Team Science: Advancing Women and Black, Indigenous, and other People of Color on the Pathway of Conducting Clinical Research.

Introduction: Innovative discovery begins with diverse perspectives; research teams should harness this model. Black, Indigenous, and other People of Color (BIPOC) and women are underrepresented as researchers. Team science leverages collaborative and cross-disciplinary approaches to diversify the research workforce, and introduces academic (and non-academic) faculty with limited research exposure/experience to clinical research. Methods: In 2020, two Black women academic physicians implemented an academic collaborative - COVID-19 Characteristics, Readmissions, Outcomes, and Social Determinants of Health (CROSS) - to investigate COVID-19 health inequities, with intentional recruitment of BIPOC and women. The 37 CROSS team members were of diverse races, ethnicities, sex, specialties, and disciplines, and represented eight hospitals. Team members were electronically surveyed to determine their interest, desired activities, and level of participation in research activities; concurrently, self-identified demographics (including race, ethnicity, sex, and language(s) spoken) were obtained. Results: All team members completed the survey: 78.4% (n = 29) were BIPOC and 78.4% (n = 29) were women. Team members spoke 18 languages (including English). Academic medical ranks included Assistant Professor (32.4%; n = 12), Associate Professor (16.2%; n = 6), and Full Professor (2.7%; n = 1). Each member identified desired activities (data collection, data analytics, manuscript development, abstract development/poster presentation, serving as a consultant) and the percentage of time they intended to allocate to each. Between June 2020 and February 2023, the team produced five original peer-reviewed manuscripts (including this article); five members served as first or senior authors. Twenty-one abstracts were presented at local conferences, and 10 at national and regional conferences. Five members achieved academic promotion, and team members were awarded three intramural grants resulting directly from team collaborations. Conclusion: Intentional recruitment and assessment of team members' desired levels of participation in an integrated clinical research team is an effective strategy to engage BIPOC and women. The CROSS Collaborative is a model for diversity and inclusion in team science and clinical research.

COVID-19 Vaccine Hesitancy Among Health Care Workers in Four Health Care Systems in Atlanta.

Coronavirus disease 2019 (COVID-19) vaccine hesitancy among health care workers (HCWs) undermines community vaccine confidence. Predictors and reasons for HCW hesitancy in the Atlanta region were evaluated using a survey between May and June 2021. Vaccine hesitancy was highest in younger and less educated HCWs. Interventions to address vaccine hesitancy in HCWs are necessary.

Clinical characteristics and social determinants of health associated with 30-day hospital readmissions of patients with COVID-19.

COVID-19 readmissions are associated with increased patient mortality and healthcare system strain. This retrospective cohort study of PCR-confirmed COVID-19 positive adults (>18 years) hospitalized and readmitted within 30 days of discharge from index admission was performed at eight Atlanta hospitals from March to December 2020. The objective was to describe COVID-19 patient-level demographics and clinical characteristics, and community-level social determinants of health (SDoH) that contribute to 30-day readmissions. Demographics, comorbidities, COVID-19 treatment, and discharge disposition data were extracted from the index admission. ZIP codes were linked to a demographic/lifestyle database interpolating to community-level SDoH. Of 7155 patients with COVID-19, 463 (6.5%) had 30-day, unplanned, all-cause hospital readmissions. Statistically significant differences were not found in readmissions stratified by age, sex, race, or ethnicity. Patients with a high-risk Charlson Comorbidity Index had higher odds of readmission (OR 4.8 (95% CI: 2.1 to 11.0)). Remdesivir treatment and intensive care unit (ICU) care were associated with lower odds of readmission (OR 0.5 (95% CI: 0.4 to 0.8) and OR 0.5 (95% CI: 0.4 to 0.7), respectively). Patients residing in communities with larger average household size were less likely to be readmitted (OR 0.7 (95% CI: 0.5 to 0.9). In this cohort, patients who received remdesivir, were cared for in an ICU, and resided in ZIP codes with higher proportions of residents with increased social support had lower odds of readmission. These patient-level factors and community-level SDoH may be used to identify patients with COVID-19 who are at increased risk of readmission.