Community Driven Approach to Mitigate COVID 19 Disparities in Hawaii's Vulnerable Populations

PROJECT SUMMARY/Abstract: The long-term goal of this proposal is to eliminate COVID-19 disparities among Hawaii's racial/ethnically diverseyet vulnerable populations including Native Hawaiian and other Pacific Islanders (NHPI) living in rural andunderserved communities by integrating innovative SARS-CoV-2 testing capacity with novel community-specificmessaging and education. Compounded by long-standing health disparities and socioeconomic challenges,NHPIs suffer from increased infection and mortality rates attributed to COVID-19. To date, NHPIs rank amongthe highest disproportionately burdened by SARS-CoV-2 in the U.S. With the nation's highest Rt, a basicreproductive metric indicating the degree of viral spread, Hawaii's disaggregated NHPI data reveal furtherdisparities. Preliminary testing data collected by our partner, the Waianae Coast Comprehensive Health Center(WCCHC), Hawaii's largest federally funded community health center, indicates a significant deficiency in testinguptake, especially among Pacific Islanders. Further, we observed under-representative coverage of testingamong youth (ages 5-19 years old) in NHPI communities, despite their higher than average infection rate. Otherfactors, including slow testing turnaround time and untested asymptomatic cases, complicate efforts to containfurther community spread. Given the looming public health concerns around re-opening businesses and schools,these gaps highlight the critical need for innovative approaches of effecting behavioral change coupled withnovel testing strategies to enhance access to all community members, including school-aged children/youth.Fortunately, our partnerships in Hawaii's culturally diverse populations offer a unique opportunity to augment thecurrent COVID-19 response with community knowledge and resilience. We propose the hypothesis thatcommunity-contextualized messaging disseminated by novel healthcare-school partnerships coupled with arobust community and patient-centered testing strategy will increase reach, access, uptake, and impact forCOVID-19 testing in vulnerable populations. To test this hypothesis, our multidisciplinary team aims to (1)evaluate SARS-CoV-2 testing data, identify gaps and barriers in testing, and augment community testingcapacity to increase uptake and (2) optimize and implement community-informed COVID-19 messaging andeducation with a novel community healthcare-school network partnership in the NHPI population across Hawaii.Building on our parent "Ola HAWAII" grant, this project leverages our existing Community Engagement,Biostatistics, and Administrative Cores with NHPI partnerships to augment the RADx-UP Coordinating and DataCollection Center for common evaluation metrics on COVID-19 testing-related outcomes and implementation.This will lay the foundation for an engaged community network primed for disseminating anticipated vaccines inHawaii's highest risk populations. Given the urgency to both improve public health safety and re-opening schools,results from this project may offer insights into an integrated model or toolkit from which health clinics and schoolsin underserved & vulnerable communities across the country might actively participate in abating this pandemic.