Chronic health conditions and uptake of COVID-19 testing and vaccination among Native Americans in the RADx-UP Consortium

Project Summary/Abstract American Indian/Alaska Native (AI/AN) populations were disproportionately affected by the COVID-19 pandemic compared to other racial/ethnic populations. AI/AN individuals experience a higher prevalence of chronic diseases that increase risk of COVID-19 complications including cancer, diabetes, chronic liver disease, chronic lung diseases, cardiovascular diseases, asthma, and obesity, and have higher rates of smoking compared to other racial/ethnic groups. The COVID-19 pandemic created unprecedented interruptions in necessary services, including healthcare, in response to social distancing mandates implemented to reduce the transmission of the virus. Health care services were further disrupted due to the necessary shift of clinical and hospital resources to COVID-19 patients. It remains unknown whether changes in healthcare access for AI/AN people or chronic health conditions impacted uptake of COVID-19 testing and vaccination and whether these changes differed by geography and sociodemographic factors (e.g., rurality and area deprivation). There is, therefore, a critical need to understand the extent to which the pandemic influenced access to healthcare and whether individuals with chronic health conditions had barriers to receiving COVID- 19 testing and vaccination. Our long-term goal is to improve access to COVID-19 testing and vaccination among AI/AN people, particularly among those with chronic health conditions. Our overall objective of this application is to analyze RADx-UP consortium data to evaluate the impact of the COVID-19 pandemic on AI/AN RADx-UP participants with chronic health conditions, changes in access to healthcare, and sociodemographic factors on COVID-19 testing and vaccination uptake. We aim to identify whether chronic health conditions, healthcare access, and sociodemographic factors impacted 1) access to COVID-19 testing and 2) access to COVID-19 vaccination among AI/AN persons. Upon successful completion of this project, the expected outcomes are that we will have identified barriers to COVID-19 testing and vaccination uptake among AI/AN RADx-UP participants with chronic health conditions, challenged healthcare access, and poor sociodemographic factors. These results are expected to have a positive impact because empirical evidence of barriers to COVID-19 testing and harmonization among high-risk populations will allow for development of intervention strategies to improve health outcomes in this underserved population.