Community-engaged Approaches to Testing in Community and Healthcare Settings for Underserved Populations

Background: The purpose of this study was to address substantial disparities in COVID-19 testing and outcomes in Oklahoma. The Oklahoma Shared Clinical and Translational Resources program and its long-standing community-engaged partnerships were well positioned to improve understanding of barriers to SARS-CoV-2 testing and to increase testing access among underserved and vulnerable populations. The study aimed to gather essential information on community, provider, and patient-level impediments to diagnostic testing while rapidly expanding testing statewide.

Materials/Methods: The study used both practice-based and community-based strategies. The practice-based component supported small primary care practices by integrating existing research infrastructure to implement guidelines based COVID-19 testing and provide patient education on risk mitigation. The community-based component deployed mobile testing sites to respond quickly to community needs, increase operational efficiency, and expand statewide testing capacity in partnership with public health authorities. The intervention was designed to remain pragmatic and adaptable to evolving barriers, shifting community attitudes, and changes in testing technology. Data were collected through comprehensive, ongoing evaluations that assessed provider and patient attitudes, barriers and facilitators to testing, identified disparities in COVID-19 impact, and compared the effectiveness of practice-based and community-based strategies.

Outcome/Impact: The study generated a detailed understanding of multilevel factors that shaped barriers to SARS-CoV-2 testing in underserved Oklahoma communities. The combined practice-based and community-based approaches broadened testing reach, strengthened public health capacity, and demonstrated scalable strategies for increasing diagnostic testing among vulnerable populations. The evaluation findings informed future collaborations and supported efforts to reduce disparities in testing access and COVID-19 outcomes across rural and high-risk populations.