Puipuia le Ola: Increasing reach and uptake of COVID-19 testing among Pacific Islanders in Hawaii and Guam

AbstractNon-Native Hawaiian Pacific Islanders (PI), defined as indigenous people having origins in Guam, theCommonwealth of the Northern Mariana Islands, American Samoa, Federated States of Micronesia, Republic ofthe Marshall Islands and Republic of Palau, have among the highest COVID-19-associated morbidity andmortality rates in the U.S. PI also suffer from medical co-morbidities known to increase their risk of severeCOVID-19. In addition, PI have poor access to health care, inadequate or no health insurance, live inmulti-generational or multi-family overcrowded housing, and have low-paying service jobs that expose them tothe infected public. Hawaii is experiencing a dramatic surge in COVID-19, with triple-digit daily counts and morethan 10,000 cases. PI, who comprise only 4% of the State's population, account for 32% of COVID-19 cases.Our long-term goal is to reduce COVID-19 disparities among PI. The overall objective of the proposed researchis to use culturally resonant community-engagement strategies to increase the reach and uptake of COVID-19testing to better understand SARS-CoV-2 infection patterns among PI in Hawaii and on Guam. Our centralhypothesis is that culturally appropriate and linguistically correct strategies will increase uptake of COVID-19testing among PI, resulting in more precise SARS-CoV-2 infection and seroprevalence rates. Ourmulti-disciplinary investigative team comprises physicians and community health workers, community-engagedresearchers and basic and applied scientists. The objective will be achieved by the following specific aims.Specific Aim 1. Develop and evaluate culturally tailored community-engaged strategies to increaseCOVID-19 testing among PI in Hawaii and Guam.Approach: Engage PI communities to jointly design a strategy with culturally and linguistically appropriatecontent to promote COVID-19 testing and mplement the strategy and evaluate its effectiveness.Specific Aim 2: Determine SARS-CoV-2 infection patterns in asymptomatic PI in Hawaii and Guam.Approach: Perform COVID-19 RT-PCR and SARS-CoV-2-specific IgG and IgM testing of asymptomatic adult PIin Hawaii and Guam to ascertain infection rates and seroprevalence.A highly committed Community and Scientific Advisory Board, comprising prominent leaders in the PI communityand academicians who are dedicated to improving IP health, will provide guidance to design culturally relevantstrategies to mitigate COVID-19 disparities among PI. Strong support from the community, academia andgovernment attest to the to the urgency of this Community-Engaged Testing Research Project.