Ethical burdens of COVID-19 testing: the case for a research agenda to improve effectiveness and equity in pandemic response

Frontiers in Public Health, Год журнала: 2025, Номер 13

Опубликована: Март 6, 2025

US public health response to COVID-19 has focused on increasing availability and access viral testing, which raises three sets of potential problems: (1) lack testing uptake, (2) diminished impact (3) loss necessary social goods supports. Moreover, these problems are encountered differentially in affluent vs. disadvantaged communities. If not addressed, could exacerbate disparities via the strategies that aim lower population-level COVID. These also risk undermining trust interventions more broadly pose challenges sustainability programs moving forward. In this perspective essay, we argue research must document understand mechanisms through living structurally environments exacerbates only logistical material burdens but ethical it creates. Such will facilitate development targeted empower people make testing-related decisions best serve both their own interests those broader

Язык: Английский

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Wastewater monitoring in tourist cities as potential sentinel sites for near real-time dynamics of imported SARS-CoV-2 variants

The Science of The Total Environment, Год журнала: 2022, Номер 860, С. 160317 - 160317

Опубликована: Ноя. 25, 2022

Wastewater-based epidemiology (WBE) complements the clinical surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its variants' distribution in populations. Many developed nations have established national regional WBE systems; however, governance budget constraints could be obstacles for low- middle-income countries. An urgent need thus exists to identify hotspots serve as sentinel sites WBE. We hypothesized that representative wastewater treatment plants (WWTPs) two international gateway cities, Bangkok Phuket, Thailand, sentineled SARS-CoV-2 variants reflect patterns at city level early indicators new entering country. Municipal samples (n = 132) were collected from eight municipal WWTPs Phuket during 19 sampling events October 2021 March 2022, which tested by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) using US CDC N1 N2 multiplex variant (Alpha, Delta, Omicron BA.1 BA.2) singleplex assays. The detection ratios followed similar trends testing data, each variant's viral loads agreed with daily cases (3-d moving average). was detected prior Bangkok, possibly due Phuket's serving tourist communities. found BA.2 predominantly drove resurgence. also noted a shifting pattern 22-d warning near real-time late 2021. potential application indicate arrival re-emerging or unprecedented infectious agents support tourism-dependent economies complementing reduced regulations while maintaining public health protection via surveillance.

Язык: Английский

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Embedding community-engaged research principles in implementation science: The implementation science center for cancer control equity

Journal of Clinical and Translational Science, Год журнала: 2023, Номер 7(1)

Опубликована: Янв. 1, 2023

Gaps in the implementation of effective interventions impact nearly all cancer prevention and control strategies US including Massachusetts. To close these gaps, evidence-based must be rapidly equitably implemented settings serving racially, ethnically, socioeconomically, geographically diverse populations. This paper provides a brief overview The Implementation Science Center for Cancer Control Equity (ISCCCE) describes how we have operationalized our commitment to robust community-engaged center that aims gaps. We describe ISCCCE is organized principles research are embedded across center. Principles community engagement been components ISCCCE. intentionally integrated throughout structures processes developed evaluation assess whether quality partnerships reflects principles. comprehensive infrastructure studying efficient, pragmatic, equity-focused adaptation historically currently disadvantaged communities with built-in methods evaluate engagement. engaged designed maximize relevance on health centers.

Язык: Английский

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A Systems Perspective of How Community-Engaged Public Health Addresses Social Determinants of Health: A Case Study of a Population-Based COVID-19 Testing Program

Journal of Public Health Management and Practice, Год журнала: 2025, Номер unknown

