Center for American Indian and Rural Health Equity

Project SummaryThe COVID-19 pandemic has disproportionately affected American Indian (AI) and Latino communities, andthese groups also have increased risk of poor prognosis due to high rates of chronic disease such as diabetes,cardiovascular disease, and cancer. In the northwestern United States, AI and Latino communities alreadyface significant disparities in health care access, which have been further exacerbated by the COVID-19pandemic. In the proposed study, Protecting Our Community: A Pragmatic Randomized Trial of Home-BasedCOVID Testing with American Indian and Latino Communities, we will leverage our long-term community-based participatory research partnerships to test the hypothesis that home-based testing will be feasible,impactful, and better-accepted using active delivery of test kits by trusted community health educators in twovulnerable, high-risk rural communities. Our two long-term partner communities are the Flathead IndianReservation of the Confederated Salish and Kootenai Tribes in Montana, and the Yakima Valley ofWashington, a large Latino community. We will determine the cultural, social, behavioral, and economicbarriers to home-based SARS-CoV-2 testing; culturally adapt and enhance home-testing educational materialsand create home-testing instructional graphics and YouTube videos; conduct a 2-arm pragmatic randomizedtrial of active (delivered by community health educator) vs. passive (mailed) home-based testing kits (n =200/community) for testing completion; and create model community-driven testing protocols that can havesignificant impact for increasing home-based testing uptake among AI and Latino communities nationally. Thiswork will enable underserved AI and Latino communities to take full advantage of the coming wave of rapidpoint-of-care home tests and decrease the significant impact of COVID-19 in their communities.