Marshallese: Alternate Surveillance for COVID-19 in a Unique Population

The Marshallese/Native Hawaiian/Pacific Islanders: Alternate Surveillance for COVID-19 in a Unique Population (MASC UP) study will use innovative, culturally tailored participatory surveillance methods to identify and evaluate strategies to reduce the spread of COVID-19 in this high-risk, clustered population. First, we will recruit a cohort to deploy a multi-modal, multi-level surveillance system in 2 of the largest Marshallese/Native Hawaiian/Pacific Islanders communities in the US: Northwest Arkansas (n = 300), Spokane County and Seattle area Washington (n = 300). Each cohort member will be followed longitudinally for at least 12 months. Modalities will include providing kits to detect changes in body temperature, public service outreach to reduce stigma associated with reporting symptoms and deploying social media and text message-based screening technology to augment conventional test-based surveillance. Second, we will construct a social contact network among participants from the surveillance cohort to identify community structures and networks that increase the risk of COVID-19 infection. We will use these findings to integrate effective components into a surveillance ecosystem that can be disseminated to other clustered groups.

Our Specific Aims are to:
1) Create a longitudinal, multi-modal and multi-level surveillance cohort (n = 600) that targets early detection of symptomatic and asymptomatic COVID-19 cases among Marshallese/Native Hawaiian/Pacific Islanders adults in the Continental US.
2) Characterize the social contact network among surveillance cohort members to identify community structures and networks that put individuals at increased risk of acquiring COVID-19.
3) Identify effective modalities for participatory disease surveillance and sustainably integrate them into ongoing COVID-19 and other public health surveillance efforts for the Marshallese/Native Hawaiian/Pacific Islanders population.

MASC UP will demonstrate the value of culturally tailored, participatory disease surveillance developed and tested in real-world settings to mitigate COVID-19 disparities in a high-risk, clustered population that has been profoundly underserved by public health efforts to date. Our findings can be rapidly adapted and disseminated for improved surveillance and disease prevention in other high-risk, non-institutionalized US minority groups.