Browsing by Author "D'Agostino, Emily M"

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    Increasing access and uptake of SARS-CoV-2 at-home tests using a community-engaged approach.
    (Preventive medicine reports, 2022-10) D'Agostino, Emily M; Corbie, Giselle; Kibbe, Warren A; Hornik, Christoph P; Richmond, Al; Dunston, Angella; Damman, Allyn; Wruck, Lisa; Alvarado, Manuel; Cohen-Wolkowiez, Michael
    Inequalities around COVID-19 testing and vaccination persist in the U.S. health system. We investigated whether a community-engaged approach could be used to distribute free, at-home, rapid SARS-CoV-2 tests to underserved populations. Between November 18-December 31, 2021, 400,000 tests were successfully distributed via 67 community partners and a mobile unit to a majority Hispanic/Latino/Spanish population in Merced County, California. Testing before gathering (59 %) was the most common testing reason. Asians versus Whites were more likely to test for COVID-19 if they had close contact with someone who may have been positive (odds ratio [OR] = 3.4, 95 % confidence interval [CI] = 1.7-6.7). Minors versus adults were more likely to test if they had close contact with someone who was confirmed positive (OR = 1.7, 95 % CI = 1.0-3.0), whereas Asian (OR = 4.1, 95 % CI = 1.2-13.7) and Hispanic/Latino/Spanish (OR = 2.5, 95 % CI = 1.0-6.6) versus White individuals were more likely to test if they had a positive household member. Asians versus Whites were more likely to receive a positive test result. Minors were less likely than adults to have been vaccinated (OR = 0.2, 95 % CI = 0.1-0.3). Among unvaccinated individuals, those who completed the survey in English versus Spanish indicated they were more likely to get vaccinated in the future (OR = 8.2, 95 % CI = 1.5-44.4). Asians versus Whites were less likely to prefer accessing oral COVID medications from a pharmacy/drug store only compared with a doctor's office or community setting (OR = 0.3, 95 % CI = 0.2-0.6). Study findings reinforce the need for replicable and scalable community-engaged strategies for reducing COVID-19 disparities by increasing SARS-CoV-2 test and vaccine access and uptake.
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    RADx-UP Coordination and Data Collection: An Infrastructure for COVID-19 Testing Disparities Research.
    (American journal of public health, 2022-09) Corbie, Giselle; D'Agostino, Emily M; Knox, Susan; Richmond, Al; Woods, Christopher W; Dave, Gaurav; Perreira, Krista M; Marsolo, Keith; Wruck, Lisa M; Kibbe, Warren A; Cohen-Wolkowiez, Michael
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    Translating knowledge into action for child obesity treatment in partnership with Parks and Recreation: study protocol for a hybrid type II trial.
    (Implementation science : IS, 2023-02) Neshteruk, Cody D; Skinner, Asheley C; Counts, Julie; D'Agostino, Emily M; Frerichs, Leah; Howard, Janna; Story, Mary; Armstrong, Sarah C

    Background

    Safe and effective treatment exists for childhood obesity, but treatment recommendations have largely not been translated into practice, particularly among racial and ethnic minorities and low-wealth populations. A key gap is meeting the recommended treatment of ≥26 h of lifestyle modification over 6-12 months. Fit Together is an effective treatment model that meets these recommendations by integrating healthcare and community resources. Pediatric providers screen children for obesity, deliver counseling, and treat co-morbidities, while Parks and Recreation partners provide recreation space for a community nutrition and physical activity program.

    Methods

    This study will use a hybrid type II implementation-effectiveness design to evaluate the effectiveness of an online implementation platform (the Playbook) for delivering Fit Together. Clinical and community partners in two North Carolina communities will implement Fit Together, using the Playbook, an implementation package designed to facilitate new partnerships, guide training activities, and provide curricular materials needed to implement Fit Together. An interrupted time series design anchored in the Process Redesign Framework will be used to evaluate implementation and effectiveness outcomes in intervention sites. Implementation measures include semi-structured interviews with partners, before and after the implementation of Fit Together, and quantitative measures assessing several constructs within the Process Redesign Framework. The participants will be children 6-11 years old with obesity and their families (n=400). Effectiveness outcomes include a change in child body mass index and physical activity from baseline to 6 and 12 months, as compared with children receiving usual care. Findings will be used to inform the design of a dissemination strategy guided by the PCORI Dissemination Framework.

    Discussion

    This project addresses the knowledge-to-action gap by developing evidence-based implementation tools that allow clinicians and communities to deliver effective pediatric obesity treatment recommendations. Future dissemination of these tools will allow more children who have obesity and their families to have access to effective, evidence-based care in diverse communities.

    Trial registration

    ClinicalTrials.gov identifier: NCT05455190 . Registered on 13 July 2022.