Culturally-targeted communication to promote SARS-CoV-2 antibody testing in saliva: Enabling evaluation of inflammatory pathways in COVID-19 racial disparities

Project Summary: African Americans develop and die from SARS-CoV-2 infection more than any other racial group in the UnitedStates, including in majority African American cities such as Flint, Michigan. SARS-CoV-2 disparities stem frommany interconnected causes. Yet, connections to inflammatory biological processes in COVID-19 disparitiesremain largely unknown. Evaluating inflammatory responses can be facilitated by SARS-CoV-2 antibodytesting, which can be used to identify and compare inflammation among those with and without confirmedSARS-CoV-2 infection, and to conduct cross-race comparisons of inflammatory factors. However, AfricanAmericans will be reluctant to partake in conventional antibody testing programs due to medical mistrust andexperiences with racism that are salient in the COVID-19 era. There is thus an urgent need to develop anddeploy culturally-relevant communication and antibody testing programs. Our long-term goal is to identify andreduce unjust COVID-19 racial disparities. The immediate objective is to better encourage understanding anduptake of SARS-CoV-2 antibody testing. The central hypothesis is that African-Americans will be receptive toantibody testing when benefits and limitations are communicated in a culturally effective manner, and whennon-invasive salivary collection methods and assays are used. Our rationale is that combining culturallyeffective health communication with salivary testing will reduce mistrust and promote uptake that can lead tobetter grasping the role of inflammation in COVID-19 disparities. Our aims are to 1) develop and compareeffects of a general versus culturally-targeted video about antibody testing on African American and White Flintresidents' antibody testing attitudes and uptake; 2) identify and compare effects of a general versus culturally-targeted video on activation of medical mistrust and racism-related cognition among African Americans whenconsidering antibody testing; 3) measure and identify multi-analyte inflammatory biomarker profiles among FlintRegistry enrollees who complete salivary antibody testing and compare inflammatory biomarker profiles byrace and antibody status. In collaboration with clinical and community partners, we will prepare and evaluategeneral and culturally-targeted video tutorials about SARS-CoV-2 antibody testing. These brief videos will bedistributed to the Flint community through the Flint Registry - a highly visible local health resource exchange.In collaboration with leading salivary bioscience experts, we will furnish an opportunity to engage in at-homesalivary antibody screening - a non-invasive route to antibody testing that is highly suited to disparities-oriented COVID-19 research. The proposed research is innovative and significant in highlighting that culturally-targeted communication and non-invasive antibody testing are vital to propelling disparities-orientedinflammatory COVID-19 research. Knowledge to be gained includes video tutorials and insights aboutcommunity-facing salivary collection that can be immediately disseminated across SeroNet to better promoteincluding racial monitories in ongoing studies of inflammation and antibody testing.