Connecting our Neighborhoods Need for Enhanced and Coordinated Testing to Achieve Equity: CoNNECT to Achieve Equality

ABSTRACTCOVID-19 infections, hospitalizations, and deaths are disparate across racial and ethnic groups in the UnitedStates (US), disproportionately impacting minority communities. Northwest Arkansas (Washington and BentonCounties) is a "COVID-19 Hot Spot" in the US, with the region reporting such stark racial/ethnic disparitiesrelated to COVID-19 that the Centers for Disease Control and Prevention (CDC) came to Northwest Arkansasto investigate in June and July 2020 and then the National Institutes of Health sent investigators in earlyAugust 2020. The CDC's July 2020 report documented that 45% of all adult cases in Northwest Arkansas wereamong Hispanic/Latinx patients and 19% were Native Hawaiian/Pacific Islander (NHPI) patients.Hispanic/Latinxs and NHPIs, only account for 17% and 2.4% of the two-county population, respectively.COVID-19 deaths in Northwest Arkansas were also disparate across race and ethnicity. NHPI deaths wereestimated to be more than 200 per 100K -much higher than the overall death ratio for the county of 5.10 per100K, as well as the death ratio for Whites of 4.03 per 100K. There is an urgent need to increase COVID-19testing and prepare for future vaccination trials, especially for the NHPI and Hispanic/Latinx communities ofNorthwest Arkansas. The uptake of current testing is low, less than 5%, and our needs assessment found thetop preferred locations identified were clinics with drive-through testing and drive-through testing in targetedhousing complex and neighborhood. We will use a community-based participatory research approach guidedby the Social Ecological Model (SEM) to target testing strategies that will have the greatest impact. Ourspecific aims are: Aim 1: leverage and fully engage our long-standing community-based partnerships toincrease COVID-19 testing and prepare for future vaccination trials; Aim 2: implement and evaluate accessand uptake strategies of two community-driven COVID-19 testing approaches to understand effectiveness andimpact for vulnerable populations; Aim 2a: evaluate which testing sites are most effective in reaching specificvulnerable populations based on age, race/ethnicity, and sex; Aim 2b: examine how social determinants ofhealth influence testing behaviors and preferred testing location; Aim 2c: conduct an implementation study todocument facilitators and barriers to implementation of community-based testing methods; and Aim 3: fullycollaborate with the RADx-UP Coordinating and Data Collection Center (CDCC) and other RADx-UP sites. Theproposed study aims are built directly on our collaborative needs assessment and recommendations from ourCommunity and Scientific Advisory Board (CSAB). Our current infrastructure and partnerships have beensustained for more than seven years and have been highly productive across multiple projects through local,institutional, and federal support. We are confident that we can leverage these partnerships to address COVID-19 mitigation efforts, including potential vaccine, and/or therapeutic implementation efforts.