Implementing Community-based Approaches to Increase SARS-CoV-2 Testing among an Underserved and Vulnerable Hispanic Population

PROJECT ABSTRACTHispanics living in the United States have been negatively affected by the COVID-19 pandemic in adisproportionate manner, including significantly higher infection and hospitalization rates compared with non-Hispanic whites. The El Paso, TX metropolitan area has a substantial Hispanic population that has beenprofoundly affected by the current SARS-CoV-2 pandemic, especially the vulnerable residents of rural El PasoCounty. Many of these residents suffer from marked cumulative disadvantages with limited healthcare, pooraccess to public transportation, work as essential workers in low-paying frontline jobs, and demonstrate apersistent hesitancy to interact with unfamiliar medical systems and processes, resulting in "SARS-CoV-2 testingdeserts". There is a critical need to increase the number of individuals being tested for SARS-CoV-2 in El PasoCounty, however, success in this space requires an integrated and personalized approach whereby residentsare engaged with and informed by trusted co-ethnics and local organizations. The proposed aims will strategicallyintegrate University of Texas at El Paso (UTEP), non-profit, business, and public partners, coupled with culturally-centric familial and Community Health Worker (CHWs) networks, as catalysts to: 1) reduce testing deficiencies byproviding SARS-CoV-2 testing information, navigation strategies to testing sites, and implementing local pop-uptesting sites, and 2) provide foundational data for understanding testing barriers and developing platforms forassessing future COVID-19 vaccine uptake willingness for El Paso residents. The UTEP Border BiomedicalResearch Center (BBRC), and associated Coronavirus Testing Program that provides CLIA-certified testing, iscentral to completion of the integrated approaches, and the established capability of the investigative team tointeract with community partners and recruit participants is a prominent strength of the proposed plan. Theproposed studies will test the novel hypothesis that improving the reach, acceptance, uptake and sustainabilityof SARS-CoV-2 testing for the most marginalized populations of El Paso County is dependent on implementingstrategies that target the cultural, social and behavioral factors characteristic of this population. The multifacetedapproach will enhance the testing capacity in the El Paso region, reduce testing hesitancy, increase coronavirustesting numbers for vulnerable populations within specific testing deserts, and exert a sustained influence on thehealth status of the region by integrating the extensive collaborative networks that are essential for addressingthe persistent negative social determinants of health.