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Exploring barriers and facilitators to women who use drugs (WWUD) awareness, acceptance and uptake of COVID-19 testing, the CARE study.

Award Number: R01DA041243
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Project Summary In the U.S. women who use illicit drugs (WWUD) have disproportionately high rates of infectious (e.g., HIV, HCV), chronic, and pulmonary diseases that elevate their risk for COVID-19. Their health and disease profile is driven by enduring social conditions (e.g., scarcity of income, food insecurity, access to health services, housing, discrimination). These prevailing social conditions can also undermine WWUDs’ ability to protect themselves from COVID-19 (e.g., washing hands, social distancing). Drug procurement and use, which are largely social processes, further challenge these self-protection measures. Testing and future vaccination is vital to reducing COVID-19 among this high-risk population, necessitating accessible testing schemes. We propose a mixed methods study that draws upon the Andersen Behavioral Model10 and is grounded in eco-social theory. Specifically, the Baltimore-based study aims to: 1) explore predisposing social factors (e.g., housing, food security), individual-level factors (e.g., drug use, mental health), and beliefs (e.g., medical mistrust) that are facilitators and barriers of COVID-19 testing and perceived risks (e.g., income generation, violence) resulting from a diagnosis through in-depth interviews among WWUD (N=15) and a cultural domain analysis (N=45); 2) gain an understanding of the enabling community-level environment (e.g., medical and social service agencies that currently serve WWUD, existing city-wide COVID-19 testing sites) that could facilitate or hinder WWUDs’ COVID-testing uptake through observations (N=8-10) and key informant interviews (N=10); and examine predisposing social factors, individual-level factors, and beliefs that are associated with COVID-19 testing and retesting among a cohort (N=250) of WWUD at baseline and 3-month follow-up. Optional testing offered at both study visits will be a self-administered, rapid antigen test. We will also examine the role of medical mistrust in shaping women’s use of healthcare services as well as experiences of stigma and discrimination in healthcare settings, particularly among Black participants. In Baltimore, this mistrust is particularly pronounced, with Johns Hopkins Hospital having a long history of mistrust in the Black community owing to experimentation and deception of research engagement. The study will be guided by a community advisory board (CAB) who will inform its design and implementation as well as engage in disseminating the results at community meetings to inform COVID-testing scale up.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2023 ( Subtotal = $138,222 )
2023	2023	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Drug Abuse and Addiction Research Programs	002	5	9/18/2023	SUPPLEMENT FOR EXPANSION	$140,846
2023	2022	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Trans-NIH Research Support	000	5	6/16/2023	SUPPLEMENT FOR EXPANSION	$0
2023	2020	THE JOHNS HOPKINS UNIVERSITY	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Drug Abuse and Addiction Research Programs	001	5	6/29/2023	NON-COMPETING CONTINUATION	-$2,624
														Subtotal = $138,222

Issue Date FY: 2022 ( Subtotal = $625,929 )
2022	2022	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Trans-NIH Research Support	002	5	8/26/2022	SUPPLEMENT FOR EXPANSION	$625,929
2022	2021	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Trans-NIH Research Support	000	5	11/26/2021	SUPPLEMENT FOR EXPANSION	$0
2022	2021	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Trans-NIH Research Support	001	5	12/16/2021	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $625,929

Issue Date FY: 2021 ( Subtotal = $1,105,922 )
2021	2021	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Drug Abuse and Addiction Research Programs	001	5	9/9/2021	SUPPLEMENT FOR EXPANSION	$451,330
2021	2021	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Trans-NIH Research Support	000	5	11/18/2020	SUPPLEMENT FOR EXPANSION	$654,592
														Subtotal = $1,105,922

Issue Date FY: 2020 ( Subtotal = $705,555 )
2020	2020	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Drug Abuse and Addiction Research Programs	001	5	6/5/2020	SUPPLEMENT FOR EXPANSION	$154,040
2020	2020	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Drug Abuse and Addiction Research Programs	000	5	6/4/2020	NON-COMPETING CONTINUATION	$551,515
														Subtotal = $705,555

Issue Date FY: 2019 ( Subtotal = $643,869 )
2019	2019	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Drug Abuse and Addiction Research Programs	000	4	4/26/2019	NON-COMPETING CONTINUATION	$643,869
														Subtotal = $643,869

Issue Date FY: 2018 ( Subtotal = $677,898 )
2018	2018	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Drug Abuse and Addiction Research Programs	000	3	5/8/2018	NON-COMPETING CONTINUATION	$677,898
														Subtotal = $677,898

Issue Date FY: 2017 ( Subtotal = $690,901 )
2017	2017	JOHNS HOPKINS UNIVERSITY, THE	3400 N CHARLES ST	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Drug Abuse and Addiction Research Programs	000	2	5/23/2017	NON-COMPETING CONTINUATION	$690,901
														Subtotal = $690,901

Issue Date FY: 2016 ( Subtotal = $730,404 )
2016	2016	JOHNS HOPKINS UNIVERSITY	1101 E 33RD STREET, STE-C-210	BALTIMORE	MD	21218	BALTIMORE CITY	USA	Drug Abuse and Addiction Research Programs	000	1	6/24/2016	NEW	$730,404
														Subtotal = $730,404

Grand Total All Awards = $5,318,700

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Exploring barriers and facilitators to women who use drugs (WWUD) awareness, acceptance and uptake of COVID-19 testing, the CARE study.

Award Number: R01DA041243

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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