COVID-19 Treatment Cascade Optimization Study

This study tested an adaptation of the HIV Continuum of Prevention, Care, and Treatment Framework (CoPCT) for use in tracking COVID-19 testing and follow-up in a medically and socially vulnerable population. Utilizing the integrated research collaborative framework that facilitates dialogue among researchers, community members, and service providers as a tool for optimizing the adaptive intervention, this study took place at the North Jersey Community Research Initiative (NJCRI). The Multiphase Optimization Strategy (MOST) was used to optimize an adaptive intervention that successfully navigates COVID-19 medically or socially vulnerable people through a continuum of prevention, care and treatment (CoPCT) modeled on the HIV CoPCT. The COVID-19 CoPCT starts with testing and continues with successful adherence to prevention or treatment guidelines to help prevent and/or treat COVID-19. The study assessed the effectiveness of Navigation Services compared to referrals in increasing COVID-19 testing and Brief Counseling in increasing adherence to the State of NJ recommendations for COVID-19 prevention and treatment. The effect of Critical Dialogue on testing behavior among people who decline to be tested for COVID-19 was also examined. The investigators developed decision rules about what evidence-based-interventions work best for what types of people (e.g., those who test right away, versus decliners) and in what period of the COVID-19 continuum. This study shed light on factors associated with testing and adherence to NJ recommendations. Investigators followed Community Based Participatory Research principles in implementing a sequential, multiple assignment randomized trial (SMART) design.