COVID-19 testing in Underserved and Vulnerable Populations Receiving Care in San Diego Community Health Centers

PROJECT SUMMARY/ABSTRACTPronounced inequities and disparities in coronavirus disease (COVID-19)COVID-19 morbidity and mortalityhave been reported among Black and Latinx individuals, largely due to comorbid conditions and socialdeterminants of health. Approximately 95% of COVID-19 related deaths occur among individuals withunderlying medical conditions. Of all racial/ethnic groups, Latinx communities in San Diego County haveexperienced the greatest burden of COVID-19 disease and deaths. Furthermore, testing challenges to dateare evident, including long turnaround of test results and longer waiting times for Black and Latinxs comparedto whites. The goal of this community-engaged proposal is to develop, test, and evaluate a rapid, scalablecapacity building project to enhance COVID-19 testing in three regional community health centers (CHCs) inSan Diego County. In collaboration with our CHC partners, their consortium organization (Health QualityPartners), and community stakeholders, we propose the following Specific Aims: 1) Compare the effectivenessof automated and live prompts and reminders and their combination for uptake of COVID-19 testing amongasymptomatic adult patients with select medical conditions and those 65 years of age and older receiving careat participating CHCs. We also will invite all study participants to: a) receive a flu vaccination; and b) assessfeasibility and acceptability of study participants to refer adult household members who are essential workersfor COVID-19 testing; and 2) Gather patient, provider, CHC leadership, and community stakeholder insights toestablish best practices for future scale-up of COVID-19 testing sustainability and vaccination. Our goal is totest 9,000 patients (3,000 per arm). Our community-engaged project includes underserved (socioeconomicallydisadvantaged and large proportion of Hispanic/Latinos) and COVID-19 vulnerable individuals (patients withmedical conditions and those 65 years of age and older). Our approach considers regional COVID-19morbidity and mortality to address disproportionate infection and death rates among vulnerable andmarginalized populations who bear a disproportionate burden of the pandemic.