Rhode Island Center for Clinical and Translational Science

SUMMARY Nationally, Latinx individuals have four times the rate of SARS-CoV-2 diagnoses compared to Non-Hispanic Whites. Furthermore, Latinx populations may face barriers in accessing SARS-CoV-2 tests, receivingtest results, interpreting test results, and getting appropriate follow-up care. Improved understanding of thesources of health equity differences for Latinx populations can be used to better guide allocation of resourcesand provide essential data for provider organizations seeking to support those in the most need. This RADx-UP project will establish a statewide research and monitoring infrastructure in partnership with communityclinics. We will develop community health teams ("Promotoras Teams") with the largest Latinx communityorganization in Rhode Island to address identified barriers to COVID-19 testing through patient navigation,health literacy support, and follow-up care. The overall goals of the proposed study are to improve testing uptake and the understanding of SARS-CoV-2 outcomes among Latinx populations. We will build on partnerships with community clinics that serve ahigh proportion of Latinx individuals (>50%) in Rhode Island. We will place particular emphasis on disparities incare faced by Latinx populations and factors that have been identified as impacting health equity in RhodeIsland (integrated healthcare, community resilience, physical environment, socioeconomics, and communitytrauma). The insights gained from the quantitative and qualitative approaches will be used to guide theimplementation of community campaigns to improve testing among Latinx populations that are in identifiedlocations with lower per capita testing than other parts of the state ("testing deserts"). This RADx-UP project will utilize a unique approach and infrastructure to monitor SARS-CoV-2 testingrates, including the use of the statewide Health Information Exchange (HIE) in Rhode Island that connects dataacross primary care, urgent care, specialty care, and acute care clinical environments. The HIE containsclinical data for most people receiving care in Rhode Island including SARS-CoV-2 test results from majorlaboratories and other facilities (e.g., CVS MinuteClinic). These quantitative data will be combined withqualitative data and organized according to the Consolidated Framework for Implementation Researchframework to guide our mixed-methods explanatory sequential design. The specific aims of this project are to:(1) Identify COVID-19 hotspots and testing deserts using a near-real time geographic information systemmonitoring system; (2) Determine community and provider barriers that impact access to SARS-CoV-2 testing;and, (3) Implement community-based approaches to improve SARS-CoV-2 testing. This RADx-UP project willdevelop a community-based infrastructure to enable structured, longitudinal relationships with a historUicallyunderserved patient population. Such insights will provide essential data for a population level decision supportsystem guiding testing prioritization and for future consideration of vaccine-based prevention strategies.