Scaling Up SARS-COV-2 Testing to Serve Latinx Communities

The global SARS-CoV-2 pandemic that causes the severe respiratory illness COVID-19 is the worst health crisis the United States has faced in a century. Although this highly contagious virus has infected millions of Americans already, the disease burdens are disproportionately born by historically underserved populations such as Latinx communities. Nationally, Latinx people with COVID-19 are hospitalized at four times the rate of Whites and have much higher rates of morbidity and mortality. This disparity is notable in Oregon, where the 13% of our population that is Latinx represents approximately 44% of COVID-19 cases. An urgent need exists to reach Oregon’s Latinx community with public health and prevention messages to increase testing. This project will implement a culturally-tailored community outreach and testing program to increase the reach, access, and uptake of testing in Latinx communities in Oregon. The project will bring together a world-class team of prevention scientists, public health experts, Latinx researchers, community partners, and biologists who have been working together to conduct SARS-CoV-2 diagnostic testing since March, soon after the pandemic first arrived in the U.S. This team has established a CLIA-certified laboratory and honed molecular testing protocols, hired and trained laboratory personnel and a field research team, procured diagnostic testing equipment and supplies, and partnered with county public health offices and hospitals throughout the state to conduct testing. The team also conducted a comprehensive community assessment using community-based participatory methods to gather Latinx community feedback on modes of communication, health messages, and testing protocols, and staffed multiple county-led testing sites serving Latinx communities. Using these resources and expertise as a foundation, a two-arm randomized controlled trial will implement community-level interventions to increase testing rates and health behaviors. Thirty-nine testing sites across 9 counties will be randomized to receive one of two outreach interventions, ‘Basic Outreach’ versus ‘Promotores de Salud.’ Promotores de Salud is a culturally-informed intervention that includes psychoeducation about COVID-19, motivational strategies, emotional support, and information support to engage individuals to attend a testing site. In addition, the study includes a booster intervention for those who attend a ‘Promotoras de Salud’ testing site. In the booster intervention, participants will receive an in-person ’Promotores de Salud’ intervention and a written pamphlet with information about health behaviors. Participants randomized to the control condition will only receive the written pamphlet. Participants in the research study will be assessed via a survey at the time of testing and 1 month later. Site- and community-level assessments will occur at three timepoints in the study: immediate, mid-term, and primary outcomes, to measure the effects of the randomization and the on-site promotores intervention. Individuals-level data will be collected from 1200 participants at two timelines—when they are at a testing visit, and approximately one month later. Over time, this project will help communities institutionalize optimal local testing frameworks supported by UO laboratory facilities for testing capacity, technical support for testing logistics, and collection of data on health behaviors, testing rates, and sustainability. The resulting structures and systems will be poised for future scale-up to other vulnerable communities and/or for other public health purposes (e.g., vaccination campaigns). If successful, this project will lead to a major reduction in COVID-19 health disparities in underserved populations.