events, invite MC attendees to participate in the research study and complete a survey, offer the Promotores de Salud, and SAII intervention to all attendees (if event is assigned to the intervention condition), and distribute rapid tests to participants.
Detailed Description
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The key targets of the SAII intervention will be structural social determinants of health (i.e., discrimination and mistrust) as barriers to testing acceptance. The study research team will employ demonstrated survey collection strategies to accomplish the following specific aims in partnership with the project's existing relationships with the state health authority and the study's community partners:
Aim 1. Pilot test rapid SARS-CoV-2 test distribution and an English and Spanish version of the SAII intervention. In the first quarter of Year 1, the study research team will tailor and pilot the existing "ultra-brief" SAII intervention to be offered in Spanish and English. The study research team will consult with the project's established community partners and CSAB to develop manualized protocols and train the research study team to administer an oral version of SAII that can be readily applied by the study research team and does not require English language proficiency or literacy. The study research team will also be trained to distribute SARS-CoV-2 rapid test kits. The purpose of Aim 1 will be to assess if the new protocol has acceptable levels of usability with this population.
Aim 2. Conduct a clustered randomized trial (CRT) testing a health equity effectiveness hypothesis. The study research team will use a 2-group × 2-time (pre-post) design to randomly assign 400 participants sampled from Mexican Consulate event attendees to either an SAII + Promotores de Salud condition or to a control condition (Promotores de Salud only) and test (a) hypothesized main effects of the SAII intervention on testing and vaccine acceptance and health outcomes, and (b) hypothesized buffering effects of COVID-19 stressors and discrimination on testing and health outcomes.
The research strategy for this project involves a data-informed approach for the study design, with the primary aim of testing a SAII intervention hypothesized to reduce barriers to SARS-CoV-2 testing. In Aim 1, the study research team will tailor and pilot a brief intervention (SAII) designed to increase health messaging uptake and rapid testing acceptance for a vulnerable population - Latinx individuals. The SAII is an "ultra-brief" exercise, where participants are asked to formulate an if-then plan with one preferred self-affirmation-inducing cognition. Together with the project's CSAB, study investigators will tailor the extant SAII intervention to be offered in Spanish and English. Based on practicing and piloting activities, the investigative team will examine the length of SAII intervention delivery, any comprehension or translation challenges, and cultural appropriateness to iteratively refine the SAII protocols for the Latinx population before study activities begin. In addition, the study research team will be trained on the use and distribution of SARS-CoV-2 rapid testing kits. Both the rapid testing distribution and the SAII will be examined for Aim 1.
In Aim 2, study investigators will experimentally evaluate the effectiveness of SAII using a 2-group × 2-time (pre-post) clustered randomized trial. The study research team will randomly assign 400 participants sampled from Mexican Consulate event attendees to either an SAII + Promotores de Salud condition or to a control condition (the Promotores de Salud only). For Aim 2, members of the study research team will approach individuals attending an event and confirm their eligibility using a recruitment screener to determine individual's eligibility. If individuals are eligible, the research team will invite them to: 1) complete the research survey; 2) receive the Promotores de Salud, and 3) receive free COVID-19 rapid testing kits. If the event is assigned to the Intervention Condition, the participants will also receive the ultra-brief SAII.
Study investigators hypothesize (a) the SAII will increase SARS-CoV-2 rapid testing, testing and vaccine acceptance, and health outcomes through enhancing health promotion messaging, reducing stigma, and affirming self-perceptions; and (b) the SAII will serve as a buffer that moderates (lowers) negative effects of COVID-19-related stressors and discrimination on testing and health outcomes. The study research team will conduct project activities at events sponsored by the Mexican Consulate throughout the state of Oregon.
Conditions
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Keywords
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Study Design
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RANDOMIZED
PARALLEL
PREVENTION
SINGLE
Study Groups
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Promotores Health Education only condition
The Promotores de Salud Health Education intervention includes: (1) a culturally tailored health education to increase knowledge about COVID-19 and the benefits of testing; (2) motivational interviewing (MI) strategies to explore personal, social, and behavioral barriers to testing and to discuss available resources to resolve these barriers; (3) emotional support to address testing-related concerns and anxieties that may dissuade Latinx individuals from getting tested; and (4) service navigation.
When promotores (community health advocates) are on-site at Mexican Consulate events, they will provide information about COVID-19 and preventive behaviors using in-person instruction on effective mask wearing, hand washing, and physical distancing, as well as the importance of repeated testing and vaccines.
