COVID-19 Testing and Linkage to Care with African American Church and Health Agency Partners

PROJECT SUMMARYAfrican Americans (AA) are disproportionately burdened by COVID19 across the spectrum of related cases,hospitalizations, and deaths compared to Whites. Many multilayered barriers increase risk for COVID19 amongAA including poverty, essential jobs with increased virus exposure, cultural norms (eg, risk denial,medical/contact tracing mistrust), and limited access to healthcare and other services/resources. Thesebarriers highlight the need for accessible, trusted COVID19 testing and linkage to care (LTC) services (eg,health, prevention programs, community resources, contact tracing) to help slow COVID19 spread in AAcommunities. The AA church is an institution with extensive influence in AA communities and may be an idealsetting for increasing reach of COVID19 testing and LTC in hard hit AA communities. Yet, no controlled AAchurch-based studies exist on COVID19 testing interventions. The primary aim of this study is to fully test aculturally/religiously-tailored, church-based COVID19 testing and LTC intervention condition against a non-tailored intervention condition on COVID19 testing rates at 6 months with adult AA church members and thecommunity members they serve. Churches will be matched on membership size, denomination and pastparticipation in church health intervention studies, then randomized to treatment condition. Sixteen churches (8churches/arm; 45 church and 15 community members/church; N=960 total) will participate in the study. LTCuse, contact tracing approval, and COVID19 prevention behaviors will also be examined at 6 months assecondary outcomes. Guided by the Theory of Planned Behavior and Socioecological Model, our community-engaged approach includes trained church leaders delivering a culturally, church-appropriate COVID19 Toolkitinclusive of digital tools: a) individual self-help materials and tailored text messages; b) in-person/virtual groupseminars for caregivers of persons with COVID19; c) in-person/virtual church services with COVID19 relatedmaterials/activities (e.g., sermons, testimonials, responsive readings); and d) church-community level LTCservices (eg, insurance, healthcare, prevention programs, community resources, contact tracing) providedvirtually by community health workers, church-community-based re-opening guidelines, and church-basedCOVID19 testing events with health agencies. Examination of LTC use and contact tracing approval will aid inunderstanding intervention impact on COVID19 testing by addressing participant essential needs. Potentialmediators/moderators related to receipt of COVID-19 testing will be evaluated, and a process evaluation todetermine implementation facilitators, barriers, and fidelity related to increasing COVID19 testing rates. Ourongoing meetings with our long-term faith and health partners is enabling us to quickly adapt our AA church-based HIV testing and diabetes prevention interventions for the proposed study. This multilevel study couldprovide an effective, scalable model for increasing COVID19 testing, prevention, and LTC/contact tracingapproval with AA churches in partnership with health agencies, and provide strategies to streamlinedelivery/uptake of future COVID-19 vaccination.