Опубликована: Фев. 3, 2025

Context: Despite the recognition that social determinants of health (SDOH) are key to improving all communities, causality and specific mechanisms through which SDOH impacts behaviors outcomes often ambiguous. Objective: The aim this study was use systems thinking document pathways affected health-seeking identify how community engagement strategies intervened address barriers. Design: We leveraged case context a large federal initiative (Rapid Acceleration Diagnostics-Underserved Populations [RADx-UP]) designed improve COVID-19 testing for underserved populations community-engaged participatory approaches. First, we used structured sessions with RADx-UP partners create causal maps documented relationships between factors relevant SDOH, behavior (COVID-19 testing), strategies. Second, searched, reviewed, tied evidence from peer-reviewed literature contextualize maps. Results: identified 17 unique linked testing. map also highlighted 3 addressed SDOH: (1) access testing, (2) addressing digital literacy, (3) conducting needs screening assistance. Conclusions: Our findings complexity public issues such as is critical equity. Importantly, dedicating resources created positive reinforcing dynamics communities; however, became better managed, funding diminished decreased capacity efforts. Research in focus on understanding reshaping support

Язык: Английский

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Equity in epidemic response: an action-oriented framework for guiding public health in equitable responses to major infectious disease emergencies

International Journal for Equity in Health, Год журнала: 2025, Номер 24(1)

Опубликована: Март 12, 2025

Abstract Background A rapid and equitable response is paramount to mitigating the spread impact of an infectious disease public health emergency. Unfortunately, responses often integrate equity as a secondary component rather than foundational one—a decision that can result in disproportionate effects epidemic on vulnerable populations may further fuel or worsen ongoing This paper introduces framework grounded principles guide design implementation efforts during emergencies. Methods The Equity Epidemic Response was developed by critically appraising synthesizing several established models into integrated framework, with active engagement from professionals specializing epidemiology, medicine, global health, mental community policy. Results covers six high-impact areas should be addressed emergency: partnerships engagement; communication ; social economic conditions; data systems methods; infrastructure supply chains for preventives , therapeutics diagnostics; accessibility outbreak resources essential services . Key priorities assessment indicators within each area were identified. Conclusions Given increasing threat emerging re-emerging diseases, this reinforces need prioritize approaches responding emergencies minimize consequences, particularly among populations. designed practical tool major aspects response, ensuring thorough efforts.

Язык: Английский

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Practical considerations for engaging staff in resource-constrained healthcare settings in implementation research: A qualitative focus group and consensus building study

Journal of Clinical and Translational Science, Год журнала: 2025, Номер 9(1)

Опубликована: Янв. 1, 2025

Abstract Background: The primary purpose of this study was to assess perceived burdens and benefits participating in implementation research among staff employed resource-constrained healthcare settings. Another objective use findings generate considerations for engaging across different phases research. Methods: This qualitative focus group consensus building involved researchers affiliated with the National Cancer Institute Implementation Science Centers Control program nine Community Health (CHCs) Massachusetts. Six groups (n = 3 CHC staff; n researchers) assessed barriers facilitators participation During discussions, we used develop as participants partners throughout Results: Sixteen 14 participated separate groups; seven discussions. Themes emerged participant three domains: (1) influences on participation; (2) benefits; (3) ways facilitate Practical included: (a) aligning organizational values priorities; (b) applying user-centered design methods; (c) individual capacity; (d) offering equitable incentives participation. Conclusions: Engaging requires knowledge about what contributes burden addressing context-specific benefits.

Язык: Английский

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Factors influencing uptake of diagnostic test interventions for SARS-CoV-2: A qualitative review

Journal of Public Health in Africa, Год журнала: 2025, Номер 16(2)

Опубликована: Апрель 26, 2025

Diagnostic tests for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may be performed based on symptomatic presentation or screening of asymptomatic persons. Testing can limit spread by enabling rapid identification cases leading to containment measures. However, views regarding diagnostic test as a intervention vary across different settings. To synthesise the findings qualitative studies perceptions and factors influencing uptake interventions SARS-CoV-2. Healthcare facilities, care homes, communities including households. We searched MEDLINE database (WHO) SARS-CoV-2 Research from 01 January 2020 06 September 2022. Qualitative data were synthesised thematically while barriers facilitators using SURE framework. The GRADE-CERQual approach was used assess confidence in each review finding, ENTREQ checklist report QES. quality included assessed with CASP tool. Twenty two Two conducted health facility setting, 2 18 community. came high-income countries, low- middle-income countries. In all, 13 analytical 31 descriptive themes low moderate evidence emerged; mainly around fear contracting COVID-19, procedure socio-economic implications positive result. Low largely due misconceptions about interventions. Sensitising engaging stakeholders healthcare system, will help mitigate barrier enhance policy coordination.

