Addressing Low-Income Housing Resident Mistrust in COVID-19 Guidance

Project Summary Ongoing engagement of low-income housing residents suggests that widespread mistrust of information about COVID-19, particularly when received from public housing authorities, has contributed to low compliance with public health guidance in these communities. In particular, recommendations for COVID-19 testing are met with skepticism and suspicion. We have received similar feedback about potential vaccination when/if a COVID-19 vaccine is developed-in addition to mistrust in COVID-19 messaging, persistent concerns about exploitation in research seem to be negatively affecting attitudes toward participation in certain types of related activities, especially when a blood draw or injection is involved. Principles and approaches from community-based participatory research guide this study. In Aim 1 we investigate why low-income housing residents report poor compliance with public health guidance,including COVID-19 testing. We will determine whether residents do not understand COVID-19 guidance (particularly whether they are able to generalize guidance from one setting to another) or if they understand, but instead choose not to comply. In Aim 2 we will assess telehealth as a potential tool for addressing low-income housing resident mistrust in COVID-19 guidance. In our preliminary work, physicians with whom residents have established relationships were considered the most trustworthy source of COVID-19 information. Unfortunately, residents commonly report that COVID-19 has disrupted how they receive medical care. In Aim 3 we develop community-informed strategies to address resident concerns about COVID-19 testing and to make testing more relevant to their needs. We will begin by exploring strategies to overcome the impact of privacy concerns of residents on the provision of services or other benefits offered or coordinated by PHAs. Other barriers will be addressed as they emerge.