Community-Driven Optimization of COVID-19 Testing to Reach and Engage Underserved Areas for Testing Equity (CO-CREATE)

Background: During the pandemic in California, there was a need to deliver simple, rapid, and inexpensive FDA-authorized COVID-19 testing using community-driven, contextually relevant strategies to accelerate testing uptake among underserved populations. San Ysidro was selected as the focus of this prototype two-year community-engaged testing research study since it is one of the poorest communities in San Diego, had the highest incidence of COVID-19 cases in the county, and is geographically distant from major health centers limiting access to testing.

Materials/Methods: The San Ysidro Health (SYC) Maternal and Child Health Center (MCHC) was chosen as the focal point. Leveraging regular prenatal and pediatric care visits, the study engaged families in COVID-19 testing in this otherwise hard-to-reach population. A multi-level community-engaged approach was implemented in partnership with a diverse Community and Scientific Advisory Board to design, implement, and evaluate strategies for accelerating COVID-19 testing among pregnant women and children.

Outcome/Impact: The project developed contextually relevant strategies that accelerated the delivery and uptake of COVID-19 testing among underserved populations in San Ysidro, with a particular focus on maternal and child health. The approach supported scaling across the entire San Ysidro community of 27,000 residents and provided a model for addressing inequities in testing access in similar underserved communities.

研究背景：新冠疫情期间，加利福尼亚州亟需采用社区主导、因地制宜的策略，开展美国食品药品监督管理局（FDA）授权的便捷、快速且低成本的新冠病毒检测服务，以提升服务不足人群的检测参与率。圣伊西德罗（San Ysidro）被选为这项为期两年的社区参与式检测原型研究的重点区域，原因在于该区域是圣迭戈县最贫困的社区之一，新冠确诊病例发病率位居全县之首，且地理位置远离主要医疗中心，导致检测服务可及性严重受限。

材料与方法：本研究选取圣伊西德罗健康中心（San Ysidro Health, SYC）妇幼保健中心（Maternal and Child Health Center, MCHC）作为核心站点。依托常规产前检查与儿科诊疗就诊流程，本研究面向此前难以获取医疗服务的人群，动员其家庭参与新冠病毒检测。研究联合多元社区与科学咨询委员会，采用多维度社区参与式方法，设计、实施并评估针对孕妇与儿童群体的新冠检测加速推广策略。

结果与影响：本项目开发了因地制宜的新冠检测推广策略，加快了圣伊西德罗地区服务不足人群的检测服务覆盖与参与率，尤其聚焦妇幼健康群体。该方案支持在拥有2.7万居民的整个圣伊西德罗社区进行推广，并为解决类似服务不足社区的检测服务可及性不平等问题提供了可借鉴的范式。