Язык: Английский

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An Environmental Equity Assessment Using a Social Vulnerability Index during the SARS-CoV-2 Pandemic for Siting of Wastewater-Based Epidemiology Locations in the United States

Geographies, Год журнала: 2024, Номер 4(1), С. 141 - 151

Опубликована: Фев. 16, 2024

Research has shown that there consistently been a lack of equity and accessibility to SARS-CoV-2 testing in underserved disadvantaged areas the United States. This study examines distribution Wastewater-Based Epidemiology (WBE) placement across States (US), particularly within context communities, explores an environmental approach address impact WBE on future pandemics. The methods combined Centers for Disease Control Social Vulnerability Index (CDC-SVI) data set at county level geospatial analysis utilizing ArcGIS multilinear regression as independent variables investigate disparities coverage US. findings show exist between counties use nationwide. results is distributed inequitably national state levels. Considering nationwide adoption funding availability through CDC National Wastewater Surveillance System, these underscore importance equitable effective COVID-19 monitoring. These offer support focus expanding communities ensures proactive inclusive strategy against

Язык: Английский

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Implementing expanded COVID-19 testing in Massachusetts community health centers through community partnerships: Protocol for an interrupted time series and stepped wedge study design

Contemporary Clinical Trials, Год журнала: 2022, Номер 118, С. 106783 - 106783

Опубликована: Май 7, 2022

Community Health Centers (CHCs) are a critical source of care for low-income and non-privately insured populations. During the pandemic, CHCs have leveraged their infrastructure role as trusted to engage communities they serve in COVID-19 testing.To directly address impact that has had on historically marginalized populations Massachusetts, we designed study community-engaged testing expansion: (1) leveraging existing partnerships accelerate rapidly disseminate effective implementation strategies; (2) incorporating efforts key barriers participation at increased risk COVID-19; (3) further developing between access disparities; (4) grounding development shared ethical framework advancing equity situations scarcity; (5) mechanisms communication science translation support community outreach. We use controlled interrupted time series design, comparing number tests overall among people identified members high-risk groups served by intervention compared with six matched control followed stepped wedge design pilot test strategies tailored outreach CHCs.Here, describe community-partnered strategy provides ongoing resources addressing needs communities. The aligns principles research including leadership, adequate partners, flexibility respond changing over time.

Язык: Английский

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COVID-19 Testing, Vaccine Perceptions, and Trust among Hispanics Residing in an Underserved Community

International Journal of Environmental Research and Public Health, Год журнала: 2023, Номер 20(6), С. 5076 - 5076

Опубликована: Март 14, 2023

The Borderplex region has been profoundly impacted by the COVID-19 pandemic. residents live in low socioeconomic (SES) neighborhoods and lack access to testing. purpose of this study was two-fold: first, implement a testing program increase number tested for COVID-19, second, administer community survey identify trusted sources information factors associated with vaccine uptake. A total 4071 members were 502 participants completed survey. resulted 66.8% (n = 2718) positive cases. revealed that most doctors or health care providers (67.7%), government websites (e.g., CDC, FDA, etc.) (41.8%), World Health Organization (37.8%). Logistic regression models several statistically significant predictors uptake such as having doctor provider, perceiving be effective, does not cause side-effects. Findings from current highlight need utilizing an integrated, multifactorial approach underserved communities.

Язык: Английский

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