Increasing COVID-19 vaccine uptake through a patient navigation intervention among underserved populations

PROJECT SUMMARY (of funded award) The novel SARS-CoV-2 continues to spread in the United States, with almost 5 million confirmed cases of and over 150,000 deaths. Given observed disparities in morbidity, hospitalization, and mortality across race, ethnicity, and socioeconomic status, there is a great need to increase testing access and uptake with rapid return of test results. We propose a community health worker (CHW)-led approach to facilitate COVID-19 testing for underserved populations, with a focus on increasing testing access, uptake, and impact among Latinx, African American, Filipino, and immigrant communities using different testing implementation strategies. Our project will utilize existing COVID-19 contact tracing and community partner infrastructure to reach individuals aged 12 and above exposed or at high-risk of COVID-19 exposure who may be less able to test. We will use a cluster randomized crossover trial to test mobile and home-based testing strategies for increasing testing uptake among contacts, referred high-risk friends and family, and the broader community. Our specific aims are to: 1) Implement COVID-19 testing integrated into community health worker contact tracing home visits and compare the subsequent uptake of testing for referred high-risk friends and family in a mobile testing vs. home-based testing approach; 2) Using a community-led rapid cycle research process, identify effective strategies to promote uptake of COVID-19 testing through mobile/pop-up testing for Latinx, African American, Filipino, and immigrant populations exposed or at high risk of exposure to COVID-19 who are not accessing testing; 3) Gather CHW and community insights to establish best practices for future scale-up and sustainability. We expect to test over 40,000 individuals through these efforts. The project will contribute to health disparity reductions in COVID-19 morbidity and mortality and produce high impact through the our core strengths in drawing on local knowledge, the team's existing community partnerships, use of culturally-competent community healthcare workers, point-of-care rapid and inexpensive testing, and the use of real-time geospatial data from our contact tracing program to prioritize locations for mobile pop-up testing. Our focus on underserved populations with high COVID-19 exposures without prior testing access will inform both future testing and vaccination efforts.