Social and behavioral implications for COVID-19 testing in Delaware's underrepresented communities

Summary: Social and behavioral implications for COVID-19 testing in Delaware's underrepresented communities The COVID-19 pandemic has put a spotlight on our nation's stark disparities in health and burden of diseaserelated to race, ethnicity, socioeconomic status, and literacy. Across our nation, the prevalence of the virus is disproportionately high in minority communities as is the number of COVID-19-related deaths. This project will triangulate data from semi-structured surveys, serology testing and census tract-linked public health and economic data to better understand social, behavioral, and ethical factors related to COVID-19 testing in minority communities, and develop communication strategies to increase acceptance of testing and a future vaccine. Social and behavioral factors will be identified through a semi-structured survey, based on the Johns Hopkins University (JHU) COVID-19 Community Response Survey available from the NIH Public Health Emergency and Disaster Research Response (DR2) platform. The survey will collect detailed information on participants' medical history and current health, family structure and living conditions, employment and socioeconomic status, social distancing knowledge and practices,access to health care, presence of symptoms related to COVID-19 in themselves and among their contacts, their history of virus testing, attitudes toward testing, and interest in receiving a vaccine. Working with community partners we will recruit participants from communities which score poorly on Delaware's community health index, and which have also been hardest hit by the virus. The surveys will be combined with rapid, finger-stick serology tests to assess recent (previous 2 - 3 months) infection with the virus. After the initial survey and test we will follow the participants over a 12 month period, repeating the survey and serology test every 4 months. Our longitudinal, cohort design will allow us to track participants' attitudes and adherence to mitigation behaviors, referral of contacts based on their test results,and attitudes toward a future vaccine throughout the changing dynamics of the pandemic and public health response Delaware State University nursing, social work and psychology students will go to trusted sites in thecommunities to administer the serology tests and survey questions to participants. Participants will be given resources for services as appropriate to their test results and health care needs and will also be compensated for their time and information. By following participant's virus-related knowledge, attitudes, testing history and mitigation practices overtime and correlating it with an objective measure of virus exposure, our proposed project will identify strategies to make testing more accessible and acceptable and to increase use and utility of test results among underserved populations.