Alive Church Network: Increasing COVID-19 Testing in Chicago's African American Testing Deserts

ABSTRACTThe epidemic of novel coronavirus disease 2019 (COVID-19) has caused an unprecedented public health crisisin the United States. African Americans (AA) have been disproportionately impacted, as systemic inequities havecontributed to increased exposure and vulnerability to COVID-19. Evidence suggests that AAs are delayingtesting and care for COVID-19, which increases risk of transmission and poor outcomes. In Chicago, segregatedAA neighborhoods have experienced some of the highest COVID-19 mortality rates in the city, yet large portionsof these neighborhoods remain testing deserts. Providing trusted, accessible, community-based testing inunderserved AA communities is critical to ensuring that AAs receive an early diagnosis, thereby reducing therisk of further transmission and improving clinical outcomes. This study leverages the Alive Church Network(ACN), a long-standing, community-driven coalition of African American pastors and public health researchersthat was developed as a sustainable infrastructure to address health inequities in chronic disease in segregatedAA neighborhoods in Chicago. The ACN was designed to address lack of access to health care, culturalinsensitivity, and lack of trust, which are the root cause of disparities in chronic disease as well as infectiousdisease, including COVID-19. The proposed project utilizes the ACN infrastructure to create a network of church-based testing sites in a segregated and underserved AA neighborhood in Chicago that will provide COVID-19testing and education as well as linkage to healthcare and social resources. Thirteen ACN pastors who servepredominantly AA congregations in the West Side of Chicago will form a coalition to promote community-wideCOVID-19 testing in local churches. Residents of all ages will receive COVID-19 education and free SARS-CoV-2 PCR testing with rapid turn-around of results from an on-site clinical team, as well as connection to localresources to address social needs, including food, housing, and medical care. Our specific aims are: (1) Conducta rapid needs assessment to identify barriers to and facilitators of COVID-19 testing to inform a tailored outreachand intervention strategy to increase COVID-19 testing among high-risk AAs; (2) (Primary Aim) Evaluate theimpact of the ACN COVID-19 testing intervention on uptake of testing among residents of target high poverty AAneighborhoods in Chicago; (3) Use the RE-AIM framework to assess the reach, adoption, implementation,maintenance and cost of the ACN COVID-19 testing intervention. Our primary analysis uses an interrupted timeseries framework, which is a quasi-experimental approach, to test whether the ACN testing intervention issuccessful at increasing uptake of testing by at least 20% among residents in the target neighborhoods.Completion of these aims will provide crucial evidence about the public health utility of this approach and informefforts to scale this intervention to increase testing uptake in other vulnerable urban areas in Chicago andnationally.