Promotores de Salud (Health Education)
The Promotores de Salud intervention includes: (1) a culturally tailored health education to increase knowledge about COVID-19 and the benefits of testing; (2) motivational interviewing (MI) strategies to explore personal, social, and behavioral barriers to testing and to discuss available resources to resolve these barriers; (3) emotional support to address testing-related concerns and anxieties that may dissuade Latinx individuals from getting tested; and (4) service navigation. When promotores (community health advocates) are on-site at Mexican Consulate events, they will provide information about COVID-19 and preventive behaviors using in-person instruction on effective mask wearing, hand washing, and physical distancing, as well as the importance of repeated testing and vaccines.
Self-Affirmation Implementation Intentions (SAII) intervention (plus Promotores Health Education)
The SAII is designed to reduce stigma and enhance uptake of health messaging. SAII couples; (a) self-affirming interventions that focus on restoring self-integrity in the face of identity threats, with (b) implementation intention interventions focus on whether realization of goal intentions for health behaviors is facilitated by forming an "implementation intention" that spells out when, where, and how of goal striving in advance.
Self-Affirmation Implementation Intentions (SAII) Intervention
In an "brief" exercise, participants are asked to provide a personal story and positive experience during the challenging and sometimes stressful COVID19 pandemic, "…a time when you felt successful and proud of yourself. …You can also tell us about a time that you did something to help someone in need." The self-affirmation is designed to offset effects of threats to self. In the next section participants are asked to formulate an if-then plan with one preferred self-affirmation-inducing cognition: "If I feel sad, threatened, or discriminated against, then I will… a)…think about things I value about myself, b)…remember things that I have succeeded in, c) …think about what I stand for, or d)…think about things that are important to me". After selecting response, participants read the full If-Then plan out loud and are provided with a paper copy of their exercise to take home.
Promotores de Salud (Health Education)
The Promotores de Salud intervention includes: (1) a culturally tailored health education to increase knowledge about COVID-19 and the benefits of testing; (2) motivational interviewing (MI) strategies to explore personal, social, and behavioral barriers to testing and to discuss available resources to resolve these barriers; (3) emotional support to address testing-related concerns and anxieties that may dissuade Latinx individuals from getting tested; and (4) service navigation. When promotores (community health advocates) are on-site at Mexican Consulate events, they will provide information about COVID-19 and preventive behaviors using in-person instruction on effective mask wearing, hand washing, and physical distancing, as well as the importance of repeated testing and vaccines.
Interventions
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Self-Affirmation Implementation Intentions (SAII) Intervention
In an "brief" exercise, participants are asked to provide a personal story and positive experience during the challenging and sometimes stressful COVID19 pandemic, "…a time when you felt successful and proud of yourself. …You can also tell us about a time that you did something to help someone in need." The self-affirmation is designed to offset effects of threats to self. In the next section participants are asked to formulate an if-then plan with one preferred self-affirmation-inducing cognition: "If I feel sad, threatened, or discriminated against, then I will… a)…think about things I value about myself, b)…remember things that I have succeeded in, c) …think about what I stand for, or d)…think about things that are important to me". After selecting response, participants read the full If-Then plan out loud and are provided with a paper copy of their exercise to take home.
Promotores de Salud (Health Education)
The Promotores de Salud intervention includes: (1) a culturally tailored health education to increase knowledge about COVID-19 and the benefits of testing; (2) motivational interviewing (MI) strategies to explore personal, social, and behavioral barriers to testing and to discuss available resources to resolve these barriers; (3) emotional support to address testing-related concerns and anxieties that may dissuade Latinx individuals from getting tested; and (4) service navigation. When promotores (community health advocates) are on-site at Mexican Consulate events, they will provide information about COVID-19 and preventive behaviors using in-person instruction on effective mask wearing, hand washing, and physical distancing, as well as the importance of repeated testing and vaccines.
Eligibility Criteria
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Inclusion Criteria
* Attending a Mexican Consulate event that our team is attending
Exclusion Criteria
* Individual has previously enrolled in the research project
18 Years
ALL
No
Sponsors
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National Institute on Minority Health and Health Disparities (NIMHD)
NIH
University of Oregon
OTHER
Responsible Party
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Principal Investigators
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Dave DeGarmo, PhD
Role: PRINCIPAL_INVESTIGATOR
University of Oregon
Locations
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University of Oregon
Eugene, Oregon, United States
Countries
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References
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Ramirez Garcia JI, Oro V, Budd EL, Mauricio AM, Cioffi CC, Anda S, McWhirter EH, DeGarmo DS, Leve LD. A Translational Case Study of a Multisite COVID-19 Public Health Intervention Across Sequenced Research Trials: Embedding Implementation in a Community Engagement Phased Framework. Am J Public Health. 2024 May;114(S5):S396-S401. doi: 10.2105/AJPH.2024.307669.
Provided Documents
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Document Type: Informed Consent Form
Other Identifiers
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STUDY00000790
Identifier Type: -
Identifier Source: org_study_id